United Health Care insufficient record bogus Denial

United Health Care has started a recent trend… just wait, it is not a good trend. UHC has denied claims stating insufficient medical records even though records has NOT been officially requested. Please update your billers so these services are NOT prematurely written off.

Submit the claims, records, and denial of insufficient records for reprocessing.

Thank you

Arizona Providers – CAQH

The state of Arizona does not issue a Controlled Dangerous Substance (CDS) certificate and Arizona Controlled Substances Prescription Monitoring Program registration information should not be entered in the CDS field.
Therefore, when completing your application or attesting in CAQH ProView, please select ‘No’ as the response to the following question:
Controlled Dangerous Substance (CDS) Registration
Do you have a CDS Registration Certificate?
By answering ‘No’ to this question you will not be required to enter a CDS number, expiration date, and you will not be required to submit a document.
If you have questions regarding this communication please contact the CAQH ProView Help Desk by chat or you may call: 1-888-599-1771.
Thank you.

Texting and E-mail in Medical Offices

HIPAA Requirements
•HIPAA Security Rule §164.312(e) requires consideration of encryptionof communications as an Addressable Implementation Specification
–Risk Analysis shows regular texting is NOT secure
–Using regular texting with PHI may be considered a breach
•HIPAA Privacy Rule §164.522 and §164.524 give patients rights of communication preferences and access of information (even if it is not secure)
–Making Patients happy
–Making HHS happy

-Jim Sheldon-Dean

Texting and E-mail in Medical Offices

Patient Communications
•The big question: “Can I text or e-mail Appointment reminders to my patients?”
•The big answer: “That depends…”
–Do you have consent under TCPA?
–Details of the message
–Context of the message
–What can you leave out?
•What if they request using plain e-mail or plain texting and don’t want to use another app or portal?
–Can you manage the communications?
–Can you document the communications?
–Issue of Response, Triage, and Medical Records

-Jim Sheldon-Dean