Hop on the HIPAA Omnibus

In the world of HIPAA we have a dizzying array of acronyms to keep straight:  HITECH, NPP, PHI, GINA, AFEHCT and on and on… Now, the HIPAA regulators at the U.S. Department of Health and Human Services (HHS) have coined a catchy term for the new HIPAA compliance laws that went into effect this Monday, September 23, 2013:  The HIPAA Omnibus Rule

The HIPAA Omnibus Rule is a more stringent set of standards and regulations which provides stronger privacy rights for patients.  The privacy rights are outlined in a new Notice of Privacy Practices (NPP) document which medical providers must give to new patients as of September 23, 2013.  New patient rights include the following: 

  • Patients now have a right to tell their provider to not share information with their health insurer about treatment paid for out of pocket.  According to practice management consultant Mary Pat Whaley, these private payments are often for psychiatric or mental health treatment, which patients do not want their insurance plans to know about. 
  • Stronger regulations are also in place regarding how patient health information may be used and disclosed for marketing and fundraising purposes.  
  • Privacy regulations now extend to business associates of medical providers, including outsourced billing companies.  As a result, we expect third party billing services to become even more cautious and strict regarding the release of patient information in the weeks and months ahead.  

As all of us in the world of litigation know, obtaining complete medical records is one of the more difficult and pain-staking aspects of working up the case.  We will keep our fingers on the pulse of these developments in the months ahead and we will keep the legal world apprised of any changing requirements regarding authorized access to patient medical and billing records.  

For any questions regarding access to medical records under the new HIPAA Omnibus Rule, please feel free to contact MEDRECS, Inc

In light of these new HIPAA regulations, we suggest that any office or firm that stores or accesses patient medical records provide HIPAA compliance training to staff and personnel on a regular basis.  The laws are constantly being updated and the penalties for HIPAA violations continue to become more serious.  Links to helpful websites are below. 

MEDRECS FAQ Page: http://www.medrecs.com/Home/FAQ

Healthcare-Informatics: http://www.healthcare-informatics.com/news-item/breaking-hhs-releases-hipaa-update

HHS Website: http://www.hhs.gov/ocr/privacy/index.html

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Patient Billing Records – the thorn in your side…

Common reaction to chasing billing records

Are Missing Patient Billing Records Ruining Your Day?

Stress no more.  MEDRECS will take care of it for you:

MEDRECS Inc. has a handle on the dizzying vicissitudes of the patient billing record industry.  We call this an “industry” because the recent proliferation of outsourced billing companies has snowballed into BIG business, on a national scale.  There is now a nationwide labyrinth of billing services, hospitals, ER departments, and parent medical systems, with requirements so complicated it will make your head spin.  The most immediate and perplexing consequence of this is that clinics and hospitals are less and less likely to maintain their own patient billing records, and often times they do not have correct information regarding how to retrieve the billing records.  Below we provide some very valuable information to help illuminate some of these recent changes for you:

EPBS Intermedix is an emergency physician billing service in Oklahoma which maintains patient billing records for no less than 6 Washington State providers.  As of recently, EPBS now requires the “emergency/medical group” name on the patient authorization –  i.e. they will no longer accept just the Hospital name on the authorization.  Below are the Hospital names with the corresponding group names that must be on the authorization. 

Capital Medical Center – Thurston Emergency Group 

Valley General – Northsound Emergency Medicine 

Swedish Medical First Hill – Seattle Emergency Physicians 

Auburn Regional – Cascade Emergency Physicians 

Holy Family – Emergency Physicians Services

Similar requirements are now in place for our local facilities in Washington: 

Association of University Physicians now requires the authorization to list not only the Hospital but the exact medical group, clinic, or emergency physicians for which you desire billing records.  

Similarly, Swedish Cancer Institute requires us to request patient billing records from 3 separate contact fax/phone numbers depending on which services were provided.

It is critical to be aware of these requirements in advance so you can plan accordingly and prepare the necessary request information.   MEDRECS is here to help you and your law firm navigate the challenging world of medical and billing record retrieval.  Please leave a comment or let us know if you have any questions.  We are always happy to help!

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