“Final Rule- CFR 42 Parts 4xx”

The following is an excerpt from the Department of Health and Human Services- Centers for Medicare & Medicaid Services. For those Health Service professionals desiring to participate in the IT Reimbursement program, a complete copy of the document may be downloaded here .

Effective Date: These regulations are effective on September 27, 2010.

42 CFR Parts 412, 413, 422, and 495- Meaningful Use

Medicare and Medicaid Programs; Electronic Health Record Incentive Program

SUMMARY: This final rule implements the provisions of the American Recovery and Reinvestment Act of 2009 (ARRA) (Pub. L. 111-5) that provide incentive payments to eligible professionals (EPs), eligible hospitals and critical access hospitals (CAHs) participating in Medicare and Medicaid programs that adopt and successfully demonstrate meaningful use of certified electronic health record (EHR) technology. This final rule specifies- the initial criteria EPs, eligible hospitals, and CAHs must meet in order to qualify for an incentive payment; calculation of the incentive payment amounts; payment adjustments under Medicare for covered professional services and inpatient hospital services provided by EPs, eligible hospitals and CAHs failing to demonstrate meaningful use of certified EHR technology; and other program participation requirements. Also, the Office of the National Coordinator for Health Information Technology (ONC) will be issuing a closely related final rule that specifies the Secretary’s adoption of an initial set of standards, implementation, specifications, and certification criteria for electronic health records. ONC has also issued a separate final rule on the establishment of certification programs for health information technology.

The original (Final Rule) is 276 pages but a resource you will use during your application.

Retention Scheduling Upgrade

Since our inception, we have made available a Retention Scheduling feature to help insure compliance as well as maintenance of our client’s records. At its most basic function, a retention schedule can be established to mark files for deletion that are of a certain age. Once these records are marked, they are removed from “view” and held for permanent removal by the Administrator. Marked files are deleted by the Administrator and are permanently removed from the system. Administrators can set the schedule using any date field. For example, “Date of Invoice”, “Date of Payment”, “Date of Service”, Date of Birth”, “Date Uploaded”, etc are valid testing fields. This basic method is now used by many clients. For simple calculations such as setting the rule to a certain number of years, months and days, this works well. In some cases, however, a more complex rule needs to be employed. For example with Health Services providers, a rule may be created to check for the Patient’s last date of service and if seven years (California) or older AND the patient’s age is 19 years or more, then mark for removal. The rule creation is flexible and can be written to meet most objectives. This system is now available and can help insure proper maintenance levels of active patients and reduce storage fees.

It is important to note that using a more complex rule like the above, requires that the date index fields are accurately captured. Records that have bad data in the date field such as no “Date Of Birth” or invalid birth dates or invalid “Dates of Service” are ignored and will not be considered for deletion.

Should you wish to investigate a more complex rule for your Records Retention schedule, contact your account manager at Global Archives or call: 1.877.257.7226.

Scanning Tips

Using Barcodes will improve efficiencies – A critical stage in the conversion process is indexing the image. Indexing is the key to later finding the document in the repository. The indexing task can be expensive and time consuming. Using the conventional method, the operator must physically find all searchable values in the document and manually enter those into the document’s database. Accuracy is paramount to quickly and easily finding the document. Poorly written words and numbers can cause major delays as well as data errors. Normally, all the fields are on the first page of the document and so the operator can focus his efforts in a specific area, however; in some cases he must flip through other pages increasing the time to process. Considering an average of 5 fields per document an operator may take as long as 25-30 secs per document and if data is missing or illegible from the front/cover page that time can exceed a minute or more. There are ways to improve on this process and many of you now employ these methods. One method is to use validation databases. Validation databases are created from the user’s system which may originate from a billing, EMR, accounting or manufacturing system. The validation works by association. For example, using this method, the operator enters one key value (Patient ID, Invoice #, Claim #, etc) and the data capture software pulls all the pertinent data from the database and accurately and quickly updates the database for the record. This still take about 5-10 secs to find, verify and enter but is much faster and more accurate than the manual method.

The next best method is to use a barcode on the document. This barcode is powerful and may be created separately and placed onto the document or on a cover page. In many cases, a barcode can be generated by the system when the document is created. The barcode operates much like the validation database method in that the barcode contains all the document searchable values. The benefit of the barcode over the validation database is that it is fully automatic and assures accuracy. Other methods of increasing overall efficiencies such as form recognition will be discussed in a future article.


Typical Index Speed — Manual entry of data (1000 documents): = ~5.5 hrs, Validation Database: =~1.4 hrs, Barcode:=~nil

LockBox Tips

Using Advance Search with Sort
LockBox has many powerful features that allow users to manipulate their database to better manage their records. In addition to creating reports, managing users and documents, it uses proprietary search engines to get the best results the fastest possible way. Whether it is full content search for information within a document or meta data search for record information, LockBox Simple and Advance search functions minimize search times and provide two powerful views of results.

The Advance Search function allows the user to search using specific key index fields. Unlike the simple search presented on the home page which will search the entire database of all fields for a specific value, the Advance Search specifically targets one or more fields, greatly reducing the number of hits. It will also allow the search results to be displayed in classical “Explorer” format or “Matrix” view. The Matrix view displays all values of the fields in a matrix layout. Other than the document’s title, the “Explorer” view displays no field values but is somewhat faster than the Matrix view.

An important feature of the Advance Search is its ability to sort the results in a A-Z or Z-A or 0-9 or 9-0 fashion. This can very helpful when searching on a common field value like “Smith” or “Date” with extensive results displayed. To employ this feature, simply select the fields to search on ( one or more) and select the “Order By” of result and finally click on the “Search” (for Explorer view) or “Matrix View” for the matrix form. The results will yield a result in preferred order.

Global Archives is a provider of streamlining services for paper intensive businesses.

Founded in 2003, its principals brought more than 20 years experience in Document Management Systems (DMS). The principal’s experience included developing powerful solutions for Fortune 500 as well as other large organizations. Recognizing the power of the Internet and Cloud computing, Global Archives developed a powerful web based document management system that could be shared -safely and securely- with hundreds of other clients reducing records management expense.

As a pioneer in web based “Software as a Service” (SaaS), Global Archives developed an enterprise solution that services a wide variety of industries. The service is Internet based and includes designing the client’s front end application for document conversion, data capture and work flow of their business process and document repository services in a safe, secure and user friendly environment.


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