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Payment Adjustments & Hardship Exceptions Tip sheet for Eligible Professionals

Overview

As part of the American Recovery and Reinvestment Act of 2009 (ARRA), Congress mandated payment
adjustments to be applied to Medicare eligible professionals who are not meaningful users of Certified
Electronic Health Record (EHR) Technology under the Medicare EHR Incentive Programs. These payment
adjustments will be applied beginning on January 1, 2015, for Medicare eligible professionals. Medicaid
eligible professionals who can only participate in the Medicaid EHR Incentive Program and do not bill
Medicare are not subject to these payment adjustments. Read More

Understanding the HIPAA standard transactions: The HIPAA Transactions and Code Set rule

Health Information Portability and Accountability Act (HIPAA) as both a patient information privacy law and electronic patient information security law.Read More

BA Deliverable!!!!!!!!!!

Watch this video and learn how to create requirement tractability matrix,RACI Matrix,User acceptance test plan,User acceptance test cases.

House Speaker John Boehner (R-Ohio)

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Meaningful Use

The Medicare and Medicaid EHR Incentive Programs provide financial incentives for the “meaningful use” of certified EHR technology to improve patient care. To receive an EHR incentive payment, providers have to show that they are “meaningfully using” their EHRs by meeting thresholds for a number of objectives. CMS has established the objectives for “meaningful use” that eligible professionals, eligible hospitals, and critical access hospitals (CAHs) must meet in order to receive an incentive payment.
Read More

Payment Adjustments & Hardship Exceptions for Eligible Hospitals and CAHs

Payment Adjustments & Hardship Exceptions for Eligible Hospitals and CAHs

Business Analyst training Service Oriented Architecture by Addiox @848-2...

Why ICD 10 ?

Reimbursement and Quality Problems with ICD 9

Six year old ICD 9system is getting replaced with ICD -10.

Example
–
fracture of wrist
–
Patient fractures left wrist
•
A month later, fractures right wrist
•
ICD-9
-
CM does not identify left versus right
–
requires additional documentation
–
ICD -10
-
CM describes
•
Left versus right
•
Initial encounter, subsequent encounter
•
Routine healing, delayed healing, nonunion, or
malunion

Example
–
combination defibrillator pacemaker device
–
Codes for this device are not in the cardiovascular chapter of ICD-9 CM with other defibrillator and pacemaker devices
–
Coders and researchers have trouble finding these codes with this type of erratic code assignment
ICD 10
-
PCS provides distinct codes for all these types of devices, in an orderly manner that is easy to
find  

Benefits of Adopting the New Coding System

1.      Incorporates much greater specificity and clinical information, which results in

1.      Improved ability to measure health care services

2.      Increased sensitivity when refining grouping and reimbursement methodologies

3.      Enhanced ability to conduct public health surveillance

4.      Decreased need to include supporting documentation
with claims

 Read more on http://library.ahima.org/xpedio/groups/public/documents/ahima/bok3_005426.hcsp?dDocName=bok3_005426

Basics of Healthcare

Module 1:

1. Healthcare claims overview – Institutional, Professional, Dental and Pharmacy
2. Health insurance claims process - Adjudication (Acceptance, Denials, Rejections, and Pends)
3. QNXT Or NASCO - Data model

Module 2:

1. Claims Models;
2. HIPAA Transactions
3. 4010 vs. 5010 Compliance
4. ICD10, HCPCS

Module 3:

1. Medicaid vs. Medicare
2. Business rules
3. Encounters Submission to States and CMS

Module 4:

1. Healthcare Reforms
2. Government Regulations and Guidelines
3. Healthcare links for online resources

Module 5:

1. Discuss Real-time BRD’s and Test Cases

Introduction

Session focus on Hands on training with several of assignments, practice exercises and quizzes Quality Study material Case Studies/Assignments based on Real-time project based Scenarios Certification Guidance Certificate of Participation at the end.

Training Details

Duration: 40 hours Training , Case Studies,Assinements Training Materials: All attendees will receive, Assignment after each module, Video recording of every session Notes and study material for examples covered. Access to the Training Blog & Repository of Materials Training Format: This course is delivered as a highly interactive session, with extensive live examples. This course is Live Instructor led Online training delivered using Cisco Webex Meeting center Web and Audio Conferencing tool. Timing: Weekdays and Weekends after work hours.

Why AddioX? How it’s different from others Role-Specific Training – Traditional training focuses on an overall business process, without regard for the individual’s role. By contrast, AddioX’s series of role-based courses delivers in-depth training on a specific role within the business process. Real-time Project Experience – Comprehension of practical skills is both reinforced and demonstrated in our training programs by completing Case studies of actual projects. Ongoing Education – AddioX continues to offer new courses so you can keep up-to-date on latest technologies and best practices. After reviewing your goals, and assessing your current IT skills capability, AddioX will mold an after-the-training program and placement plan that will meet your needs in successful placement. This includes Resume preparation assistance, Mock interviews (technical and project based), Soft Skills and On-the-job support.

Who Should Join

Entry-level Business Analysts Non IT professionals aspiring to get into Business analysis/analyst. Self-taught IT Business Analysts wanting to fill in the gaps and put all the pieces together Systems Analysts and programmers interested in expanding their role into the business area

About the trainer

More than10 Years of Business Analysis Experience, including experience consulting Domain expertise across multiple business verticals including Finance, Health Care Accomplished trainer with experience conducting corporate workshops for audience of 30 people and more Experience mentoring Business/System Analysts for large several clients. Independent consultant hired by Federal and State Government agencies to advance Business Analysis on highly visible, critical and time sensitive projects. Member of multiple organizations including the IIBA and PMI,AHIP

Topics Covered in this Training

Training uses best practices and guidelines from International Institute of Business Analysis (IIBA®) in their Business Analysis Body of Knowledge® (BABOK® v2.0). The training content is tailored to meet the real-world needs of a Business Analyst proficient. In this training, attendees learn: 1. Introduction to Business Analysis 2. Understanding and Capturing business needs 3. Requirement Analysis Process 4. Creating Requirement gathering strategy 5. Modeling Data and Processes 6. UML Methodology 7. Creating Effective Use Cases 8. Business Analysis Tools 9. Requirement Gathering, Business Modeling & Analysis Tools – MS Visio & Enterprise Architect 10. Project Documentation and Management 11. Software Testing 12. Requirement Gathering, Analysis and BRD creation in Real World domains, such as Financial, Health Care, Technology domain Attendees also learn: 1. Resume Preparation Guidelines and Tips 2. Mock Interviews and Interview Preparation Tips

Topics Covered

Introduction to Business Analysis

1. Introduction to Business Analysis 2. Business Composition and Architecture 3. Roles and Responsibilities of a Business Analyst 4. Need for a Business Analyst 5. Project Team 6. Importance of a Business Analyst in the Project Team

Business Analysis Techniques

1. PESTLE – Political, Economic, Sociological, Technological, Legal, Environmental 2. MOST – Mission, Objectives, Strategies, Tactics 3. SWOT – Strengths, Weaknesses, Opportunities, Threats 4. CATWOE – Customers, Actors, Transformation Process, World View, Owner, Environmental Constraints

System Development Life Cycle (SDLC)

1. Understanding Concept of Business Modeling 2. Requirement Gathering 3. Analysis 5. Implementation 6. Testing 7. Deployment

Understanding and Capturing business needs

1. Setting up priorities 2. Feasibility studies 3. Project scope 4. Business case 5. Risk assessment 6. Evaluating and selecting an initiative 7. Setting up future vision

Software Engineering Methods

1. Waterfall Method 2. Rational Unified Process (RUP) 3. RAD Methodology 4. AGILE Methodology 5. Prototype Model

Requirement Analysis Process

1. Creating Requirement gathering strategy 2. Planning 3. Requirements Activities 4. Requirement Gathering Techniques 5. Different Types of Requirements 6. Creating Business Requirement Document 7. Creating Software Requirement Specifications 8. Requirements Risk Management 9. Manage Requirements Change

UML Methodology

1. Use Case Diagrams 2. Activity Diagrams 3. Sequence Diagrams 4. State Chart Diagrams

Use Cases

1. Understanding Use Cases 2. Use Case Relationships 3. Use Case Brainstorming 4. Creating Use cases from Requirements 5. Creating Use Case Narratives 6. Change Management & Version Control Concept

Business Requirement Gathering Tools

Rational Requisite Pro Enterprise Architect MS Visio

Business Process Improvement

1. Selection of process teams and leader 2. Process analysis training 3. Process analysis interview 4. Process documentation 5. Review cycle 6. Problem analysis

Modeling Data and Processes

1. Data models 2. Conceptual, logical and physical schemes 3. Data modeling process 4. Modeling methodologies 5. Entity relationship diagrams 6. Generic data modeling 7. Semantic data modeling

Software Testing

1. Introduction to QA Methodology 2. Role of BA in Testing 3. Creating Test Plans 4. Creating Test Cases 5. Different Testing Methods 6. Functional and Regression testing 7. White Box and Black Box Testing 8. Positive and Negative Testing 9. GUI and Unit Testing 10. User Acceptance Testing

Business Analysis Governance

1. International Institute of Business Analysis (IIBA)® 2. Business Analysis Body of Knowledge (BABOK)® 3. Certified Business Analysis Professional (CBAP)®

Resume Preparation

1. Resume Review 2. Resume Preparation Tips 3. Sample Resumes

Interview Preparation

1. Mock Interviews 2. Interview Preparation Tips 3. Sample Interview Questions 4. How to clear an Interview