HHS Proposes New Standards
Last week, the Department of Health and Human Services (HHS) proposed a rule that would create standards for what they call “health care attachments.” This includes documents like referral notes, x-rays, and medical charts. In conjunction with these standards, HHS proposes standards for electronic signatures and modifications to reduce the burden of claims submissions and referral certification and authorization.
The goal is to reduce administrative burden for both health care claims and prior authorizations. Health plans have a variety of requirements for submissions and often require faxes, mail, web portals, or other manual methods of submission. Implementing these changes will speed up processes for patients and the Centers for Medicare & Medicaid Services (CMS) estimates that it will save $454 million in annual administrative costs.
Implementing standards across healthcare is often a slow and arduous process, but given the patient care implications and potential cost savings, it’s clear that it’s a worthy mission. Despite progress, there’s still a long way to go as well. Every day, we encounter health systems that lack standardization even within their own organization. This means they run into issues like having hundreds of document types. Worse yet, many organizations are missing the discrete data that supports treatment plans for their patients.
In our experience, there’s only so much staff you can throw at a problem before it’s unmanageable due to volume fluctuations, accuracy, and staffing availability. That’s where standards and automation make a big difference. When discrete data flows into a healthcare organization automatically, clinicians have better vision into where referrals or health maintenance plans might be needed and administrative staff aren’t opening up scores of PDFs to find the document they need.
If you’re interested in hearing how we’ve automated document identification, sorting, routing, and data extraction at the country’s top healthcare organizations and would like to see what our software can do for you, please reach out.
As is always the case with new rule proposals like this, there is an ongoing public comment period; this one lasts until March 21st. The full text of the proposed rule, “Administrative Simplification: Adoption of Standards for Health Care Attachments Transactions and Electronic Signatures, and Modification to Referral Certification and Authorization Transaction Standard,” can be found here along with a link to submit comments.
