Sunday, 22 January 2017

Covered Counseling Service for Increased Risk Patients

When scheduling a patient for their first visit to your practice, you should advise them of what they need to bring to help ensure a smooth registration process and to assist your physician in making that first visit as thorough as possible.

Follow this check list as a guide:

Picture identification and current insurance card(s)

Hint:  Once provided with this information, you need to verify insurance coverage and benefits.  This is the optimum time to collect copayments from the patient.

Contact information for emergency contact and/or healthcare surrogate

Hint:  Make sure the patient indicates the name(s) of any authorized persons on your HIPAA notification form.

Contact information for all current healthcare providers

Hint:  Please have the patient add to the HIPAA form, the names of any physicians they would like your physician to communicate with or share their medical records.

Copies of any applicable medical records and recent diagnostic testing results

Hint:  If you are handed records that are the patient’s only copy, make your own copy and return the “originals” to the patient.  They may need them for another provider.  X-rays or radiology “films” stored on computer discs, should be logged in the patient’s record if they are left behind after the visit.

Complete list of current medications, both prescription and over the counter.

Hint:  Adding the pharmacy name and phone/fax number into the patient chart facilitates issuing any required prescriptions.

Medicare Covers STDs Screening

Sexually Transmitted Diseases (STDs) are no longer conditions that are only discussed in back alley clinics.  Proof is based on the fact that statistics show that STDs are commonly affecting those as young as 15 and Medicare now covers STD preventive services.  A diverse range of clinicians from Pediatrics to Geriatric Medicine are being called upon to help reduce STD’s in our communities.

Not all diseases are preventable, but in the case of STDs, awareness is the key to prevention as emphasized this month by Centers for Disease Control (CDC).  As always awareness goes hand in hand with education.  As the key sponsor of Sexually Transmitted Disease Awareness for the month of April, the CDC is offering a wide range of information for both the public and healthcare professionals alike.

Many people would be shocked to read these STD statistics:

Approximately 20 million new STD’s are diagnosed each year

Half of all new STD’s are attributed to people age 15-24

Annual cost of treating STD’s is almost $16 billion

Even though there have been noted disparities in the occurrence of STDs in certain populations, there is no race, sex, economic status or age group that is exempt.  It is of the utmost importance that healthcare professionals take advantage of each opportunity to have an open and frank discussion with all of their patients regarding these highly preventable conditions.  

These discussions should include these basics:

Inquiries about high risk behavior

Ways to prevent contracting a disease

The signs and symptoms associated with common STDs

As mentioned earlier in this article, as of November 8, 2011, CMS made Sexually Transmitted Infections (STIs) and High Intensity Behavioral Counseling (HIBC) part of its panel of covered preventive services.

The tables below highlight coverage information that can be found at:

Covered Screening Service for Increased Risk Patients

ICD-9 Codes
Patient Financial Responsibility

86631, 86632, 87110, 87270, 87320, 87490, 87491, 87810
Non-pregnant female:V74.5 & V69.8
Pregnant female: V74.5 & V69.8 & V22.0,V22.1, or V23.9
Deductible and coinsurance waived

87590, 97591, 87850
Non-pregnant female:V74.5 & V69.8
Pregnant female: V74.5 & V69.8 & V22.0,V22.1, or V23.9
Deductible and coinsurance waived

Combined Chlamydia and Gonorrhea
Non-pregnant female:V74.5 & V69.8
Pregnant female: V74.5 & V69.8 & V22.0,V22.1, or V23.9
Deductible and coinsurance waived

86592, 86593, 86780
Non-pregnant female:V74.5 & V69.8
Pregnant female:V74.5 & V22.0, V22.1 or V23.9
Male: V74.5 & V69.8
Deductible and coinsurance waived

Hepatitis B
87340, 87341
Pregnant female: V73.89 & V69.8 & V22.0, V22.1, or V23.9
Deductible and coinsurance waived

Covered Counseling Service for Increased Risk Patients

Patient Financial Responsibility

High Intensity Behavioral Counseling
Up to two HIBC counseling sessions annually
Deductible and coinsurance waived

Equal Healthcare for Minorities

This April, National Minority Health Month is supported by the Office of Minority Health and other agencies to raise awareness about health disparities that continue to affect racial and ethnic minorities. The Patient Protection and Affordable Care Act's groundbreaking policies are aimed to reduce these disparities and achieve health equity.

Health disparities defined

The National Institutes of Health (NIH) defines health disparities as differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups.

The Patient Protection and Affordable Care Act also created the National Institute on Minority Health and Health Disparities (NIMHD) at NIH. The NIMHD will control all aspects of the NIH in regards to these minority health issues. The main goal is to bring attention to and find solutions for the unequal burden of illness affecting minority, rural and poor populations in this country.

The United States Department of Health and Human Services (HHS) drew on the same legislation when developing its Disparities Action Plan. The HHS Action Plan to Reduce Racial and Ethnic Health Disparities outlines goals and actions HHS will take to reduce health disparities among racial and ethnic minorities that include current common healthcare improvement strategies of evidence-based programs, integrated approaches and best practices.

Racial and ethnic minorities

The HHS Disparities Action Plan is designed around race and ethnicity, but those are not the only American populations effected by health disparity. Geographical location and poverty have long been associated with reduced healthcare equity. Religion, gender, age mental health, disability, sexual orientation or gender identity can all provide obstacles to appropriate healthcare.

Even though causes of health disparities can vary as widely as the diversity of the population, one issue consistently shows to be a key indicator in the quality of health care received by minority populations: insurance coverage. Statistics have shown that racial and ethnic minorities are significantly less likely than the rest of the population to have health insurance. (See table below)

This article highlights how the ACA will facilitate access to insurance:

As we have seen numerous public agencies have all joined together to affect change in the area of health disparities. Each of them plays a significant role in achieving the goals of the Healthy People 2020 initiative. Additional information can be found on the main CDC Minority Health website.

2010 United States Census has published the following insurance coverage statistics:

Race/Ethnic Group % of Population with No Insurance
African-Americans 20.8
American Indians/Alaska Natives 29.2
Asian-Americans 18
Hispanics 30.7
Native Hawaiians/Pacific Islanders 17.4
Non-Hispanic Whites 11.7

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