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Deciphering The New CMS 1500 Claim Form
Q: I am confused on using the new 1500 form, particularly Block 14 and Block 15. What is required and how do I properly fill these out? And do I actually have to use this new form or may I continue using the old version?
Getting Athletes Back in the Game: Low-Level Laser Therapy for Sports Injuries
Sports injury rehabilitation is all about getting back in the game quickly and with optimal health. A relatively new tool for the treatment of sports injuries is finding global success, and it is doing so in a fast, efficient way.
Super Bowl Chiropractor
With opening night of the 2014 National Football League season only a month away, what better time to talk to Dr. Jim Kurtz, team chiropractor for the defending Super Bowl champion Seattle Seahawks?
Talking to Skeptical MDs: "Just the Facts, Ma'am"
The first lesson in public speaking is to know your audience. This is particularly applicable when talking to skeptical medical doctors about chiropractic. You have to understand where they are coming from and speak the language they understand.
Hazards in the Environment Making Your Patients Sick
Working both separately and together, Western and Chinese medicine have many successes in the treatment of the myriad diseases that afflict human beings in modern times.
Inside Liver Failure, Cirrhosis and Cancer
The Liver belongs to Wood in Five Element Theory and is in charge of Dispersing and Expanding which means all the processing and detoxifying of harmful substances such as medications and chemicals require the efforts of the Liver.
The Kidney Official
The Kidney is known as the Official Who Controls the Waterways. In Western medical terms, a major function of the Kidneys is to filter the blood. Every day, a person's kidneys process about 200 liters of blood to sift out about two liters of waste and excess water.
Post-Concussion Patient Care: Relevance of the Chiropractic Adjustment
There is a widespread understanding within the profession of the general guidelines for care of the concussion patient. These include guidelines for physical and cognitive rest, return to normal activities and so forth.
Resolving Medial Arch Suspicions: The Navicular Drop Test
Healthy feet have three distinct arches: medial longitudinal, lateral longitudinal and anterior transverse.
F4CP: New Campaign to Promote Chiropractic as a Career
The F4CP has announced a "targeted cooperative campaign" that will engage doctors of chiropractic and chiropractic students, as well as chiropractic colleges, chiropractic media, state associations and vendors, to encourage DCs to recommend a chiropractic career to patients, family and friends.
Looking For Answers In Many Places
I am sure we have all heard the old adage: "When the only tool in your toolbox is a hammer, everything starts to look like a nail."
The Acupuncture Success Express
Time is passing very quickly these days. We are atoms half the way through the year of the horse. You could call it "horse racing season" for this profession. Perhaps it is time for reinvention during this time.
Primary Lateral Sclerosis: A Condition With a Chiropractic Connection
Primary lateral sclerosis (PLS) is a slowly progressive, adult degenerative disease of the upper motor neurons characterized by progressive spasticity or stiffness. It is a clinical diagnosis that has been avoided because it is (largely) a diagnosis of exclusion.
Offline Marketing Techniques: Opportunities to Help Grow Your Business
In a world becoming increasingly dominated by connected devices, when we think of marketing, we often think of online and social media marketing. Considerable attention is given to Facebook and Twitter, as well as CPC [cost-per-click] advertising.
Not Another Typical Drug Company Lawsuit
It's becoming more common to see drug manufacturers negotiate "false claims" settlements for millions and billions of dollars.1-2 Most of these settlements have to do with violations in the marketing of the drugs they produce and sell.
Healing With Simple, Healthy Food
When it comes to your health, there is no better way to take control and create positive outcomes than by focusing on diet and lifestyle. As chiropractors, you know the power that regular self-care has for your patients.
The Gluteal-Knee Connection
The underlying causes of knee pain and dysfunction are rarely isolated to the knee. The knee is a relatively stable joint with limited intrinsic ability to adapt to aberrant motion.
Best Practices for Website Success
If one asked 10 years ago whether a website was relevant I was the first to suggest no. Yet as the world moves increasingly towards electronic information there is a dire need to have a website for your practice. Your website is actually your electronic calling card.
Medical Qigong for the Heart: Part II
Chinese Medicine is rich in commentary regarding the emotions and how they affect our qi.
Advice for Young Doctors
When I began practice, I was just shy of my 25th birthday. I was young and I looked it. I had been told this would be a problem when starting a practice – and it was. Older patients often paused when they entered for care.
Healing With Hope
Ella is a Gulf War veteran and a survivor of military sexual trauma. Like hundreds of veterans, Ella was on 11 different medications for depression, anxiety, insomnia, irritable bowel syndrome and chronic pain.
Looking Back: Abstracts From Chiropractic History
D.D. Palmer's Technique for the Posterior Apical Prominence; An Early Attempt to Achieve Consensus on Subluxation; Chiropractic Subject Headings: Past, Present and Future; Mabel Palmer: A History of Chiropractic That Almost Wasn't.
December, 2002, Vol. 02, Issue 12
What Is HIPAA, and How Does It Affect You? Part I
By Vivian Madison-Mahoney, LMT
I am asked frequently about the HIPAA rulings regarding electronic transactions and privacy rules. Because of this, I decided to do some research to obtain some answers to common questions I hear, especially regarding rules which might affect us as massage therapists and bodyworkers.
I wrote to "Center for Medicare & Medicaid Services" (CMS) to inquire as to the necessity of alternative medical providers (massage therapists included) having to comply with HIPAA Rules.Their reply is as follows, along with information on HIPAA in general.
With the above response provided to me, I was able to gather a large amount of additional information from a variety of their websites. If you wish to obtain more information than what I have provided within this article, please connect to the websites or call the phone numbers provided herein.
Question: What Is HIPAA?
Answer: HIPAA is the acronym for the Health Insurance Portability and Accountability Act of 1996. The Centers for Medicare & Medicaid Services (CMS) is responsible for implementing various unrelated provisions of HIPAA, therefore HIPAA may mean different things to different people.
The Health Insurance Portability and Accountability Act (HIPAA, Public Law 104-191), signed by President Clinton on August 21, 1996, aims to improve productivity of the American health care system. The law encourages development of information systems based on the exchange of standard management and financial data using Electronic Data Interchange (EDI). It also requires organizations exchanging transactions for health care to follow national implementation guidelines for EDI established for this purpose. For more information, please go to http://aspe.os.dhhs.gov/admnsimp/.
The Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA, Title II) require the Department of Health and Human Services to establish national standards for electronic health care transactions and national identifiers for providers, health plans, and employers. It also addresses the security and privacy of health data. Adopting these standards will improve the efficiency and effectiveness of the nation's health care system by encouraging the widespread use of electronic data interchange in health care.
HIPAA Rules Regarding Providers Who Do Not Submit Claims Electronically
Question: If I am a provider who does not submit any electronic transactions, do I have to comply with the HIPAA Administrative Simplification regulations, or submit an ASCA compliance plan to get an extension?
Answer: No. All of the HIPAA Administrative Simplification regulations apply to all covered entities. Health care providers who transmit health information in electronic form meet the final rule definition for a covered entity. If you do not transmit such information in electronic form, you are not a covered entity and HIPAA does not apply to you. Therefore you do not need to submit a compliance plan to request a compliance extension.
The Administrative Simplification Compliance Act (ASCA) prohibits Health & Human Services, (HHS) from paying Medicare claims that are not submitted electronically after October 16, 2003, unless the Secretary grants a waiver from this requirement. It further provides that the Secretary must grant such a waiver if there is no method available for the submission of claims in electronic form, or if the entity submitting the claim is a small provider of services or supplies.
In this case, small provider of services or supplier means:
Entities that qualify for this waiver do not need to submit a compliance plan and will be allowed to continue to file paper claims for Medicare payment. The Secretary may grant such a waiver in other circumstances. HHS will publish proposed regulations to implement this new authority.
Note: Since we as massage therapists at this time, do not bill for Medicare services, we do not have to be concerned with any of this documentation that pertains to Medicare. However, you may work in an office that does work with Medicare, therefore I have included this information.
Question: Are small providers exempt from HIPAA?
Answer: No. Any provider who transmits any of the designated transactions electronically is subject to the HIPAA Administrative Simplification requirements, regardless of size.
Small providers are exempt from the ASCA provision that excludes paper claims from Medicare coverage effective October 16, 2003. Small providers will be able to continue to submit paper claims.
Note: See ASCA definition of small provider or supplier in paragraphs above.
Question: Does the ASCA extension affect the compliance date for the HIPAA Privacy Standards?
Answer: No. The compliance date for the Privacy Standards is still April 14, 2003 or, for small health plans, April 14, 2004.
Question: What is the HIPAA Administrative Simplification Compliance Act (ASCA)?
Answer: In December 2001, the Administrative Simplification Compliance Act (ASCA) extended the deadline for compliance with the HIPAA Electronic Health Care Transactions and Code Sets standards (codified at 45 C.F.R. Parts 160, 162) one year, to October 16, 2003 for all covered entities, other than small health plans (whose compliance date was already October 16, 2003).
To receive an extension, covered entities must submit their ASCA compliance plans on or before October 15, 2002.
ASCA requires that a sample of the plans be provided to the National Committee on Vital and Health Statistics (NCVHS), an advisory committee to the Secretary of Health and Human Services. The NCVHS will review the sample to identify common problems that are complicating compliance activities, and will periodically publish recommendations for solving the problems.
Under the Freedom of Information Act (FOIA), information held by the federal government is available to the public on request, unless it falls within one of several exemptions. The model form is designed to avoid collection of any information that would be subject to exemption, such as confidential personal or proprietary information. If such information is submitted, both the FOIA and the ASCA require that it be redacted before the files are released either to the NCVHS or to the public.
Question: Do all covered entities automatically get an ASCA extension?
Answer: No. Covered entities must submit a compliance extension plan to the Department of Health and Human Services (HHS) before October 16, 2002 to get an extension.
Question: Where can I get a copy of the ASCA compliance form?
Answer: The form was released on March 28, 2002 and is available on our website at: www.cms.hhs.gov/hipaa/hipaa2/ASCAForm.asp. The form was published in the Federal Register on April 15, 2002.
Question: Can I file the ASCA compliance extension form electronically?
Answer: Yes, electronic filing of compliance extension plans is encouraged, although plans submitted on paper also will be accepted. To submit a form electronically, go to www.cms.hhs.gov/hipaa/hipaa2/ASCAForm.asp.
Click here for more information about Vivian Madison-Mahoney, LMT.
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