Tag Archives: medical

All You Need To Know About HIPAA Business Associate Agreements

18 Aug

Source:  Jeff Broudy, PCIHIPAA

Medical and dental practices are hearing more and more about large fines and data breaches surrounding HIPAA (Health Insurance Portability and Accountability Act of 1996).   Many are fearful that significant fines could affect their practice, their patients, and their livelihood.  Is this a real threat?  I believe it is.  HIPAA law is confusing and protecting the security and privacy of your patient information is critical.  And with the enactment of the Omnibus Rule back in 2013, HIPAA compliance now extends to your Business Associates.

The Ponemon Institute states that 39% of all Business Associates have experienced a data breach, and in one case a practice was fined $31,000 for not having a Business Associate Agreement on file.  That’s an expensive document!

As HIPAA Compliance Specialists, a day rarely goes by that we don’t receive questions about Business Associates.  “Who’s a Business Associate?”  “Do I have risks if I don’t have execute the proper agreements?“ What does my practice need to do?”  In fact, out partners at PCIHIPAA created a HIPAA Webinar Series for our clients to help answer these questions.  Let me know if you would like more information on this webinar series, and let me help clarify some of these questions.

1 ) “Do I need to have a Business Associate Agreements on file?”

Yes.  If you are a Covered Entity under HIPAA, you are required to execute Business Associate Agreements. The Health and Human Services website (HHS.gov) defines a Covered Entity as health care providers who electronically transmit any health information in connection with transactions for which HHS has adopted standards.

Bottom line:  Examples of Covered Entities under HIPAA are: Doctors, Clinics, Psychologists, Dentists, Chiropractors, Oral Surgeons, Podiatrists, Opthamologists, Nursing Homes, Pharmacies, Health Insurance Companies, HOMs, Company Health Plans, and Labs are all considered to be Covered Entities.

2) “Then, who is a Business Associate?

A Business Associate as any organization or person working in association with, or providing services to, a Covered Entity who handles or discloses Protected Health Information (PHI) or Personal Health Records (PHR.)  A business associate may also be a subcontractor that creates, receives, maintains, or transmits PHI on behalf of another business associate.  Think of it this way, if you contract with a person or an entity that needs access to your PHI to do their job, they are most likely a Business Associate.

Bottom line:  Examples of Business Associates are Lawyers, Accountants, IT Programmers and Representatives, Shredding Companies, Marketing Software Companies, Practice Management Software Providers, Data Backup and Storage Companies, and Billing Companies.   

“Are there exceptions?”

Yes.  HIPAA excludes conduits of information (UPS, FedEx), governmental agencies (Medicare and Medicaid), and anyone else this is not required to handle your PHI to do their jobs (Janitors, Landlords, Water Delivery Services).  Also your employees are not considered Business Associates.  They need to be trained on HIPAA, but you don’t need to execute Business Associate Agreements with your employees. 

3) “What exactly is a Business Associate Agreement, and why is it important?”

A Business Associate Agreement is a binding legal document that is now required under HIPAA for you to execute with all of your Business Associates. It is imperative that your practice has Business Associate Agreements in place, with a log kept for reference. Because your practice (as a Covered Entity) is sharing PHI with your Business Associate, this document ensures that the HIPAA mandates are in place and that your patients are protected.   If you use the right Business Associate Agreement, it also includes an “Indemnity Clause.”  The Indemnity Clause protects you financially, if PHI is compromised under your Business Associate’s watch.  This is a crucial clause that should be included in any Business Associate Agreement you execute.

Contact me for more information and/or assistance in creating a Business Associate Agreement (BAA) for your practice.

Click Here to take a free, no-obligation, HIPAA Risk Assessment.  The results will inform you of where you are compliant and where you are deficient in your HIPPA security.

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Podcast For Business – Are You Getting Paid?

15 May

Are You Getting Paid with David Wiener – Podcast For Business

The serious problem businesses have with collections is real. And it’s not going to get better any time soon. Today’s talk with David will shed some light into the world of collections and offer some real solutions to businesses who are struggling with receiving payment for services rendered.  Listen to this important podcast by clicking here.

Contacts:
David Wiener
Phone: 770-224-8504
Website: http://cashflowstrategies.us
Twitter: https://www.twitter.com/mr_cash_flow
LinkedIn: https://www.linkedin.com/in/cashflowstrategies

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Taming Your Cash Flow Before It Eats You Alive

23 Apr
Source – TSI  http://tsico.com

There are no shortage of “beasts” your business needs to tame in order to thrive in the marketplace.

Some might read that and think of scaling to meet the needs of a growing client base or managing difficult employees, but cash flow can be one of the biggest monetary monsters you can encounter as a business owner. This far-to-often overlooked financial factor can be contained as easily as it can go out of control. Take a look at these four simple, yet sound, principles for taming cash flow in order to make it your business’ best friend rather than an arch enemy.

Let’s discuss how to keep the cash coming in rather than rolling out.

1. Increasing Incentives to Deter Debt Collection

This might seem like a simple psychological trick, but it is an easy way to tame the cash flow beast. Adding incentives for clients who consistently pay on time (or, even better, early) and/or having consequences for clients who are tardy with the amount due will help you keep your cash flow steady and on time. Another way to ensure cash flow is to offer incentives to clients who decide to pay in full rather than installment payments. You can rest assured you get all the cash you need with only a minor deduction of a discount, or whatever incentive you choose. A small discount now is better than having to pay for debt collection later to support cash flow.

2. Cash Flow Cognizance: Being Present & Aware of Cash Flow

It’s your business, livelihood, and financial future. So, why wouldn’t you want to be as aware of and up-to-date with all of your cash flow details? Analyzing your monthly cash flow and keeping a more frequent check on accounts receivable will help you stay on top of delinquent payments from clients and reel in any out-of-control outgoing cash on your part. Knowledge is truly power, as it can be easy to overlook cash flow issues. Awareness equals accountability for you and for your accounts receivable.

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Being keyed into your cash flow is the best way to continue saving money instead of burning up revenue.

3. Be Crafty With Credit Cards

Utilizing credit cards in the right way is another simple way to tame your cash flow. Not only do credit cards provide you more time to make payments as it can take 1-2 months for money to be deducted from your company account, but you can increase your credit score over time to gain access to even more benefits from your credit cards. The number one thing to remember for this tip to be successful is that you must always pay the balance in full and on time to avoid even more cash out with extra interest fees or penalties.

4. Consider Your Taxes

Taxes are, unfortunately, unavoidable. You have to factor them in when analyzing cash flow. If you are not taking the cost of taxes into consideration, then you are not properly projecting your cash flow and will be doing yourself a disservice. Automatically set aside the taxes that you will need to pay out and don’t even factor this money into anything you could utilize as cash out for your business. Try to even save extra just to have a cash buffer. In tough times, a little buffer can go a long way. You can also check into any tax discounts and creditsthat could be applicable to your business, because who doesn’t like a little help from time to time?

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Stay educated on business taxation to continue to tame cash flow.

Keeping these cash flow tips and tricks in mind will help your business position itself for the most potential profit and the least unnecessary loss. There’s a lot more of these principles to be taught and we can help you learn more about how to optimize your revenue today! content?Action=tp&cid=45676

Call me directly at 888-780-1333 or email me at david.wiener@cashflowstrategies.us for more information.

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Has Your Medical/Dental Practice Had It’s “Checkup?”

13 Apr

There are many things that can cause a busy medical or dental practice to be less profitable that it could be.

Meet Dr. Bob and how he found the answer to higher profits and better cash flow for his practice.

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Is Your Collection Agency Putting Your Medical or Dental Practice at Risk?

11 Apr

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The collection agency industry is highly regulated and there are numerous laws on the books designed to protect consumers, which make it more difficult to collect. While it costs agencies more to be legally compliant and hinders their collections efforts, not complying can lead to class action suits and sanctions against the agency (and possibly their clients) that are more costly in the long run if not fatal to the agency’s very existence. Lets examine how this affects your practice.

The Laws You Know

Most Practice Administrators are familiar with the Fair Debt Collection Practices Act (FDCPA) of 1978 which creates a set of guidelines that collection agencies are required to follow as well as penalties for not adhering to the Act. Additionally, practices are familiar with HIPAA laws and the security requirements of Protected Health Information (PHI).

But Do You Know About These Laws?

Despite having been a law since 1991, most practices are not familiar with the Telephone Consumer Protection Act (TCPA)  which also impacts collections. Among other provisions of the TCPA (such as calls can only be made between 8am and 9pm), the TCPA prohibits the use of automated dialers to cell phones or leaving automated messages on cell phones. While auto-dialers represent a technological efficiency that allows a collection agency to make more frequent calls and collect more money, their use is not compliant with the TCPA when the phone number the patient has provided the practice with is a cell phone. In order to be TCPA compliant when calling a cell phone, it must be manually dialed. Even if a live collector will be connected with the consumer upon pick up, a cell phone can not be dialed using a computer.

Medical Collections Impact

A recent data analysis by Transworld Systems, a large national collection agency specializing in medical collections, revealed that 60% of the phone numbers that their medical practice clients are obtaining from patients are cell phones. In order to avoid fines of $1500 per incident and class action suits, Transworld Systems has enforced strict policies of identifying and separating land line numbers from cell phone numbers. Additional research is conducted to see if the patient also has a land line which can be put on an auto-dialer to obtain better contact rates.

What does all this mean for your practice?

Today with the ever-changing federal and state regulations, you need to ask more questions of your collections vendor to find out if they are compliant with all laws. Ensure your practice cannot be named as a co-defendant in a potential class action suit should your agency be accused of being non-compliant. It is important to have a Hold Harmless Agreement in your collection agency contract where the agency agrees to hold your practice free from responsibility for any liability or damage that might arise out of their collection activities. Ask questions first before you have to answer for shortcuts or missteps later that could result in hefty fines for lack of compliance. It is paramount to ensure your company of choice is an expert in their field who stays abreast of, and quickly adapts to, the seemingly endless stream of regulations designed to protect consumers rights, often at the expense of their creditors.

Here is a sample list of questions to ask your current agency and any potential collection agency you are considering working with:

1.    Is your company compliant with TCPA, HIPAA and familiar with state laws regarding collections?

This is not a yes/no question, they should be able to provide additional information including how often their collectors are re-tested for compliance and how their performance is monitored for compliance.

2.    Does your company perform background checks on collectors in required states?

3.    How are cell-phone calls handled?

If they dont maintain a separate policy for handling cell phone calls, that should be a red flag to you to find another vendor.

4.    Do you know what PHI is and what steps do you take to ensure its security during storage as well as communication with our practice?Ask how they receive data from their clients (do they accept secure electronic encrypted data or do they expect you to fax or mail patient files which are more easily compromised?) Do they provide you with a secure website to view collections status and if not, do they at least have the ability to encrypt emails when attaching a list of status updates which include PHI.

5.    Is your company licensed to collect in all states?

Even if your patients are primarily local to your office, sometimes they move out of state and your agency will have to be compliant with the laws that govern the patients new residence.

6.    Is your company bonded and insured?

Ask for copies of the documents proving bonding and insurance to make sure your money wont disappear if your agency goes out of business, either as a result of poor performance or as a result of a fatal class action suit.

Call me at 888-780-1333 for a 100% compliant option that will keep you and your practice safe during these times of changing and ever-increasing regulations.

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RECOGNIZING THE FOUR PATIENT PAYER TYPES

20 Mar

The way that healthcare approached patient payers in the past no longer works nearly as effectively as it once did.  With the dramatic rise in high deductible health plans (HDHP) and higher co-pays, collecting patient balances quickly and effectively is imperative.  The “one size fits all” approach is dead, both in follow-up and collections of slow-pay and delinquents accounts.

Reasons for a patient not paying the bill when due can be varied.  Some don’t pay on time because of financial reasons, many times because of the high deductibles in their health plan.  Others have the funds but, due to confusion surrounding their insurance policy, aren’t sure the balance is correct.  Others are simply too disorganized to remember to find the statement and pay the bill when they have the money.  Still others feel that their insurance has paid enough and the practice should be satisfied with that.  Some will say, “that doctor is rich, he doesn’t need my money!”

It is a delicate balance that practices must strike to be aggressive enough to motivate the patient to pay the bill without being so aggressive that the practice risks losing what might be a profitable patient in the future.  Some practices spend great deals of money with internal follow-up through statements, phone calls and letters, not realizing that each contact with a patient in follow-up internally can cost the practice between $10-12.  That expense, not to mention the staff time and attention this takes, can wind up making the whole follow-up proposition more expensive than it is actually worth.

So what is a practice supposed to do?

We, at TSI (formerly known as Transworld Systems) have determined that there are actually four distinct types of patient payers.  Each is motivated in a different way to pay the bill, and it is a mistake to treat them all the same.  They are:

THE DUTIFUL PAYER

The dutiful payer feels a keen responsibility to pay their debts in a timely manner.  They are motivated to pay the bill by the initial statement you send following patient responsibility.  Fortunately, they are (or should be) the largest category in your practice.

THE DISTRACTED PAYER

The distracted payer has the very best intentions to pay your bill, but they seem to be so busy and distracted that they misplace your statement or just forget to pay it.  Timely reminders are sufficient to motivate them to get that bill paid.

THE DISRESPECTFUL PAYER

The disrespectful payer tries to see what they can get away with, and hope that you will give up trying to collect the bill if they dodge you long enough.  They do not respond to your statements, letters, or phone calls.  Rather it will take a contact by a third party collection agency for them to be convinced that the practice is serious about collecting the debt.  That alone will motivate them to pay, and they will generally pay the bill after they receive the first contact by that third party.

PROFESSIONAL DEBTOR

The professional debtor never intended to pay the bill when they received service.  They are likely in collections with other creditors already.  These, and these alone, need to be in the hands of professional collectors, familiar with medical debt, before too much time has elapsed and too much money has already been spent chasing them.

TSI offers a free interface that works with virtually all dental software to help you identify which type of category each patient falls into, and tools to communicate with them in an appropriate manner.  The practice retains control of each account, and the type of communication that is being used on a particular patient.  These tools eliminate the need for the practice to continue time-consuming internal chasing of accounts at a cost that is generally less than they are spending on follow up currently.

For a full description of the tools and services provided by TSI, please call 888-780-1333 to speak to me personally, or email me at david.wiener@transworldsystems.com.

 

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RECOGNIZING THE FOUR PATIENT PAYER TYPES

12 Feb

The way that healthcare approached patient payers in the past no longer works nearly as effectively as it once did.  With the dramatic rise in high deductible health plans (HDHP) and higher co-pays, collecting patient balances quickly and effectively is imperative.  The “one size fits all” approach is dead, both in follow-up and collections of slow-pay and delinquents accounts.

Reasons for a patient not paying the bill when due can be varied.  Some don’t pay on time because of financial reasons, many times because of the high deductibles in their health plan.  Others have the funds but, due to confusion surrounding their insurance policy, aren’t sure the balance is correct.  Others are simply too disorganized to remember to find the statement and pay the bill when they have the money.  Still others feel that their insurance has paid enough and the practice should be satisfied with that.  Some will say, “that doctor is rich, he doesn’t need my money!”

It is a delicate balance that practices must strike to be aggressive enough to motivate the patient to pay the bill without being so aggressive that the practice risks losing what might be a profitable patient in the future.  Some practices spend great deals of money with internal follow-up through statements, phone calls and letters, not realizing that each contact with a patient in follow-up internally can cost the practice between $10-12.  That expense, not to mention the staff time and attention this takes, can wind up making the whole follow-up proposition more expensive than it is actually worth.

So what is a practice supposed to do?

We, at TSI (formerly known as Transworld Systems) have determined that there are actually four distinct types of patient payers.  Each is motivated in a different way to pay the bill, and it is a mistake to treat them all the same.  They are:

THE DUTIFUL PAYER

The dutiful payer feels a keen responsibility to pay their debts in a timely manner.  They are motivated to pay the bill by the initial statement you send following patient responsibility.  Fortunately, they are (or should be) the largest category in your practice.

THE DISTRACTED PAYER

The distracted payer has the very best intentions to pay your bill, but they seem to be so busy and distracted that they misplace your statement or just forget to pay it.  Timely reminders are sufficient to motivate them to get that bill paid.

THE DISRESPECTFUL PAYER

The disrespectful payer tries to see what they can get away with, and hope that you will give up trying to collect the bill if they dodge you long enough.  They do not respond to your statements, letters, or phone calls.  Rather it will take a contact by a third party collection agency for them to be convinced that the practice is serious about collecting the debt.  That alone will motivate them to pay, and they will generally pay the bill after they receive the first contact by that third party.

PROFESSIONAL DEBTOR

The professional debtor never intended to pay the bill when they received service.  They are likely in collections with other creditors already.  These, and these alone, need to be in the hands of professional collectors, familiar with medical debt, before too much time has elapsed and too much money has already been spent chasing them.

TSI offers a free interface that works with virtually all dental software to help you identify which type of category each patient falls into, and tools to communicate with them in an appropriate manner.  The practice retains control of each account, and the type of communication that is being used on a particular patient.  These tools eliminate the need for the practice to continue time-consuming internal chasing of accounts at a cost that is generally less than they are spending on follow up currently.

For a full description of the tools and services provided by TSI, please call 888-780-1333 to speak to me personally, or email me at david.wiener@transworldsystems.com.

 

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Medical and Dental Practices, What Would You Do?

7 Jan
WWYDLogoWhat would you do if your patient data was stolen or a fire or flood destroyed your office?  Suppose one of your employees opened a malicious e-mail and your patient data was encrypted and held for ransom?   I know this sounds absurd, but just Google “data for ransom”.  What would be your first step?  With most medical records being stored digitally, it’s not a matter of if you’ll experience an incident regarding your electronic patient information; it’s a matter of when.
Technology is moving so fast in every industry, but in the medical industry, technology advancements are leading to more and more protected health information (PHI) theft and data breaches.   Patient information is not being properly protected. As you are well aware, protecting your patient’s confidential information is the law. Computers, laptops, e-mail, mobile devices, and thumb drives, all store and send ePHI.  Without the proper controls in place, your patient information can easily fall into the wrong hands, exposing your OMS practice to large governmental fines, and reputational risk.
HIPAA just announced that they will be conducting random audits starting in 2016.  Their pilot audit program revealed that many small to mid – size medical practices are not taking the necessary steps to protect their patient information and are not complying with even the basic HIPAA Security and Privacy Laws.   The HIPAA Security Rule now mandates that every practice take an annual risk assessment. The government also strengthened its ability to enforce the law in medical practices with fines reaching up to $50,000 per violation with a maximum $1.5 million annual penalty.  This is why Cash Flow Strategies is recommending PCIHIPAA, as a dedicated source for protecting your practice.
Cash Flow Strategies has many of our clients participating in their Compliance Program.  They have agreed to provide a complimentary HIPAA Risk Assessment (a $599 value).  You can take the Risk Assessment online and immediately receive your risk score with no further obligation.  I encourage you to take 5 to 10 minutes as soon as possible to complete the Risk Assessment  by clicking here. You’ll receive a 23- page Risk Analysis, and a 30-minute consultation that you can also schedule online.
Just click here to start your Risk Assessment.  It will be a great way to start your practice off on the right track in 2016.

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INSURANCE MONEY WON’T PAY YOUR BILLS ANYMORE, DOC!

16 Jun

I was told today by a doctor that he refrains from pushing too hard to collect from a patient who owes him money, because of all the money he makes on the patient from insurance companies.  He is willing to write off patient balances, to keep making insurance money from the patient visits, and doesn’t want to offend the patient into leaving the practice by insisting he pay his bill.

This is the general attitude many doctors had 25-30 years ago.  It may have had some validity back them but times have changed!  Insurance money alone will not keep your doors open and your lights on any more doc.  You are putting your practice in jeopardy by not seeing what is happening around you!

High deductible health plans are the norm these days, and co-insurance is rising all the time.  Despite what the government tells us, there are more and more patients who do not have insurance, or have adequate insurance.  Self pay is now the highest payer in the medical world behind Medicare and Medicaid, and it is catching up fast.  According to recent statistics, patient balances now represent over 35% of a doctors income and soon, if major changes aren’t made, will be over 50%.

You can’t wish it away, or ignore it away.  You MUST find a way to motivate patients to pay you, and pay you faster than before.

Medicine, whether you like or not, or understand it or not, is a business.  You are trading a service for money, and the patient knows it.  They also know when you are leaving them alone about their bill so that you can continue to collect insurance money. Not only do they know, but guess who they tell?  EVERYBODY!!!  And guess what happens?  You get all the patients who don’t want to pay their bills.  Great!  Until, that is, until you watch your patient A/R go through the roof.  By the time you see this happen, you are already in trouble.

Don’t waste time.  There are automated tools to help your practice both maintain your good relationships with your patients, AND get them to pay you their portion of the bill sooner.  Call me today at 888-780-1333 and I will tell you about them.  Isn’t it worth 20-30 minutes of your time to keep the lights on in your practice over the long haul?

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Medical and Dental Practices: Is insurance follow-up eating up your staff time?

11 Feb

Insurance companies have a vested interest in paying your practice as slowly as possible. They will delay, deny, and “on-hold” you to death just to keep your money a few days longer and earn interest on that money.

 

Living “on-hold” with insurance companies seems to be a way of life for some of your office staff, as clerks search forever for claim information. Sitting and waiting while they look up claims is costing you big time, not just in employee salaries, but also in lost productive time.

 

What if there was a highly effective, inexpensive way to motivate insurance companies to contact you regarding those claims? What if you didn’t have to waste the time of your employees “on-hold?” What if you could get an answer or your money more quickly?

 

Transworld Systems, a sponsored program with the AMA, a Preferred Vendor with the MGMA, and the largest collector of medical debt in the US, has a unique Insurance Resolution service that you can use to make these things a reality. For a low flat fee per claim, you can have them contact the insurance companies for you. When the insurance companies are contacted by a third party such as Transworld Systems, they will treat the inquiry with much higher priority than they will when they are contacted by your practice or a hospital. When receiving a third party inquiry, they are required to escalate the inquiry to a supervisor, and then have the supervisor contact your practice to resolve the claim.

It’s quick, it’s inexpensive, and it’s easy. And best of all, you can have your “on-hold” person spend their time on something less frustrating and more profitable for your practice.

It is just one of a whole suite of services that Transworld Systems can provide for your practice to help you get paid faster by both patients and insurance companies. Contact me for a free 30 minute demonstration of their services and a no-obligation analysis of your Accounts Receivable. Call me at 888-780-1333, or email me at davidhwiener@gmail.com.

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