Author Topic: Proof for HIPAA  (Read 9190 times)

easternbikes540

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Proof for HIPAA
« on: September 02, 2009, 05:59:26 AM »
How do you show proof (or do you) for being HIPAA compliant? I know your business has to be HIPAA compliant, so is there a certificate or something that shows that your business is HIPAA compliant so you can show your clients. Not totally sure how this works. Is it just a trust thing?

Steve Verno CMBS, CEMCS

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Re: Proof for HIPAA
« Reply #1 on: September 02, 2009, 07:19:44 AM »
When a practice I worked for was being investigatd by Federal Marshalls,  they came in flashed their badges and gave us a subpoena. The first thing they asked for was the practice financial plan and then they asked to see the practice compliance plan.  Using those, they went around and started looking.  They checked to see if we were doing what we said we would be doing. They opened desk drawers to see what was in them,  they sat near the break table to see what they could hear.  They looked in trash cans.  They looked to see if computers were left unattended and available during breaks and meals.  They were with us for 2 weeks.  They spent alot of time in my office asking tons of questions and seeing how I did my job as systems manager.  When they left, all they said was we did fine.  Mainly they wanted to see if we followed our compliance plan and the practice financial plan.  This was generated based on a complaint by a Medicare patient who said they never got a refund of their ovepayment.
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Michele

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Re: Proof for HIPAA
« Reply #2 on: September 02, 2009, 10:57:52 AM »
From what I've read, there are no 'HIPAA Police.'  They usually only investigate if a complaint is made.  The important thing is that you have a compliance plan in place and that you are following it.  If a complaint is made they will come in to see what your plan is and if you are following it.

Michele
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PMRNC

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Re: Proof for HIPAA
« Reply #3 on: September 02, 2009, 11:10:56 AM »
I have been asked my numerous clients and potential clients to see my compliance plans. Your Medical Associations are advising physicians that outsource or are thinking of outsourcing to get a copy of the compliance plan from the third party medical billing company, so it's good to have this IN place ASAP
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

jmitchellgarraway

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Re: Proof for HIPAA
« Reply #4 on: October 27, 2009, 02:54:16 PM »
Do you no where I can obtain a compliance plan for my billing company?
J. Mitchell-Garraway
Gabriel Medical Billing & Consulting
Billing Manager

Pay_My_Claims

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Re: Proof for HIPAA
« Reply #5 on: October 27, 2009, 03:46:49 PM »
it is something you design yourself. go to the oig website and look at what they recommend for billing services. that is a good starting point for you.

kwardbilling

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Re: Proof for HIPAA
« Reply #6 on: January 07, 2010, 03:15:25 PM »
Hi, can you be a little more specific about the oig website.  I visited hippacdemy and compliance 360, was very overwhelmed with the amount of material and where to actually head I then looked on the oig site, but didn't see anything specific to billing servies?  I am a very small billing sevice, out of my home.  I started billing for a clinician 3 years ago out of my home and want to make sure I'm following all the rules....thanks for any suggestions or more information.

Karen

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Re: Proof for HIPAA
« Reply #7 on: January 20, 2010, 10:46:24 AM »
The OIG has a "sample" compliance plan for third party billers. You will want to read and review it. It isn't about copying a compliance plan and putting your name on it. You must adhere to the things IN the compliance plan and the plan should be formatted around YOUR company and compliance. Every billing company should have one, the last thing you want to do is not have one when a provider asks to see it. Same goes for policies and procedures, HIPAA BA Agreements. And let's not forget there are now HITECH regs which required Business Associates to amend their BAA's.   
Linda Walker
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oneround

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Re: Proof for HIPAA
« Reply #8 on: January 20, 2010, 04:01:03 PM »
I agree with Linda, you don't just make one up and then not adhere to it.  It has to become LAW in your office.  We work with our ee's, BA's and physicians in constantly educating them on HIPPA.  Our presentaions are put on monthly and mandatory testing is done yearly.  There have been many times in which I visited a BA and no sooner then I walked in their door did I start finding violations.  The OIG site will direct you to the Federal Register which is good. hcca.com is a great compliance fourm in which many of my peers help out on many issues and also you can use compliancehome.com as another compliance resource.  I have a HIPPA implementation PDF that contains much information in which your seeking but it is to large to send as an attachment here.
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare

PMRNC

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Re: Proof for HIPAA
« Reply #9 on: January 26, 2010, 01:49:29 PM »
 I Also like Compliance 360.  There are some companies that are way over priced IMO and taking advantage of consultants and practices. Really you just need to educate yourself and remember CYA!!
oh.. and remember HITECH now :)
Linda Walker
Practice Managers Resource & Networking Community
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jcbilling

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Re: Proof for HIPAA
« Reply #10 on: January 26, 2010, 10:19:20 PM »
When compiling a Compliance Plan, do you outline every step of your billing process?

Sometimes it is different for each client... I have DME, Family Practice, Chiro, and PT offices and each one has a different method for sending me their work, we use different systems, etc.

What process do I need to outline in my compliance plan? just the general stuff?

Michele

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Re: Proof for HIPAA
« Reply #11 on: January 27, 2010, 05:57:08 AM »
It can't be too general or else that will defeat the purpose, however, we too get info different from each client.  We outline what we do once we receive the info more than how we get the info. 

Michele
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PMRNC

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Re: Proof for HIPAA
« Reply #12 on: January 27, 2010, 02:19:42 PM »
You might be confusing policies and procedures with compliance. Your compliance plan will be a general overall road map of what you do to ensure compliance within YOUR business. The steps you will take to protect your clients, yourself, etc.. It is basically your compliance bible.. If you have a question come up about something a client is doing or not doing they should be doing, you refer to your compliance plan to see what appropriate actions should be taken and you implement that protocol.

A policies and procedures is just that.. a full and comprehensive plan of all your policies and procedures I have mine in the same binder with my compliance plan. Each medical practice should have one as well. I require each client to give me a copy of their P&P when they sign with me as well as office policies, financial policies, etc.
Linda Walker
Practice Managers Resource & Networking Community
One Stop Resources, Education and Networking for Medical Billers
www.billerswebsite.com

oneround

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Re: Proof for HIPAA
« Reply #13 on: January 27, 2010, 09:55:29 PM »
I strongly agree with both Linda and Michele.  My only disagrement is in Linda's statment, do not confuse compliance and P&P's.  I say that becuse as a compliance office, I implement alot of P&P's, for my BA's, for my company, for my PMG's and my at home billers, simply from my observations.  So, it goes hand in hand.  I stand firm in the advice this fourm has given you, but again, implementing a P&P is easy, but do you follow it?  Case example, we have at home billers, if that is your occupation, but while I was there reviewing her case load she had a friend knock on her door and she let her in.  Now mind you, her comp., was up with and patint information on the screen and needless to say, she had all the pt bills laying around her table.  I do not care if you a at home biller our you a PMB, laws apply and adhere all the same
Michael A. Reynolds, CPC, CCP-P, CPMB, OS
Project Manager
Corporate Compliance
Sharp HealthCare

Annacate

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Re: Proof for HIPAA
« Reply #14 on: January 29, 2010, 04:04:07 PM »
I am here for the first time, and hope you guys can help me. If a medical assistant refuses to chart when a patient comes in to get an injection (only), and says the superbill is document enough, can I be liable if I send that claim to an insurance company? (The MG is not even listed on the superbill). I told the doctor if there was no documentation it was like it was not done. To make a long story short, the doctor said the superbill was sufficient. I disagree but wanted your opinion. I may have to find other employment. Help! Ann