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What are the deadlines for compliance with the HIPAA rules?
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If you dont comply with HIPAA privacy regulations, you may face civil penalties of up to $25,000 for each requirement violated, and criminal penalties of up to $50,000 and one year in prison for obtaining or disclosing protected health information.
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Whether your hospital has embraced the methodology associated with the term revenue cycle management, chances are youve heard the words bandied about. Certainly the crucial importance of accurate and efficient front-end operations to a health care providers bottom line is emphasized whenever there is a gathering of health care industry leaders.
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When Donna Madlener agreed to lead the Revenue Enhancement Committee for the James Cancer Hospital, which is part of The Ohio State University Health System (OSUHS) in Columbus, she signed on for a unique experience that went to the heart of such issues as financial responsibility and internal customer service.
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One of the concepts Joe Denney, CHAM, has become familiar with in his position as director of revenue management at The Ohio State University Health System (OSUHS) in Columbus is something called pricing sensitivity, he says.
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In October 2002, HCA in Nashville, TN, won an $8.8 million arbitration decision against Humana Medical Plan Inc. of Florida for the late payment or nonpayment of 3,300 patient accounts at 16 hospitals in Florida. HCA alleged that Humana paid hospital bills for patients in its HMO, preferred provider, Medicaid, and Medicare health plans as much as one year late, and that its hospitals sometimes had to rebill the insurer three or four times to receive reimbursement.
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In December 2002, the Department of Health and Human Services (HHS) Office of Civil Rights (OCR) released an extensive guidance outlining various aspects of the privacy portion of the Health Insurance Portability and Accountability Act (HIPAA). That follows a recent decision by HHS to place OCR in charge of enforcing HIPAAs privacy mandates.
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The Department of Health and Human Services (HHS) has said for months that HIPAA would continue to be a work in progress. The agency proved that again last month when it added a new section to the guidance on public health disclosures and another on workers compensation disclosures.
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One of the many challenges facing providers under HIPAA, particularly in the context of oncology, cardiac surgery, and OB/GYN services, involves health care services provided to a family member.
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The Centers for Medicare & Medicaid Services (CMS) has created a Privacy Accountability Database to aid in tracking, reporting, and accounting the disclosures made from all CMS systems of records permitted by the Privacy Act of 1974 and HIPAA.
