WebPT Blog - HIPAA
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2 CommentsMar 25, 2013| Heidi Jannenga PT
Today's blog post comes from WebPT Co-Founder Heidi Jannenga, PT, MPT, ATC/L.
Today, copays are the norm, and they’re only becoming more costly. To top it off, many insurance plans—especially those that individuals and small businesses purchase (including HSAs)—have very large deductibles that patients must meet before insurance will pay for anything. While it’s obvious that these increased copays and deductibles put a burden on patients, they also burden physical therapy practices. How? Many practices don’t have the procedures in place for effective fee collection from patients—especially not in person. Instead, many are willing to simply write off cash collections when the patient doesn’t pay. But with declining insurance reimbursements, successful over-the-counter collections are more important than everWhat are the implications of not collecting?
In an APTA Podcast, Nancy White says, “studies show that the chance of collecting from a patient drops almost 20% as soon as the patient leaves the office.” Anecdotally, I think its higher—especially after patient discharge. While some front offices may find it easier to simply mail a statement after the visit, there are usually hidden costs associated with this. In fact, according to Nancy White, there is data that indicates “it may cost between $5–$10 per patient to send and process each statement by mail.” Not to mention that when you mail statements rather than collect upfront, you’re decreasing your chances of receiving payment and there’s a self-made waiting period for any payments patients do send. -
Aug 21, 2012| Charlotte Bohnett
This month we’ve run the gamut on compliance topics. From autonomy to HIPAA myths, we’re on a mission to simplify this oh-so-weighty topic. While we’ve provided some tips and tricks for tackling compliance, sometimes you may find your clinic in a situation that requires absolute expertise. And because most small to mid-size clinics simply cannot afford to staff a full-time physical therapist and compliance officer, it’s a good idea to turn to a consultant. But there’s lots to consider before hiring any ol’ compliance consultant. Here are four to ponder:1.) Credentials
As is the case with hiring for any position, experience is key. When shopping around for a compliance consultant, make sure they have the necessary credentials to ensure trustworthiness and peace of mind.
One must-have credential? Compliance certification! According to Nancy Beckley (@NancyBeckley), “CHC credential [is a] good place to start.” The Certified in Healthcare Compliance (CHC) website breaks down their certification process and details the following benefits of certification:- Enhance the credibility of the compliance practitioner as well as the credibility of the compliance programs staffed by these certified professionals.
- Assure that each certified compliance practitioner has the broad knowledge base necessary to perform the compliance function.
- Establish professional standards and status for compliance professionals.
- Facilitate compliance work for compliance practitioners in dealing with other professionals in the industry, such as physicians and attorneys.
- Demonstrate the hard work and dedication necessary to perform the compliance task.
The Health Care Compliance Association also promotes CHC and encourages certification. In fact, the HCCA CEO wrote quite an impassioned letter regarding the topic entitled “Compliance certification by the profession, for the profession, and of the profession.” The AAPC also issues certification (Certified Professional Compliance Officer), which one can attain through an AAPC membership and rigorous examination.
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Aug 16, 2012| Erica Cohen
Today's blog post comes from WebPT copywriters Charlotte Bohnett and Erica Cohen.
So, you probably remember a few weeks ago we wrote a pretty comprehensive overview on how you can ensure HIPAA compliance in your clinic. We covered everything from HIPAA basics to continuing education and training. In case you didn’t have a chance to read it, here’s a refresher:
US Congress established the Health Insurance Portability and Accountability Act in 1996. They implemented Title II: Preventing Health Care Fraud and Abuse to protect a patient’s private health information (PHI).“Under this act, all healthcare providers, insurers, and their business associates may only collect, share, or use a patient’s PHI in approved methods and only for the explicit purpose of furthering patient care.
“A HIPAA violation can be anything from discussing identifiable patient information with your friends over lunch to leaving your not-password-protected work laptop open at a coffee shop. And, if you are found to have committed wrongful disclosure of individually identifiable health information, there are financial and criminal repercussions—including fines of up to $50,000 and one-year imprisonment.”
Now that we all know the basics, how about we tackle something a bit more tricky: HIPAA myths. There’s a lot of lore out there surrounding mobile devices and technology. What’s compliant? What isn’t? Can I use this? What about that? Let’s nip these worrisome quandaries in the bud here and now. Enter the WebPT mythbusters!
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Aug 2, 2012| Charlotte Bohnett
Today's post comes from WebPT copywriters Charlotte Bohnett and Erica Cohen.
The Health Insurance Portability and Accountability Act (HIPAA) is as dense as it is important. But for any healthcare provider handling private personal health information, which you promised to protect as part of the Health Information Privacy Rule, there are a few things you must know.
First, a little background information on HIPAA: US Congress established the Health Insurance Portability and Accountability Act in 1996. They implemented Title II: Preventing Health Care Fraud and Abuse to protect a patient’s private health information (PHI).
Under this act, all healthcare providers, insurers, and their business associates may only collect, share, or use a patient’s PHI in approved methods and only for the explicit purpose of furthering patient care.
PHI is defined as demographic information; medical history; test and laboratory results; insurance information; and any other data health professionals collect to identify individual patients and determine their appropriate care. -
May 2, 2012| Lindsay Bayuk
We've seen that patients data privacy and liability are two top concerns for PTs as they relate to the adoption of cloud-based EMR systems. Typically there is concern about information getting “hacked” online. We’re here to tell you there’s no need to worry. Cloud computing can actually make your dreams come true.
The US Department of Health and Human Services has released a report on HIPAA violations last year. Michael Koploy from Software Advice shared this data with us and crunched some numbers:
- 6,800 paper records that were supposedly mailed but never received
- an impostor posing as a recycling-service employee stealing over 1,300 individuals’ records and films
- a laptop stolen by a former employee that contained personal health records of over 50,000 patients
As Michael concluded in his article “HHS Data Tells the True Story of HIPAA Violations in the Cloud,” hacking electronic records is not the major concern for “stealing” patient data. The real problem? Medical professionals losing their hard drives or lost paper records. Is inadvertently leaving your laptop in an unlocked car a potential risk? Sure. It’s more of a risk than someone hacking data hosted in the cloud. Patient data stored in a secure cloud environment is safer than paper records or even local devices.
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Feb 22, 2012| Lindsay Bayuk
Today's post is contributed by Greg Babiec, Physical Therapist, and Owner Evolve Physical Therapy & Sports Rehabilitation in New York. Greg is also a member of WebPT. You can follow him on Twitter at @DrBadBack. Thanks, Greg, for contributing your insights and expertise today!As a PT, understanding how health insurance works can sometimes be an unpleasant yet important part of the profession. Of course, treating patients is our primary role but since we spend so much time with our patients, taking an opportunity to educate them about their insurance can set us apart from other health care professionals. I recommend a bit of research about the insurances you deal with most and a good place to start is on the APTA website.
In my experience there are a few key things that we as PTs should know about insurance:
1) Understanding the insurance verification
2) What is the patients responsibility
3) What is your responsibility as the PT
Once a patient attempts to schedule an appointment for PT, most PT clinics have an administrative staff member perform an insurance verification. I think all PT’s should do a few just for the experience. If you have never done an insurance verification before, its very simple and usually is best done with a phone call to the insurance company. Once the patient provides you with their information, call the insurance company to speak to a representative.
The rep will tell you about the co-payment, co-insurance, deductible and maximum out of pocket costs. Do a web search for these terms or read something like this so that you know the difference. The rep will also tell you if the patient needs authorization, how many visits they get and if there are special forms that need to be filled out. Try to get a good understanding of what needs to be done so that you know what the patient needs to do and what things you need to do.
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Dec 8, 2011| Lindsay Bayuk
We’re seeing a lot of talk about 5010 as the end of the year approaches. Curious to learn more, we took it to our resident experts, Kayla Milburn and Paul Schwartz, for all the answers.Lindsay: Kayla and Paul, thanks for taking time today to tell us about 5010. Can you tell me what physical therapists should know about 5010?
Paul: Not much. This change is really important for insurance companies and billing companies. Any physical therapist that uses an in-house software such as Kareo, or outsources their billing doesn’t have much to worry about. CMS has more resources and AMA has a toolkit to get started with 5010.
“Practices that conduct one or more of the HIPAA transactions electronically, such as submitting a claim or checking a patient’s eligibility, or rely on a billing service or clearinghouse to do this on their behalf, are affected by this change.” - American Medical Association
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