HIPAA COMPLIANCE PLAN

HIPAA Transaction Rule & Electronic Claims

MD Medical Solutions, Inc. and our assigned collection agencies, attorney teams nationwide, and billing companies are all HIPAA Compliant. The deadline for compliance with the transaction rule was October 16, 2003. The transaction rule is heavily focused on the technicalities of the electronic billing process and, in short, requires the use of standard formats whenever healthcare transactions such as claims are sent or received electronically. Therefore, to be in compliance, practitioners who submit claims electronically must use either some form of software or a healthcare clearinghouse to convert information and data into the required format.

HIPAA is working to provide practitioners with clear information about the transaction rule and the choices available to them. To that end, HIPAA is in the midst of an ongoing effort to identify electronic claims solutions that meet the needs of practicing psychologists, many of whom submit a small number of claims per month and require a service that is cost’ effective, easy to use, and accompanied by solid customer support. More information about electronic claims solutions can be gained by logging into www.hhs.gov.com and accessing the Compliance Center.

"Getting Ready for HIPAA: A Healthcare Guide to the Transaction Rule" was mailed to all HIPAA special assessment payers in September 2003 and is now available to special assessment payers at www.hhs.gov.com.

HIPAA for Healthcare Providers On-line Privacy Rule Compliance Course Available Now!

April 14, 2003 was the deadline for healthcare providers to comply with the privacy rule that resulted from the Health Insurance Portability and Accountability Act (HIPAA) of 1996. The privacy rule sets minimum standards for protecting the privacy of patient records that are or might be electronically transmitted. Most practitioners are affected by HIPAA and need to take the necessary steps to meet the requirements of the privacy rule.

HIPAA for Healthcare Providers On-line Privacy Rule Compliance Course by Healthcare Providers Practices Organization and the Healthcare Insurance Trust.

The Healthcare Providers Practices Organizations and the Healthcare Insurance Trust have teamed up to offer HIPAA for Healthcare Providers, the most comprehensive resource available to help practitioners comply with the HIPAA Privacy Rule. HIPAA for Healthcare Providers became available on January 28, 2003 on www.hhs.gov.com.

Understanding Health Information Privacy

The HIPAA Privacy Rule provides federal protections for personal health information held by covered entities and gives patients an array of rights with respect to that information. At the same time, the Privacy Rule is balanced so that it permits the disclosure of personal health information needed for patient care and other important purposes.

The Security Rule specifies a series of administrative, physical, and technical safeguards for covered entities to use to assure the confidentiality, integrity, and availability of electronic protected health information.

Health Information Is Protected By Federal Law

Most of us believe that our medical and other health information is private and should be protected, and we want to know who has this information. The Privacy Rule, a federal law, gives patients right’s over their health information and sets rules and limits on who can look at and receive their health information. The Privacy Rule applies to all forms of individuals' protected health information, whether electronic, written, or oral. The Security Rule, a federal law that protects health information in electronic form, requires entities covered by HIPAA to ensure that electronic protected health information is secure.

Who Must Follow These Laws

The entities that must follow the HIPAA regulations covered entities.

Covered entities include:

Health Plans including health insurance companies, HMOs, company health plans, and certain government programs that pay for healthcare, such as Medicare and Medicaid.
Most Healthcare Providers—those that conduct certain business electronically, such as electronically billing patients health insurance—which includes most doctors, clinics, hospitals, psychologists, chiropractors, nursing homes, pharmacies, and dentists.
Healthcare Clearinghouses—entities that process nonstandard health information they receive from another entity into a standard (i.e., standard electronic format or data content), or vice versa.

Who Is Not Required to Follow These Laws

Many organizations that have people’s health information do not have to follow these laws.

Examples of organizations that do not have to follow the Privacy and Security Rules include:

life insurers
employers
workers compensation carriers
many schools and school districts
many state agencies such as child protective service agencies
many law enforcement agencies
many municipal offices.

What Information Is Protected

Information that doctors, nurses, and other health care providers put in your medical record
Conversations a doctor has a patient’s care or treatment with nurses and others
Information about a patient’s in the health insurer’s computer system
Billing information about a patient at a clinic
Most other health information about a patient held by those who must follow these laws.

How This Information Is Protected

Covered entities must put in place safeguards to protect health information.
Covered entities must reasonably limit uses and disclosures of health information to the minimum necessary to accomplish their intended purpose.
Covered entities must have contracts in place with their contractors and others ensuring that they use and disclose patient’s health information properly and safeguard it appropriately.
Covered entities must have procedures in place to limit who can view and access patient’s health information as well as implement training programs for employees about how to protect patient’s health information.

What Rights Does the Privacy Rule Provide Over Personal Health Information?

Health insurers and providers who are covered entities must comply with patient’s right to:

Ask to see and get a copy of their health records
Have corrections added to their health information
Receive a notice that tells that patient’s how their health information may be used and shared
Decide if they want to give their permission before their health information can be used or shared for certain purposes, such as marketing
Get a report on when and why their health information was shared for certain purposes
File a complaint with their provider, health insurer, or the U.S. government if they believe their rights are being denied.

Patients should get to know these important rights, which help to protect their health information.

Patients can ask your provider or health insurer questions about your rights, or they may go to www.hhs.gov.com

HIPAA, ACA & FDCPA Compliance

MD Medical Solutions, Inc. and its assigned collection agencies’ and attorney teams’ nationwide are all members of and comply with both the HIPAA, A.C.A. (American Collections Association) and F.D.C.P.A (Fair Debt Collections Practices Act 1988.) Our assigned collection agencies are all insured and bonded.

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