Patient Access Technology
Published March 3, 2011 | 
We are required to use and learn about a variety of different technologies everyday in our job. Our industry is forever changing and we are required to keep up with it. From copiers that can not only copy insurance cards but can also fax them or upload them to your computer to touch I-Pads for bedside registrations. We are also required to learn all the software that controls those machines as well. With the enactment of HITECH – Health Information Technology for Economic and Clinical Health Act that is requiring medical providers to adopt health information technology and to ensure that all electronic medical information is protected and the privacy of the patient is maintained. Our industry depends on electronic transmission of claims, online verification of insurance and precertification of services and we are being tasked with identity theft protection as well (Red-Flag Rules).
One of the solutions that is coming of age is the medical smart card. The Smart Card Alliance has a website with an abundance of helpful information that explains what they are and how they work. These are general credit cards with special chips that hold information on patients and can include demographic, insurance and patient medical records. Some have pictures on the card or within the demographic info section. They can be plastic cards, fobs, subscriber identity modules (SIMs) used in GSM mobile phones, or USB-based tokens (kind of like a flash drive you put into a USB port). The Alliance even offers certification classes for those who wish to take them. Check out their website to read more at: http://www.smartcardalliance.org We have even read about a Patient Access Kiosk that will allow the patients to check themselves in for services, pay copays and updated their own demographic and insurance information! (Watch Out We May Become Obsolete)
Health Care Reform For Patient Access Reps
Published May 1, 2010 | Of course the most talked about subject in healthcare is the new Healthcare Plan that is now a law. As Medical Clerks we really need to understand the changes coming and to be able to help our patients understand some of their rights under the new plan. There are literally hundreds of different websites that have information on the changes that are taking place now and in the future. Which one you choose to read is really up to you. Read your employers information as well as some of the different medical associations websites for updates now and in the future. Be sure to bookmark the ones you find the most useful.
http://www.whitehouse.gov/issues/health-care
Here is an excerpt from their website:
“It makes insurance more affordable by providing the largest middle class tax cut for health care in history, reducing premium costs for tens of millions of families and small business owners who are priced out of coverage today. This helps 32 million Americans afford health care who do not get it today – and makes
coverage more affordable for many more. Under the plan, 95% of Americans will be insured.
It sets up a new competitive health insurance market giving millions of Americans the same choices of insurance that members of Congress will have. It brings greater accountability to health care by laying out commonsense rules of the road to keep premiums down and prevent insurance industry abuses and denial of
care.
It will end discrimination against Americans with pre-existing conditions. It puts our budget and economy on a more stable path by reducing the deficit by more than $100 billion over the next ten years – and more than $1 trillion over the second decade – by cutting government overspending and reining in waste, fraud and abuse.”
The second website we looked at is simply called the HealthReform.gov The information on the website is geared mostly towards patients and small business who are most affected by the changes. There is a pretty good FAQ section for both. It also has news sections for each state.
So give these two websites a try and read through the information. The more you know and understand about insurance the better able you will be to help your patients and your employer!
Red Flag Law Updates
Published November 15, 2009 | If you haven’t heard yet the “RED LAWS”, Red Flag Policies or Identity Theft Prevention requirements for medical profession businesses have been postponed until next year. Yes, each medical practice will be required to have written policies for their employees to adhere to help fight Identity Theft of their patient’s information. The new laws have been modified to exclude medical practices with less than 20 employees and will not be officially enforced until June 1, 2010.
There is a report produced by the World Privacy Forum that has some very helpful information for Healthcare Practitioners and their office personnel: http://www.worldprivacyforum.org/pdf/WPF_RedFlagReport_09242008fs.pdf
For Healthcare practitioners that might be excluded from these rules you can read the HealthLaw Blog on the subject at: http://www.healthlaw-blog.com/2009/10/small-business-exemption-from-the-red-flag-rule-new-legislation/
To read more about the rule and how it affects medical offices go to the Federal Trade Commissions website at: http://www.ftc.gov/bcp/edu/pubs/articles/art11.shtm
Red Flags and Healthcare Providers
Published October 1, 2009 | Hey gang! Do you know what a “Red Flag’ rule means to healthcare providers? If you haven’t been keeping up with the news lately it seems that the Federal Government has written a specific rule to protect the identity of your patients that doesn’t have anything to do with HIPAA. There is a great article about the requirements on the web by the Federal Trade Commission. That is the agency that will be regulating the industries to make sure they are following the rules. Read the article for yourself at: http://www.ftc.gov/bcp/edu/pubs/articles/art11.shtm
Here is an excerpt for you to read: “Health care providers may be subject to the Rule if they are “creditors.” Although you may not think of your practice as a “creditor” in the traditional sense of a bank or mortgage company, the law defines “creditor” to include any entity that regularly defers payments for goods or services or arranges for the extension of credit. For example, you are a creditor if you regularly bill patients after the completion of services, including for the remainder of medical fees not reimbursed by insurance. Similarly, health care providers who regularly allow patients to set up payment plans after services have been rendered are creditors under the Rule. Health care providers are also considered creditors if they help patients get credit from other sources — for example, if they distribute and process applications for credit accounts tailored to the health care industry.
On the other hand, health care providers who require payment before or at the time of service are not creditors under the Red Flags Rule. In addition, if you accept only direct payment from Medicaid or similar programs where the patient has no responsibility for the fees, you are not a creditor. Simply accepting credit cards as a form of payment at the time of service does not make you a creditor under the Rule.
The second key term — “covered account” — is defined as a consumer account that allows multiple payments or transactions or any other account with a reasonably foreseeable risk of identity theft. The accounts you open and maintain for your patients are generally “covered accounts” under the law. If your organization or practice is a “creditor” with “covered accounts,” you must develop a written Identity Theft Prevention Program to identify and address the red flags that could indicate identity theft in those accounts.”
Whether or not your office meets these requirements or not it is best to have some kind of written policy about protecting your patients identity to meet HIPAA. Also, it is best to be able to prove you are treating the person you are supposed to treating. With all the push for Electronic Medical Records these days it might be a good idea to have a copy of the patient’s photo ID within them. In our emergency room we are required to ask for a Photo ID AND copy the fronts and backs of all insurance cards to keep with each episode of care. With the volumes of patients that we see there are instances of people using the insurnace cards of others or giving the wrong demographics to receive care. There is not a lot you can do about that because of the EMTALA law but we do get some illegals and drug-seekers who hospital hop. All you can do is be consistent with your registration requirements and verify their information everytime the patients come into your clinic or hospital.