The Administrative Simplification
provisions of the Health Insurance Portability and Accountability
Act of 1996 (HIPAA) were established to reduce the costs
of healthcare administration, protect individual privacy,
and secure health care information. These provisions, which
create uniform standards for the handling and transmission
of individually identifiable healthcare information, can
be broken down into four separately defined standards:
Electronic Transactions
and Code Sets Standards
Among other things, this
rule establishes a uniform format for sending and receiving
electronically transmitted healthcare information,
such as claims, eligibility information and payments. It
also mandates the adoption of a standardized set of codes
that would be used to describe injuries and illnesses,
identifying the cause of the problems, and defining
the remedies administered. This section has the most obvious
correlation to a practice management system.
Privacy
Standards
These regulations define a patient's control
of their medical records, including restrictions on the
access, uses, and disclosures of their personal and medical
information. It also imposes stringent safeguards to
protect paper-based medical records, and requires that
a "Notice of Information
Practices" be given to patients that outlines
how the healthcare organization plans to use and
safeguard all health information gathered.
Security
Standards
Both the security and privacy standards
share a number of common themes, primarily in regards
to the safety of patient information. For example,
the rules require the implementation of physical
and technological safeguards to protect the security
of electronically stored health information. The
security standards also call for an administrative
infrastructure similar to the privacy standards
that manage these safeguards.
Unique Identifiers
The regulations specify that four identifiers be used
in healthcare transactions to distinguish employers,
health plans, providers, and patients. The employer
identifier is slated to be the same number as the Employer
Identification Number (EIN) issued by the Internal Revenue
Service. The provider number would be a single code
that would be used by healthcare providers with every
company they do business with. The health plan identifier
- while similar to provider numbers - are unique codes
to identify health plans. This is meant to distinguish
organizations that offer both health plans and healthcare
provider services. Individual identifiers would be used
to identify patients.
The Relationship Between Software and HIPAA
The most important
thing to remember when establishing the relationship
between practice management systems and the HIPAA regulations
is that not all of HIPAA's rules apply to medical software.
Practice management systems were originally designed
to increase productivity and reduce the chances of error.
HIPAA essentially regulates some of the software's core
functionality, such as sending electronic transactions
and restricting access to electronically stored patient
information. However, using a practice management system
does not mean that an organization will be in complete
compliance with the legislation. After all, software
cannot prevent a doctor from violating the privacy standards
by talking about a patient without the patient's permission.
Most practice management systems by design perform two
of the four tasks regulated by HIPAA: electronic transactions
and security. Software that sends and receives electronic
transactions should be pre-programmed to adhere to
the ANSI X12 standards defined by HIPAA, as well as provide
the uniform code sets for patient information that
is electronically stored. To address the security issues,
medical office software should also be able to restrict
user access to records, and more importantly, track
what activity took place with a patient's record.
While on the surface it seems as though there is very little
practice management systems can do to address the privacy
and unique identifiers standards, there are, in fact,
features that can help medical offices comply with these
regulations. Since the privacy standards require that
patients receive a letter advising them of how their
individually identifiable information will be used,
medical software systems can produce customized letters
for each patient, and can track which patients have
acknowledged receiving and signing these letters. And
just as the systems store and use the standardized code
sets, they could also maintain the employer, health
plan, provider, and patient unique identifiers.
medical office management , medical office management atlantic county , medical office management bucks county , medical office management burlington county , medical office management camden , medical office management cumberland county , medical office management hunterdon county , medical office management mercer county , medical office management monmouth county , medical office management montomery county , medical office management new jersey , medical office management nj , medical office management ocean county , medical office management pa , medical office management pennsylvania , medical office management philadelphia
electronic medical office management , electronic medical office management atlantic county , electronic medical office management bucks county , electronic medical office management burlington county , electronic medical office management camden , electronic medical office management cumberland county , electronic medical office management hunterdon county , electronic medical office management mercer county , electronic medical office management monmouth county , electronic medical office management montomery county , electronic medical office management new jersey , electronic medical office management nj , electronic medical office management ocean county , electronic medical office management pa , electronic medical office management pennsylvania , electronic medical office management philadelphia , electronic medical office management somerset county
|
