Heather Skelton recently added her expertise to an article in The Coding Institute’s Part B Insider (November 2010), entitled “Just Because Lawyers Request Records Doesn’t Mean You Must Send Them.”
See a reprint of this informative article on HIPAA compliance and providing medical records for use in legal actions here.
November 4th, 2010
Humana, Inc. has announced a collaboration with athenahealth that will link Humana’s Primary Care Rewards program with electronic health records provided by athenahealth. The Humana-athenahealth Medical Home EHR Rewards Program is designed to reward primary care physicians for quality performance and better clinical outcomes, as well as to increase the efficiency of the health care system as a whole.
Included in the program is a subsidy to eligible family and internal medicine physicians in the Humana network to implement athenahealth’s EHR service. One of the goals of the program is to make electronic record keeping an integral part of delivering quality health care services, reducing error, and improving communication among providers and giving physicians a better overall picture of a patient’s history and care profile.
The program will also measure physician encounters using HEDIS quality measures, which include opportunities to improve such areas as readmission rates, generic drug dispensing, and completion of health risk assessments.
Practices will be provided with customized goals and will be assessed regularly for performance and to provide feedback. Practices that demonstrate an improvement in their care delivery will receive care-coordination payments and will be eligible to receive additional benefits through a shared-savings program.
Humana considers this alliance with athenahealth a “leaping ahead” of the government’s efforts to drive meaningful use of EHRs. For more information on this program, please see Humana’s information release and FAQ.
October 22nd, 2010
As the end of the year approaches, restrictions on the expansion of physician-owned hospitals – part of the healthcare reform law passed in March – will begin to take effect.
New doctor-owned facilities must be certified as Medicare participants by Dec. 31, 2010, or they will not be allowed into the program; and the law will put immediate restrictions on the growth of presently existing physician-owned facilities.
The reform law also includes caps on physician ownership, the repeal of some exceptions to Stark self-referral bans, and more disclosure of potential conflicts of interest when physicians send patients to facilities in which they have ownership.
Physician-owned facilities have found themselves in lawmakers’ sights before, and the new restrictions reflect the view that physician-owned facilities create conflicts of interest and that they cherry-pick the more profitable patients, straining community facilities.
Advocates of physician-owned hospital argue that the physician-owned model provides high-quality alternatives to patients in the marketplace, especially as physicians have more control over patient care and less competition from administration.
One lawsuit has been filed U.S. Federal Court in Texas, challenging the constitutionality of section of the law which would limit the expansion plans of a physician-owned facility.
Many physician investors await the results of the November elections, in the hope that a shift in the political make-up of Congress might help the situation before the end of the year.
Find more detailed information at American Medical News.
September 23rd, 2010
For the May 2010 Roundtable, healthcare attorney Heather Skelton presented her advice on terminating the doctor-patient relationship with disruptive patients. If you weren’t able to attend, please take a look at the outline of Heather’s talk:
How To Terminate Disruptive Patients, Legal Risks, and Solutions
Additional information can be found in the North Carolina Medical Board’s position statement on the physician-patient relationship.
August 20th, 2010
Heather Skelton led a discussion with healthcare professionals on October 31st during her complimentary roundtable about Medical Malpractice and associated danger zones. Malpractice examples, theories of liability for patient care and other topics were addressed. The monthly meeting took place at Heather’s new location at 409 East Blvd., Charlotte, NC 28203.
If you were unable to attend, or would like an electronic version of this session’s handout, please click on the link below and download her handout containing valuable information for your medical practice.
Medical Malpractice Danger Zones – October 2007 Handout
November 3rd, 2007
Heather Skelton and area healthcare professionals gathered September 25 to discussed the recent managed care settlements for a complimentary roundtable. Heather led the discussion on how medical practices can submit claims for refunds to carriers that denied past payments due to unfair and deceptive practices.
If you were unable to attend, click on the link below and download her session handout that includes valuable information for your medical practice to review and implement.
The Managed Care Settlements-September 2007 Roundtable Handout
October 11th, 2007
Area healthcare professionals joined attorney Heather Cook Skelton for the August complimentary roundtable discussing the legal obligations of payment issues such as refunds and balance adjustments. The monthly meeting took place at Heather’s new location at 409 East Blvd., Charlotte, NC 28203 on August 29th. Topics included refunds, balance write-offs, hospital discounts and more.
If you were unable to attend, or would like an electronic version of this session’s handout, please click on the link below and download her containing valuable information for your medical practice to review and implement.
Legal Obligations: Refunds, Balance Adjustments, and Other Payment Issues
August 31st, 2007
Heather Skelton and area healthcare professionals discussed the self-pay patients at the July 27 complimentary roundtable. Heather led the discussion by asking participants how their organizations handled the increase in these patients, what fee schedules are being utilized and collections successes. Then she offered some insight on patient education and national and North Carolina collections decisions.
If you were unable to attend, click on the link below and download her session handout that includes valuable information for your medical practice to review and implement.
Self-Pay Fee Schedules and Collections – July 2007 Roundtable
July 31st, 2007
At the June 27th complimentary roundtable, Heather Skelton and area healthcare professionals discussed the topic of Health Savings Accounts (HSAs). Heather offered HSA basics, some concerns that should be addressed, and what practices can do. If you were unable to attend, click on the link below and download her session handout.
HSAs and Medical Practices
Heather’s next Complimentary Roundtable topic is “Fee Schedules for Self-Pay Patients and How to Collect” and takes place on Friday, July 27 (12:00–1:00 p.m. – Lunch Provided) at 401 N. Tryon Street, Charlotte, NC 28202. To register, for more information, or to sign up for a monthly email reminder, please send your name and practice name with address and phone to info@doctorslawyer.com. Or call us at 704-643-9076.
July 11th, 2007
During the May’s complimentary roundtable, Heather Skelton and area healthcare professionals discussed the topic of Managed Care contracting for the specialty medical practices. Heather offered negotiating strategies and tips to help practices keep the edge on the competition and improve the bottom line. If you couldn’t attend, click on the link below and download her session handout.
Managed Care Contracting – A Review and Some Tips
June 4th, 2007
