Jul 14, 2020 | Administrative Safeguards, Live Compliance, Medical Billing Software Blog, Partner
Whether you and your workforce are back in the office, or still working from home, there are new compliance regulations, and your HIPAA Compliance program may be a bit different.
Reliable and Effective Compliance
• Completely online, our role-based courses make training easy for remote or in-office employees.
• Contact-free and accurate Security Risk Assessments are conducted remotely. All devices are thoroughly analyzed regardless of location.
• Policies and Procedures curated to fit your organization ensuring employees are updated on all Workstation Use and Security Safeguards in or out of the office and updated in real-time.
• Electronic, prepared document sending and signing to employees and business associates.
Don’t risk your company’s future, especially when we are offering a FREE Organization Assessment to help determine your company’s status regarding the new compliance regulations. [ Click here to download a “HIPAA Compliance Requirements” document ].
Live Compliance is a partner of EZClaim, and you can contact them directly by either calling them at (980) 999-1585, e-mail Jim Johnson at Jim@LiveCompliance.com, or visit them at LiveCompliance.com
[ Written by Jim Johnson, President of Live Compliance ]
Jul 14, 2020 | Administrative Safeguards, Uncategorized
Credit card collections are a BIG part of any successful medical practice, and there has been a shift, in the last decade, that more insurance policies are adding co-pays with higher deductibles—which makes getting paid even more challenging.1 One industry report said that “73% of physicians shared that it typically takes at least one month to collect a payment, and 12% of their patients wait more than three months to pay.”2 With the current trend, more medical practices and their billing departments (or outsourced billing firms) are going the route of processing payment via credit cards, which has its PROS and CONS.
In light of this new information, the following are a few pros and cons for credit card processing that we anticipate in the near future and some insights for choosing the best billing software that supports the credit card processing needs of medical practices:
- PRO: To protect against the dangers of stolen data, fraud, or other compromises in security, practices should seek out medical billing software that has credit card processing built-in, which can help safeguard against these dangers.
- CON: Security is a big risk, and a leak in data leading to stolen funds can end up in a physician paying out-of-pocket for the breach. It is also important to note that breach of credit card data is also considered a violation under the federal Health Insurance Portability and Accountability Act (HIPAA).
- PRO: Implementing credit card processing will reduce long waiting periods for payments from the majority of your patients, and will also reduce the additional effort your billing staff has to extend to collect on overdue notices.
- CON: Practices cannot require patients to share their credit card information to receive medical care, and even if patients do share their credit card information, physicians cannot continue to charge the credit card without a patient’s consent.
- PRO: Physicians can end the process of being a “line of credit” to unpaid or underpaid claims, and collect on funds immediately.
- CON: You will need to implement internal processes that include, but are not limited to proper personal information storage and security, establishing guidelines on maximum percentages charged per bill, and personal consent forms.
Overall, there are definitely MORE ‘PROS’ than cons for implementing credit card processing for your medical practice, and all the trends are pointing to this being the PREFERRED METHOD of payment in the near future. EZClaim is proud to announce that it will release an integrated credit card processing solution, EZClaimPay, that is backed by a national merchant services vendor. [ EZClaim will be sharing more details about EZClaimPay in the weeks to come, via their social media platforms, their monthly newsletter, direct communications, and more ].
In addition to the credit card collections PROS and CONS above, we reached out to one of our partners, Live Compliance, to gather some regulatory and security advice. They suggested the following:
- When accessing, transmitting, storing, or receiving any Protected Health Information (PHI), the Health and Human Services (HHS) Office of Civil Rights (OCR) mandates that you are to maintain HIPAA compliance.
- When accepting, processing, or maintaining credit card information and debit card information, you must ensure that your organization is PCI DSS compliant (Payment Card Industry Data Security Standard).
- In addition to the above Federal regulatory requirements, most states require privacy and security compliance requirements to be implemented, along with strict adherence to the privacy of Personally Identifiable Information (PII) and Breach Notification requirements.
For more information on your compliance requirements, visit Live Compliance for a Free Organization Assessment to identify and uncover your organization’s vulnerabilities.
If you are not a current customer of EZClaim, we would very much like to connect with you. You can either schedule a one-on-one consultation with our sales team, view a recorded demo, or download a FREE 30-day trial right now. For detailed product features or general information about EZClaim, visit our website at ezclaim.com.
[ NOTE: If you would like a quote on the upcoming merchant services, please e-mail sales@ezclaim.com your last three merchant statements. For more on our ongoing updates and industry news, you can follow EZClaim on Facebook and LinkedIn ].
Source Material:
1 – America’s Health Insurance Plans” report that there were 20.2 million co-pays in 2017, which was up tremendously from just over 1 million in 2005.
2 – Source: From InstaMed’s annual “Trends in Healthcare Payments” report.
> For more on this topic, read a previous article, “Why Do I Have A Balance? – Patient Payments”
Mar 10, 2020 | Live Compliance, Partner
An independent physician gastroenterology practice in Utah had to report a breach related to a dispute with a Business Associate to the Office for Civil Rights Department of HHS.
After the investigation into the breach, it was determined that the practice of Steven A. Porter, MD “had failed to complete an accurate and thorough risk analysis, and failed to implement security measures sufficient to reduce risks and vulnerabilities to a reasonable and appropriate level” and therefore, has agreed to pay a $100,000 fine.
In addition to the monetary penalty, the practice is required to implement a Corrective Action Plan (CAP). According to the investigation resolution agreement, the practice agreed to conduct a thorough Risk Analysis, the Practice must develop a complete inventory of all its categories of electronic equipment, data systems, and applications that contain or store ePHI, which will then be incorporated into its Risk Analysis and must complete a Risk Management plan. They must also revise and implement actionable policies and procedures, all of which should have been in place prior to the breach incident.
Have you ever read such headlines and doubted whether a small Billing Company or independent physician practice actually ever face penalties?
According to the Resolution Agreement, the practice must also completely reinvent its Business Associate process, and implement a strict protocol to ensure it’s Business Associates are HIPAA Compliant. In addition to ensuring their Business Associate relationships are accurate, the entire staff must undergo security and privacy training that stresses the use of Business Associate services and applications, disclosures to Business Associates that require a Business Associates agreement, or other reasonable assurances in place to ensure that the Business Associate will and can safeguard the PHI and/or the ePHI. This puts immense pressure on the Business Associates, such as Billing Companies, to ensure that they are HIPAA Compliant, but also independent physician practices to ensure their Business Associates, “down the chain” are also compliant. This is also known as gaining Satisfactory Assurance of vendor HIPAA compliance.
What can you do?
As we have stressed before, it is important for you to understand that every complaint or potential breach must be investigated by HHS/OCR. If you, a billing company, or another vendor, suspect a breach you must inform the covered entity (your client) and have a breach risk assessment completed to determine key factors and take action. Keep in mind, a business associate is a ‘person’ or ‘entity’. This means there is no Billing Company too small or too large to comply with the Federal HIPAA regulations. Again, if you haven’t completed an accurate and thorough security risk assessment prior to that, you could also be penalized under ‘willful neglect’. This category alone is $50,000 per violation!
What we do is keep this from ever being a worry for you! In fact, we have a 100% audit pass rate! For example, Live Compliance has easy to understand HIPAA breach notification training. We perform your security risk assessment and manage all your requirements, including business associates, in a clean, organized cloud-based portal. Don’t risk your company’s future, especially when we are offering a FREE Organization Assessment to help determine your company’s status. It’s easy, call us at (980) 999-1585, email me jim@LiveCompliance.com or visit LiveCompliance.com
[ Contributed by Jim Johnson, President of Live Compliance ].
Dec 10, 2019 | Administrative Safeguards, Live Compliance, Partner
ONE patient complaint leads to $2.175 Million fine! AND 2 Years of OCR Monitoring.
Contributed by Jim Johnson, President of Live Compliance
One patient complaint, that’s all it takes. Have you ever read such headlines and doubted whether a small billing company or independent physician practice would ever face such seemingly insurmountable penalties? Actually, there should be no doubt! The Sentara Hospital violations are violations that every small billing company or independent physician practice would face, not just because Sentara is a hospital.
So what happened? In short, a complaint from an individual came from a person receiving a bill containing another individual’s billing statement. As a result of Sentara investigating this breach, Sentara reported a breach affecting 8 individuals, when in actuality, Sentara mailed 577 patient’s statements to the wrong addresses. This is an example of why you must perform and document a breach risk analysis as soon as you become aware of a potential incident. It is important that you understand what a breach is and the breach notification requirements.
The second issue discovered during the investigation revealed Sentara failed to have a business associate agreement in place with an entity that performed business associate services for Sentara. This reinforces the importance of having business associate agreements in place and your understanding that BAA’s are contracts that outline timeframes and provide your attestation to a satisfactory assurance of your ability to safeguard PHI among other things.
Maybe most importantly, you should know every complaint must be investigated by HHS/OCR. What that means is, if you improperly disclose protected health information, like sending a statement to the wrong patient, you, a billing company, must inform the covered entity (your client) and have a breach risk assessment completed to determine several key factors. Then the covered entity must take action based on these findings. If you haven’t completed an accurate and thorough security risk assessment prior to that, you could also be penalized under ‘willful neglect’. This category alone is $50,000 per violation!
In fact, Texas Health received a $1.6 million fine for improperly disclosing ePHI. Texas Health failed to comply with several HIPAA requirements including failure to perform the HIPAA Security Risk Assessment.
The fines are huge, but the reputational damage to your billing company and the covered entity is expensive and difficult to overcome.
What we do is keep this from ever being a worry for you! In fact, we have a 100% audit pass rate since 2010! For example, Live Compliance has easy to understand HIPAA breach notification training. We perform your security risk assessment and manage all your requirements, including business associates, in a clean, organized cloud-based portal.
Don’t risk your company’s future, especially when we are offering a FREE Organization Assessment to help determine your company’s status.
It’s easy, call us at (980) 999-1585, email me jim@LiveCompliance.com or visit LiveCompliance.com
Keep in mind, a business associate is a ‘person’ or ‘entity’. This means there is no billing company too small or too large to comply with the Federal HIPAA regulations.
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