Top HIPAA Violations that Can Affect Your Healthcare Organization’s Reputation
HIPAA violation is one of the biggest challenges that healthcare organizations are facing these days. There has been a record of fines reaching up to $50,000 per occurrence and a maximum annual penalty of $1.5 million per violation. Therefore, medical practices need to ensure they stick to HIPAA compliance. While all HIPAA violations are potential threats, some are more common than others. Also, HIPAA regulations are complex and ever-changing. When you ensure the staff is well-trained on HIPAA compliance and understanding which violations occur the most often. The practice can more adequately protect against any form of violation.
Here is a list of the most common HIPAA violations that revenue cycle management companies shall focus on.
An essential part of the revenue cycle management, staff members must keep documents with PHI in a secure location. Besides, physical files containing PHI must be locked in a desk, filing cabinet, or office. For example, a professional healthcare debt collection agency will lock digital files with passwords. Moreover, they’re encrypted whenever possible.
The dangers of leaving PHI data vulnerable without encryption are pretty simple. Encrypting the data is an added protection, especially when there’s a high chance of getting stolen or lost. In addition, it offers an additional layer of security when a password-protected device is somehow accessed, i.e., through hacking.
While encryption is a stringent requirement from HIPAA, revenue cycle management companies will ensure they don’t compromise in such circumstances. You must be familiar with State’s HIPAA regulations, as many States have passed laws requiring ePHI and PII to be encrypted.
While we think it would never happen, there have been circumstances where hacking has been a real threat to medical ePHI. In addition, some people will use the information for malicious purposes; therefore, revenue cycle management companies need to protect against hacking wherever possible.
When keeping antivirus software updated and active on all devices containing ePHI, it’s definitely a great place to start. With firewalls, you can add another layer of protection as well. Meanwhile, creating unique and difficult-to-remember passwords, and changing them frequently, is another essential measure to prevent hacking.
Loss of devices
There was a case registered back in 2016 where an iPhone got stolen. The device contained many ePHI, including social security numbers, treatment and diagnosis information, medications, etc. This left ePHI vulnerable to access by anyone possessing the phone.
A combination of home residents and family members, 412 people, were affected due to the data breach, and the facility was fined $650,000. Unfortunately, when devices containing ePHI are not stored in a secure location, they’re subject to lose or theft.
Devices containing ePHI aren’t stored in a secure location at all times; they might be subject to loss or theft. Furthermore, when the information stored on such devices is not encrypted or password protected, the loss or theft of the device becomes even more severe.
When it comes to employee training in HIPAA compliance, it’s essential that every member who needs to work with data be thoroughly educated. Employee HIPAA training is more than a recommendation; moreover, it’s a requirement of the HIPAA law.
All staff members must be well-trained in the laws of the particular policies and procedures set forth by the individual practices.
PHI should always be off-limits. When talking to coworkers, there’s no reason to discuss PHI. Plus, it comes with a hefty fine. Medical practice employees with access to patient PHI need to be careful about the information they share with others. When discussing PHI, one must always be aware of who may be listening. You must keep the conversation about PHI behind closed doors and only with appropriate personnel.
Improper disposal of records
When training staff members on HIPAA regulations, one of the most effective procedures is to ensure proper disposal of PHI records. Staff members must also understand that all information that contains PHI, i.e., social security numbers, medical procedures, diagnoses, etc., should be shredded, destroyed, wiped from the hard drive, etc.
Unauthorized information release
Unauthorized information release is another violation that occurs when the media release PHI regarding public figures. This may occur when medical personnel releases PHI to unauthorized family members. You must also know that only dependents and those with a Power of Attorney are allowed to access the PHI of a family member.
3rd party disclosure of PHI
When discussing PHI, it should only be discussed with the people who need to know. This may include the patient, the doctor, and the person billing for the procedure, medication, or other related services. When you have access to PHI and discuss it with those who do not have proper access to this information is a direct violation of HIPAA.
But it does happen frequently. When you educate all staff members with access to PHI about HIPAA regulations, you can eliminate the majority of data breaches caused due to the violation.
Another example of 3rd party disclosure would be when the revenue cycle management companies were to release the wrong patient’s information due to human errors. The act may be an accident; however, the consequences would be similar to those for a purposeful violation.
Keeping the medical practice staff well-educated on HIPAA regulations and ensuring all the policies and procedures reflect the most current rules associated with the law should be the target. In addition, a well-trained team of healthcare debt collection agents can make things possible. Also, avoiding ending up with a hefty fine or even jail time is what you can expect.
Boosting your performance
Updating the revenue cycle management strategy is a great place to start when it’s about boosting revenue for medical practice. RCM is a process of handling payment information. With a solid RCM strategy, it’s easy for small errors to cause delays in payments and negatively impact earnings.
Improved patient registration accuracy
It’s essential to start strong by obtaining comprehensive information during patient registration. You must ensure they have accurate and complete contact, payment, and insurance information that help reduce errors during the filing and payment.
Automate scheduling and appointment reminders
With advanced technology throughout the scheduling process, you can ensure patients have a user-friendly experience. In addition, it solidifies long-term payment loyalty. Finally, an appointment reminder alleviates the burden on administrative staff and increases patient follow-through.
Automate patient eligibility
Avoid claim denials by automating the patient eligibility verification process. There’s another opportunity to reduce the strain on in-house staff. When you can pre-determine patient eligibility with the insurance carrier, you’ll receive timely service payments without any unwelcome complications.
Healthcare debt collection agency will house all the relevant data on an accessible cloud-based system. It’s more about ensuring that all administrators and caregivers access the same information throughout the treatment and billing process.
Billing software enables you to submit correctly coded claims to insurance providers easily. The claim generator system is what revenue cycle management companies utilize to categorize and catch errors early in the filling process.
Outsource a professional firm
There are some goals you must consider to run the service seamlessly.
With most healthcare organizations operating in negative margins, cost reduction is a critical goal. Unfortunately, while most service providers offer labor arbitrage-based savings, only some can sustain that savings model and enhance upon that year over year.
Partnering with a professional service provider with a stack of pre-built automation tools reduces manual effort and total costs to collect.
Hospitals lose 3-5% of their revenue due to issues such as DNFB and addressable denials. Inefficient coding, ineffective follow-up, and denial clearance programs are some issues you need to keep in mind. This revenue loss is often more than 3X what you pay an offshore revenue cycle service provider and effectively makes the entire outsourcing program accessible.
Over the last few years, the increase in High Deductible Health Plans has led to the patient’s emergency as a more significant payer of services. Here, the outsourced team needs to handle patient outreach processes, including appointment scheduling, registration, self-pay estimation, and collections, with empathy and efficiency.
At Vital Solutions, we simplify the overall patient management process. We implement the latest cutting-edge technology, prioritizing innovation and partnering with industry experts. As a result, we run a different approach, proactively analyzing the workflow and KPIs to deliver the best possible solutions to your practice.