LA Department of Health latest ransomware victim

February 29, 2016 | By Susan D. Hall

The Los Angeles County Department of Health Services has been targeted in a ransomware attack, just days after Hollywood Presbyterian Medical Center paid about $17,000 to hackers who left employees without access to systems for more than a week, reports the Los Angeles Times.
At the LA health department, remnants of a ransomware thread were found on five work computers last Wednesday, but the attack did not affect operations, spokesman Michael Wilson told the LA Times. The malware did not spread and the network was not compromised, he added.

The incident was reported to the Los Angeles County district attorney's office and the county's chief information office, and Wilson said the country will not pay the ransome.

While often the source of a ransomware attack is unknown, Turkish hackers have recently claimed credit for the Hollywood Presbyterian attack. They vowed to keep up attacks as long as the U.S. government continues to support Kurdish rebels,according to the International Business Times.

Health systems in the U.S. are not the only victims in the recent growth of ransomware incidents. At least two German hospitals also have come under attack, according to DW.com. IT officials at Lukas Hospital in Germany's western city of Neuss took systems down after noticing unusual pop-up warnings and the network running slowly. Malware infected systems at Klinikum Arnsberg hospital in the German state of North Rhine-Westphalia apparently through a booby-trapped email attachment.

Security experts have previosuly predicted a rise in ransomware attacks. Last month, Mount Pleasant Texas-based Titus Regional Medical Center's electronic health record system was left inaccessible by such an attack.
Experts have also said attackers could use ransomware to target medical devices.

To learn more:
- here's the LA Times article
- read the Register story
- check out the International Business Times piece

New Threat to Clinical Documentation

by  Laurie M. Johnson, MS, RHIA | Monday, 22 February 2016 

On Feb. 5, Hollywood Presbyterian Medical Center experienced an electronic health record (EHR) outage that began due to ransomware. This type of malware had shut down the hospital’s internal computer system and communication devices, with only a software “key” capable of reopening the internal data files. The hospital has reported that patient care was not compromised at any time or in any way. 

Hollywood Presbyterian returned to paper registrations and documenting on paper forms throughout the incident. The emergency department and fax machines were some areas that were affected by the hacking, however. 

The hospital released a statement on Feb. 17 noting that it had paid the ransom of 40 bitcoins, or approximately $17,000, in order to obtain the decryption key and return the operations to normal as soon as possible. Bitcoin is a type of digital currency that is difficult to trace. Operations were restored on Feb. 15.
Hollywood Presbyterian Medical Center notified law enforcement immediately, and the Federal Bureau of Investigation (FBI) is now involved with the case. Computer experts assisted the facility in getting their health information systems back online and in understanding the event. According to a memo released by the hospital’s president, Allen Stefanek, “we have no evidence at this time that any patient or employee information was subject to unauthorized access.”

This incident raises the importance of backup systems, redundancy, security, and information governance. Could a hacker invade an electronic health record and impact patient care? Could a hospital be shut down permanently? How do security measures need to change in order to keep our health information safe?     
February is Information Governance Month. You may wonder, “what is information governance?”   This American Health Information Management Association (AHIMA) initiative is focused on protecting and maintaining high quality of data and integrity of all types of data. As we have learned in recent years, data is very important in the healthcare industry to providing high quality of care, a safe environment, and cost-effective treatment. Information is an asset to any organization that must be kept safe and secure. We need information governance so that we can extract clinical and business information and optimize its usefulness.  
Health information management (HIM) professionals have always understood the importance of data security and consistent data. As healthcare delivery becomes more electronic in nature, the need for security and management will become heightened.

This cyberattack highlights the need to remain diligent in our security practices to protect the most personal of information – our health records.

About the Author
Laurie Johnson, MS, RHIA, FAHIMA is the director of health information management (HIM) consulting services for Panacea Health Solutions Inc. She has conducted ICD-10 education sessions and documentation reviews for multiple organizations. Prior to working for Panacea, Laurie worked for Peak Health Solutions and Optum.

$25 billion in ICD-10 claims already!

RelayHealth counts $25 billion in ICD-10 claims already

Firm predicts "groundswell of issues," including increased denials and rejections

By Henry Powderly

Revenue cycle firm RelayHealth said that ICD-10 claims "are flowing succesfully," to the tune of approximately $25 billion thus far. 

"Now the industry must be ready to tackle the next set of challenges: timely and correct reimbursement," said Joshua Berman, ICD-10 Lead for RelayHealth, in the announcement. Berman added that RelayHealth will be tracking closely days until final bill, an important metric that will signal just how disruptive the code change is to the industry.

According to RelayHealth's ICD10Central website, days until final bill has averages 14.8 days since the Oct. 1, but most of those claims were coded in ICD-9. There are still a few weeks until the wave of ICD-10 claims begin to be paid.

In an earlier announcement, Berman discussed what he saw on Oct. 1.

"RelayHealth saw about five million institutional claims pass through the clearinghouse. Only around 50,000, or .01 percent, of these claims were coded ICD-10.  As of October 5, the ICD-10 volume grew to approximately 4 percent  (or about one million claims) -- still a small part of the volume. The jump on professional claims (physician billing) was more significant; increasing from 1 percent to 36 percent. in the same timeframe," he said."

"We did see a one day decrease in Days to Final Bill from 14.8 to 13.6 days, which is counterintuitive to what you may expect post-ICD-10 deadline and likely due to a hard push to get to get ICD-9 claims completed."

Berman, however, said troubles with ICD-10 could be felt soon.

"As the majority of providers -- representing a majority of the healthcare dollars -- move fully to ICD-10, post-ICD-10 technical claims are released, and the time for expected remittances arrives, we continue to anticipate a groundswell of issues in getting claims out the door and an increase in denials and rejections."

How is ICD-10 affecting claim denials?

by CARL NATALEJAN 27, 2016 - 06:00 AM

  

There are some mixed messages on how much claim denials have risen since Oct. 1.

Some healthcare providers are reporting a few ICD-10 denials but not enough to worry about. On the other hand, a healthcare consultant found out that a California HMO was denying medical claims on a massive scale. And NCDs and LCDs have needed tweaks to prevent mistaken denials.

If this isn't a major national problem, it certainly can be a major problem for individual medical practices. So it needs to be fixed.

First, measure ICD-10 claim denials and monitor revenue-based metrics. It is important to understand where the problems are occurring. Then medical practices can start fixing the problems that create denials.

Second, figure out if the right ICD-10 codes are being used.  There is lots of room for error so make sure the medical claims are coded correctly and clinical documentation supports the diagnoses. Keep investing in coding training.

Third,  keep calling the healthcare payers until they answer questions. Do not let any denial go because it's too much work.

Best advice: Prevent denials

Chris Nerney at Revenue Cycle Insights identifies three things that can help healthcare providers prevent claims denials:

1. Registration processes: Denial problems can start before the first ICD-10 code is recorded.
2. Medicaid: Which comprises 13 percent of all denials. Start by checking eligibility, medical necessity and pre-authorization.
3. High-impact specialties: Specialties contribute heavily to major amounts of claim denials. (Repeat the advice in the first two tips).

In a way, the macro claim denial statistics don't matter as much as the individual anecdotes. Those stories are valuable examples of how to solve denial issues.

RN-Coder ICD10 Test-Prep Feb. 15-19, 2016

You've received this email because you signed up or made a purchase at http://www.RN-Coder.com RN-Coder ICD10 Test-Prep! Week of Feb. 15th Homewood Suites Henderson, South Las Vegas We need 10 nurses to make this program a GO! The AACCA RN-Coder ICD10 Exam is Given onFriday, Feb. 19th Per the attached email from Rosa Silva, our Group Sales contact at Homewood Suites, the CUT-OFF for the RN-Coder GROUP RATE for this program is FRIDAY this week.   If you are planning to attend, please CALL ROSA: 702-450-1045 as soon as possible. R   REMEMBER:  YOU DO NOT HAVE TO ATTEND A TEST-PREP IN ORDER TO COMPLETE ANY RN-CODER CE PROGRAMS -- AND YOU MAY TAKE YOUR AACCA CERTIFICATION TEST AT HOME. Rosa Silva Hi Joyce,   Just a friendly reminder that your cutoff day is right around the corner and I still don’t have any reservations for the month of February.  Please let me know what you would like to do. Kindest Regards,   Rosa Silva BTS Manager   HOMEWOOD SUITES By Hilton 10450 S. Eastern Avenue Henderson, NV. 89052   Ph: (702) 450-1045 Fax: (702) 450-1046 Mobil: (702) 689-4588 Email:  Rosa.Silva@hilton.com   Our Hotel is an Award winning Upscale All Suites Hotel.  Enjoy our extra complimentary amenities, such as :    *Complimentary Full Hot Breakfast Buffet is included daily for all guests, (not just a continental breakfast).   *Complimentary Dinner Reception including Beer & Wine. (Mon. –Thurs. @ 5pm-7pm)   *Complimentary Shuttle available at the Top of the Hour to McCarran International Airport   *Complimentary Local Shuttle service available within a five mile radius.   *Complimentary High Speed Internet   *Full Kitchens, stove top, Full size refrigerators & microwaves with all utensils including dishes & cookware.   *Sofa Sleepers in every Suite   *Two or More Flat Screen TV’s (One Flat Screen TV in our King Studio Suites).   * All with No Hotel fees. Very cost effective, considering No added expense of meals.     RN-CODER NETWORK |www.RN-Coder.com | 855-987-6268 If you no longer wish to receive communication from us: Cancel To update your contact information: Update RN-Coder Network LLC 1142 S Diamond Bar Boulevard, Suite 796 #796 Diamond Bar, CA 91765-2203 US RNCoder2015@gmail.com 909-579-0507

Get Your "Sepsy" On!

Please send this excellent training music video to all your nurse & physician friends far & wide.  It is an EXCELLENT way to get everyone watching for
the signs & symptoms of Sepis!

https://www.facebook.com/EMTsParamedics/videos/10153681909773624/

Thank you!
- Joyce

AACCA RN-Coder Test-Prep Dates Announced for 2016

PLEASE COMPLETE THE ONLINE VERSION OF THIS PROGRAM BEFORE ATTENDING THE TEST-PREP.  This is NOT a class, it is a REVIEW. You do NOT have to attend a Test-Prep in order to complete a program -- ALL programs are available online 24/7 and may be completed at home, including the AACCA testing.  For questions, please contact Patricia  AACCAMembers@gmail.com.

AACCA RN-Coder ICD10 Certification Exam 

IS GIVEN ON FRIDAY OF THIS WEEK. There are 2 online sections, about 4 hours total. We are usually finished by 1pm on Fridays.

FREE HOT BREAKFAST & DINNER for those nurses staying at Homewood Suites daily. FREE WIFI & FREE SHUTTLE to/from airport, local restaurants & stores. There is no Daily Resort Fee -- so staying with us at Homewood Suites will save you about $500 for the week!

** THIS IS A NO SMOKING FACILITY **

We start promptly at 8:00am daily. We will be going over the power point presentations, homework assignments and grading the Mid-Term Exam. On Thursday please have the Final Exam ready to turn in. Each day we will review ICD10CM and ICD10PCS. There will be assignments daily. Dress is casual and comfortable.

Go to RN-Coder Continuing Education Programs for course descriptions & information about the Homewood Suites property.

You must call Homewood Suites 702-450-1045 to make reservations so we know you are attending THIS test-prep. If we do not have 10 nurses staying at the hotel by two weeks prior, the test-prep may be cancelled.

THIS SCHEDULE IS SUBJECT TO CHANGE WITHOUT NOTICE.  

Please check with the hotel prior to making non-refundable travel arrangements.

THERE IS NO COST FOR THE TEST-PREP & YOUR TESTING FEES ARE WAIVED IF YOU REGISTERED FOR THE RN-CODER COMBO PKG.  If you registered for a SINGLE PROGRAM, the cost of the Test-Prep is $499 for all 5-days and the Exam fee is $399.  You must be an AACCA member to be able to sit for the Certification Exam.  Go to www.AACCA.net for membership details.

CLICK ON THE BIG BLUE BUTTON ON THE RIGHT SIDE OF
www.RN-Coder.com  or click a link below:

AACCA RN-Coder ICD10 Test-Prep - February 15 - 19, 2016
https://tockify.com/rncoder/detail/29/1455552000000

AACCA RN-Coder ICD10 Test-Prep - May 16-20, 2016
https://tockify.com/rncoder/detail/30/1463410800000

AACCA RN-Coder ICD10 Test-Prep - September 12-16, 2016
https://tockify.com/rncoder/detail/31/1473692400000

AACCA RN-Coder ICD10 Test-Prep - December 5 - 9, 2016
https://tockify.com/rncoder/detail/32/1480953600000