Tag: Mental health billing

APA & Climate Change: What psychology can do

Posted on | by SOS Blog | 5 Comments on APA & Climate Change: What psychology can do

I sat down Monday morning to write this week’s blog post. I was intent upon writing about American Psychological Association’s (APA) recent report on climate change and what the psychology community can do about it. I had previously glanced at the executive summary of the report and was excited to learn what the entire report recommended. Unfortunately, I must have been a bit too tired when I started out in my reading. I was only on page three when my eyes glazed over.

I do have a history with APA; I have been a member for 30 years. I joined as soon as I was eligible after completing my Ph.D. In the early 1990’s I served on two different committees within APA—the Public Information Committee and the Committee for the Advancement of Professional Practice. I have read more than my share of scholarly papers and APA organizational documents. Since retiring from the practice of psychology in 1993 and moving to full-time involvement in the business of psychology billing and clinical record software, I have become more removed from scholarly work and more involved in the action orientation of the business world.

Psychology and Global Climate Change: Addressing a Multi-faceted Phenomenon and Set of Challenges, while perhaps intended to be a call to action, is actually a carefully written and documented organizational treatise on the psychological phenomena involved in this crisis, the psychological research and knowledge which are applicable to these events, and recommendations for the role APA as an organization and psychologists as professionals and individuals can and should play as this crisis unfolds. It is what I should have expected, but not what I hoped it would be.

In order to make this document useful, I believe it needs to be broken down into parts and digested in that fashion. Accordingly, over the next few months, I am going to take each section of the report and tell you about what is in that section. I hope this will have the result of helping us glean the recommendations of the APA and determining what constructive actions individual mental health professionals and behavioral health community organizations can take.

The APA Climate Change Task Force considered six questions:

  1. How do people understand the risks imposed by climate change?
  2. What are the human behavioral contributions to climate change and the psychological and contextual drivers of these contributions?
  3. What are the psychosocial impacts of climate change?
  4. How do people adapt to and cope with the perceived threat and unfolding impacts of climate change?
  5. Which psychological barriers limit climate change action?
  6. How can psychologists assist in limiting climate change?

In examining these questions, they reviewed the psychological literature to focus areas in which additional research might be useful and in which current data might enhance the work of climate scientists.  By way of this report, the task force attempted to create bridges between the climate science community and the psychological community.

It is also clear from these questions that the authors were considerably concerned about what the psychosocial effects of climate change might be. Since those of us who work with individuals, families and communities about various emotional and behavioral health concerns will undoubtedly need to address these impacts, it behooves us to be prepared…at least with knowledge.

Finally, the task force recommended that specialists in behavioral and psychological research adopt the following principles in an attempt to maximize the value and use of psychological principles in climate change work:

  1. Use the shared language and concepts of the climate research community where possible and explain differences in use of language between psychology and this community.
  2. Make connections to research and concepts from other social, engineering, and natural science fields.
  3. Present psychological insights in terms of missing pieces in climate change analysis.
  4. Present the contributions of psychology in relation [to] important challenges to climate change and climate response.
  5. Prioritize issues and behaviors recognized as important climate changes causes, consequences, or responses. 
  6. Be cognizant of the possibility that psychological phenomena are context dependent.
  7. Be explicit about whether psychological principles and best practices have been established in climate-relevant contexts.
  8. Be mindful of social disparities and ethical and justice issues that interface with climate change.

If climate change continues and has even some of the potential impacts that are predicted, mental health and behavioral specialists will be deluged with people caught in and reacting to those impacts. What can you and your organization do to prepare for addressing the fallout of some of these impacts? What would be the result of a Katrina-equivalent in your community? What knowledge and expertise do you need to gain?

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Are your passwords HIPAA secure?

Posted on | by SOS Blog | 4 Comments on Are your passwords HIPAA secure?

Standard advice for securing computer systems is to require users to change passwords frequently. Something about this recommendation has always bothered me, but I never really thought it through. A current blog posting at Healthcare Informatics by Dale Sanders really hits the nail on the head. He points out that these change-passwords-frequently policies actually undercut password security rather than enhancing it, once you factor in human psychology. If you have to replace your password frequently, you will probably come up with something simplistic, or resort to a post-it note on the monitor, or maintain a paper list. It would be far more secure to create a single, strong password or passphrase and continue to use it for a much longer period.

To manage passwords used on the web, you can’t go wrong with Roboform. Create a strong master password (long, and using a combination of letters, numbers, and special characters), then let Robo’s password generator suggest strong passwords for individual web sites. Once you select and use a password on a web site, Robo will remember and “type” it in for you when you next visit that site. All you have to do is enter your master password once in each browser session; Robo uses that to unlock your password library and cleverly selects the right one whenever you hit a login window. There is even a version of Roboform that you can install on a USB “thumb” drive, so you can securely carry your passwords with you for use on multiple computers, or even public computers when traveling.

In the course of providing technical support on our billing and EMR software, I am exposed to the password selections of many of our users. It is amazing how rare it is to find anyone using serious passwords. Names, almost surely loved ones or pets, are the most common, but way too frequently I see passwords that are identical to user IDs, or non-passwords like “123” and “password”. Although we have optional rules in our products that would require strong password choices if enabled, they rarely are used.

Coming up with an easily remembered, secure, master password is not really all that hard. Just think up a short sentence that includes punctuation and some numbers. You can check the quality of your choice using Microsoft’s password checker.

Here’s an example: “Turning 60! soon.” This easily remembered phrase is actually more secure than “3-vO$aLKG7”, which conforms to all the standard password creation advice.

Maintaining medical privacy is serious business. Current HIPAA rules provide for serious penalties when medical information is not properly secured. Are you guilty of password negligence yourself?

Seth Krieger

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Mental Health Billing and the ICD-10

Posted on | by SOS Blog | 9 Comments on Mental Health Billing and the ICD-10

Back in August, the U.S. Department of Health and Human Services (HHS) posted a proposed rule requiring the implementation of the portion of HIPAA that mandates use of the ICD-10 by October 2011. The International Classification of Diseases-10 was endorsed by the 43rd World Health Assembly in 1990 and was implemented by many World Health Organization (WHO) member states as early as 1994. The United States is 14 years behind the curve on use of this updated version of the ICD, the list of diagnoses used in all medical billing. As more healthcare organizations implement electronic medical records (EMRs) ICD diagnostic codes are used ever more widely, but at present payment for health services is still the most important function of these codes in the U.S.

There was an immediate outcry from provider and payer organizations that the 2011 date was too soon. The Medical Group Management Association, the American Medical Association and America’s Health Insurance Plans registered objections with HHS over the implementation date indicating that the costs would be too great for providers and payers, especially given the recently completed and very costly implementation of the NPI (National Provider Identifier).  But now, the American Hospital Association has supported the 2011 date suggesting that the potential gains from use of the ICD-10 are too great to wait any longer to implement the new codes.

We know the pain that has been experienced by customers of Synergistic Office Solutions in adopting the NPI and continuing to get paid for services rendered. Our software has been able to handle the NPI since early 2007, but some of our customers still struggle with the confusion caused by this transition.  While software can be made ready for the ICD-10 without very much difficulty, we are concerned about how this change will be handled in the real world by psychologists and psychiatrists and social workers who are accustomed to using the DSM-IV and ICD-9 for diagnoses for mental health conditions.

What do you think about a move to ICD-10? Do you expect this next round of changes required by HIPAA to be simple? to be problematic? What do you expect the impact will be for your organization and how do you plan to handle it? What is the best way for vendors of mental health billing software and medical billing software, medical EMRs and behavioral health EMRs to assist providers in implementing the new ICD-10 codes? Let us know what you think. We want to help make this new transition as smooth as possible.