Manage My Practice

The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).  This means that the numbers do not carry other information about healthcare providers, such as the state in which they live or their medical specialty.

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 requires issuance of a unique national provider identifier (NPI) to each physician, supplier, and other provider of health care (45 CFR Part 162, Subpart D (162.402-162.414).
To comply with this requirement, the Centers for Medicare & Medicaid Services (CMS) began to accept applications for, and to issue NPIs, on May 23, 2005.

Beginning May 23, 2007 (May 23, 2008, for small health plans), the NPI must be used in lieu of legacy provider identifiers. Legacy provider identifiers include:

• Online Survey Certification and Reporting (OSCAR) system numbers;

• National Supplier Clearinghouse (NSC) numbers;

• Provider Identification Numbers (PINs); and

• Unique Physician Identification Numbers (UPINs) used by Medicare.

They do not include taxpayer identifier numbers (TINs) such as:

• Employer Identification Numbers (EINs); or

• Social Security Numbers (SSNs).

You see a tidbit about an article that sounds interesting, but when you click on the link you get just a few lines of the article and are encouraged to subscribe to an organization so you can gain access to the rest of the article.  You have just hit a Pay Wall.

• A/I/U –Adopt, implement or upgrade

• CAH –Critical Access Hospital

• CCN –CMS Certification Number

• CDS –Clinical Decision Support

• CMS –Centers for Medicare & Medicaid Services

• CY –Calendar Year

• EHR –Electronic Health Record

• EP –Eligible Professional

• eRx –E-Prescribing

• FFS –Fee-for-service

• FY –Federal Fiscal Year

• HHS –U.S. Department of Health and Human Services

• HIT –Health Information Technology

• HITECH Act –Health Information Technology for Electronic and Clinical Health Act

• HITPC –Health Information Technology Policy Committee

• HIPAA –Health Insurance Portability and Accountability Act of 1996

• HPSA –Health Professional Shortage Area

• IFR –Interim Final Rule

• MA –Medicare Advantage

• MCMP –Medicare Care Management Performance Demonstration

• MITA-Medicaid Information Technology Architecture

• MU –Meaningful Use

• NPI –National Provider Identifier

• NPRM –Notice of Proposed Rulemaking

• OMB –Office of Management and Budget

• ONC –Office of the National Coordinator of Health Information Technology

• PQRI –Medicare Physician Quality Reporting Initiative

• Recovery Act –American Reinvestment & Recovery Act of 2009

• TIN –Taxpayer Identification Number

Health Story is a non profit, informal industry alliance of members who share a vision and mission and who contribute through active participation and annual membership dues.

The project was initiated by the Association for Healthcare Documentation Integrity (AHDI), Medical Transcription Industry Association (MTIA), American Health Information Management Association (AHIMA) and M*Modal and is being managed by Alschuler Associates, LLC and Optimal Accords, LLC.

Approximately 1.2 billion clinical documents are produced in the United States each year. These documents comprise around 60% of clinical information, the majority of physician-attested information and are used as the primary source of information for reimbursement and proof of service. This tremendous source of clinical information is underutilized in current computer-based record systems.

Health Story is an alliance of healthcare vendors, providers and associations that pooled resources over the previous three years in a rapid-development initiative to produce data standards for the flow of information between common types of healthcare documents and electronic health records.

Our Mission:  To develop and promote information standards through HL7 that support the flow of information between narrative documents and electronic medical records.

The Health Story Project established the following five-year goals:

• Establish awareness
• Maintain strong coalition
• Publish catalog of data standards through HL7
• Increase market demand for standards
• Earn national endorsement
• Foster widespread adoption of standards
• Declare success

From the Health Story Project website here.

Starting the Day:

1. Disarm the burgler alarm.
2. Turn on the lights.
3. Check the condition of the office – did the cleaners miss anything?  Check the patient bathrooms for cleanliness and supplies.
4. Check that yesterday’s specimens were picked up by the lab.
5. Make coffee.
6. Turn on the copiers to give them a chance to warm up.  Make sure all copiers and faxes are full of paper.
7. If you’re using paper charts, make sure there aren’t any “unfound” charts for the day’s patients.
8. Check the fax machines to see if any faxes arrived overnight.
9. Have a morning huddle with the staff.  Discuss which providers are working, any problems from yesterday, any unusual things expected today, any schedule changes, any staff assignment changes, and any protocol reminders.
10. Make sure the lab/clinic person has performed the lab controls and checked the refrigerator/freezer temperatures and documented them.
11. Unforward the phones from the answering service, disconnect the answering machine, and have a staff member take any messages from overnight.
12. Open the safe and remove the check-out change drawers, placing them at check-out.  Make sure change is available.
13. Unlock the doors.

Ending the Day:

1. Make sure all patients have left the practice.
2. Lock the doors.
3. Check to make sure the coffee pot is off and the lunch room has been tidied by the staff.
4. Confirm who is on first and second call.
5. Turn the phones over to the answering service (make sure they have the call provider name(s)) or the answering machine (make sure it states how to contact the provider(s) on call).
6. As appropriate, send emails or distribute lists with the next day’s schedule if the providers are rounding, performing surgery, or working at alternate sites.
7. If using paper charts, make sure charts are pulled for next day’s patients.
8. Turn off radios, fans, heaters, copiers, etc.
9. Make sure fax machine is loaded with paper.
10. Have staff sign off all computers.  Perform computer backup, if not automatically run.
11. Lock the change drawer and the day’s deposit in the safe.
12. Lock the sample closets, Rx pads, and all on-site medications.
13. Turn off the lights, lock the doors and set the burgler alarm.

A botnet is an army of infected computers that hackers can control from a central machine.

There are two models for search firms, retained and contingency.

A retained firm works for the organization and is paid a flat fee upfront (a retainer) to launch the search and an additional fee when the position is filled.  Retained firms usually visit your community to understand your needs and culture, carefully sourcing candidates who will be a good fit for your organization.  Retained firms are often the answer for hard-to-recruit for locations or specialties.

A contingency firm works for the candidate and is paid if/when you hire a candidate they found for you.  There is an agreement that you sign before they present any candidates stating that you will agree to pay them if you hire anyone they have introduced to you, typically within 12 months of the introduction.  You may sign an agreement with as many contingency firms as you like.  There is a great variance in candidates sent by different firms – some are pre-screened and some are not.  Because their goal is to place candidates, they may well be presenting a candidate to you and to your competition simultaneously.  Make sure that a contingency firm presents a name to you before sending a CV in case another firm has also presented the same candidate.  Some firms charge a flat fee and some charge a percentage of the hired employee’s first year gross salary. Contingency firm fees hover around $10K for mid-level providers (nurse practitioners and physician assistants) and around $20K for physicians.

Some recruiters have the reputation of being out for themselves and not serving their clients (candidates and organizations), but instead only serving themselves.  The professional organization for physician recruiting organizations is the National Association of Physician Recruiters (NAPR) which has a Code of Ethics that members must adhere to.  You can research member firms here.

On the NAPR website, it notes a collaboration with MGMA:

MGMA, in collaboration with NAPR, surveys its membership to obtain the most recent physician starting salary placement compensation data. This is the fourth year of data collection and the third year of stand-alone publication for the Physician Placement Starting Salary Survey report. The report provides accurate data on the range of physician placements to assist recruiters and health care organizations in benchmarking salaries and other employment terms. The report also allows users to compare and learn more about the factors affecting first-year placement compensation. All survey participants receive a complimentary copy of the Physician Placement Starting Salary Survey

Social media researchers Danah Boyd of Microsoft Research New England in Cambridge, Mass., and Nicole B. Ellison of Michigan State University define social networking as having three distinct features

• they must provide a forum where users can construct a public or semipublic profile;
• create a list of other users with whom they share a connection;
• and view and move around their list of connections and those made by others.

Examples of social networking sites are FaceBook, LinkedIn, and Twitter.

The term Steampunk denotes a time when steam power was still widely used—usually the 19th century, and often Victorian era England—but with prominent elements of …either science fiction or fantasy, such as fictional technological inventions like those found in the works of H. G. Wells and Jules Verne! Steampunk fashion relys heavily on “brass bits, buckles and buttons”! Not healthcare, but interesting nonetheless!