Health Insurance, medical insurance and individual health insurance plans.

Health insurance is something that everyone needs today. The rising cost of visiting a health care provider or a hospital stay makes it imperative that everyone have some type of health care coverage. Government statistics estimate that over 40 million people in America are not covered by any type of health insurance on any given day. That's an enormous number of people who really are taking a financial risk.

The best information on individual Health Insurance.

While most Americans are able to obtain some type of health insurance through their place of employment, many others, the underemployed, the self-employed and the unemployed simply don't know where to find good, quality coverage at a fair price. The Census Bureau estimates that nearly 15% of the population has no coverage. The long term effects of this are hard to quantify because it means that young children do not see a health care provider unless they are seriously ill. Unfortunately this approach while appearing to save money can be devastating to the long term health of the child.

Health care providers and other experts all recommend that every one have some type of health insurance for the necessary time when they'll need to visit their Doctor or hospital.

Mike Yeager

http://www.a1-healthinsurance-4u.com/

mjy610@hotmail.com

Student Health Insurance

Students often wonder if they really need health insurance. It seems like a reasonable question when you are young and healthy and seemingly invincible. After all, almost everyone who knows how to access the health care system is provided with basic health care services and acute care (like emergency care) in the United States, regardless of whether or not they have health insurance. Young adults tend to use health care services less often than any other group. The odds are that a young adult will go more than 12 months without any need for health care. Even among those who need health care, the likelihood of exceeding $1000 annual healthcare expenses is very small. So it is reasonable to wonder whether a young adult really needs health insurance at all.

But the situation changes when we consider the more extensive and more costly types of health care. The ability of a patient to obtain top quality medical care for the most serious types of health care - things like transplants, extended hospital care, physical rehabilitation, and long term outpatient care - depend more on whether the patient has adequate health insurance than any other factor. A simple attack of appendicitis could easily wind up costing more than $25,000. Even an affluent family will have difficulty arranging adequate medical care without insurance coverage. Unfortunately, if you wait until you need this type of care it will be difficult or impossible to buy health insurance that covers these items.

Often the most immediate insurance concern for young people is the fact that most colleges, trade schools, internship programs, sports teams, community-sponsored travel opportunities and many other activities require health insurance as an admission requirement. Without health insurance, you do not pass "go". So there is usually no question about it - most young people with ambitions to advance their education need to have some type of health insurance.

Coverage Options
There are many types of health insurance plans available to young adults. The most popular plans are listed below.
Parent's Policy - Most students continue to be covered under a parent's policy. If this option is available, it is almost always the best option. But most health plans require that proof of full-time enrollment be provided. Be aware of the maximum age for this benefit. In many cases this coverage will expire when the student reaches age 23 (or at another age as stated in the insurance policy).

Employer Group Coverage - Most employers provide health insurance to their full time employees and pay for most of the cost of this employee benefit. This is called group health coverage. This benefit is completely under the control of the employer. Many people do not realize that there is no requirement for an employer to provide this benefit. Most group health plans require that new employees wait a few months before becoming eligible for coverage.

School-Sponsored Coverage These are usually uninsured managed care arrangements to provide care to students in the local area of the college or university.

Student Medical Policies These are privately insured major medical policies designed specifically for students. These are portable and offer coverage to the student in any location in the U.S. These plans also cover graduate students, and are available regardless of age or health. In most parts of the U.S., students can buy a high quality health insurance plan for less than $70 per month at www.medsave.com.

Short Term Medical Policies - Interim or gap insurance policies are available to cover from one to 12 months. This coverage is inexpensive and easy to obtain online in most states. The quality of the coverage is excellent except that it does not cover pre-existing conditions. These provide coverage in the U.S. only.

Individual Medical Policies - Permanent policies that you buy directly from an insurance company offer excellent coverage, strongest financial guarantees, and the most stability. These often provide worldwide coverage. But all this comes at a higher price and coverage is issued for a minimum of 12 months.

Travel Coverage / International Policies - Students planning overseas travel should purchase a separate medical insurance plan for the time that they are traveling, since most student health plans do not cover charges incurred outside of the U.S. These policies are specifically designed to pay for medical expenses and deal with the other international complications (language, currency and business issues) typically incurred while obtaining medical treatment overseas.

Terms to Know
Deductible or Co-payment - this is the portion of the bill that you pay before the insurance comes into play. These help reduce the cost of the insurance.
HMO - stands for "health maintenance organization". The HMO may pay to keep you healthy, rather than only cover problems hen things go wrong. HMOs tend to be popular among young healthy people, but criticized by people receiving more serious medical care. Private physicians tend to feel that they lose control over the quality of a pateint's care when an HMO is involved.
Indemnity plan - means that the policy reimburses you for any ordinary and necessary medical expenses. This is the least restrictive type of coverage but also the most expensive.
Managed Care - this means that the insurer has some authority to influence the type of health care you are provided. This cuts healthcare costs but may also limit your treatment.
Pre-existing condition - a medical situation that started before your insurance policy that may not be covered by the health insurance policy.
Premium - the cost of the policy, usually ranging from $25 to over $200 monthly.
Tax-deductible - reduces your taxable income and thereby reduces your total tax due at the end of the year. Most health insurance is not tax deductible by individuals.
Tax-free - the benefit provided by health insurance is usually tax-free. This means the value of the coverage received as well as any cash benefit paid as the result of a claim.
Underwritten - this means that not everyone will be accepted because acceptance is based on individual medical history. The insurance company reviews each application and selects the healthiest applicants for enrollment. Premium rates are lower for those accepted, but these plans offer no solution for people with pre-existing health conditions.

But the situation changes when we consider the more extensive and more costly types of health care. The ability of a patient to obtain top quality medical care for the most serious types of health care - things like transplants, extended hospital care, physical rehabilitation, and long term outpatient care - depend more on whether the patient has adequate health insurance than any other factor. A simple attack of appendicitis could easily wind up costing more than $25,000. Even an affluent family will have difficulty arranging adequate medical care without insurance coverage. Unfortunately, if you wait until you need this type of care it will be difficult or impossible to buy health insurance that covers these items.

Often the most immediate insurance concern for young people is the fact that most colleges, trade schools, internship programs, sports teams, community-sponsored travel opportunities and many other activities require health insurance as an admission requirement. Without health insurance, you do not pass "go". So there is usually no question about it - most young people with ambitions to advance their education need to have some type of health insurance.

Coverage Options
There are many types of health insurance plans available to young adults. The most popular plans are listed below.
Parent's Policy - Most students continue to be covered under a parent's policy. If this option is available, it is almost always the best option. But most health plans require that proof of full-time enrollment be provided. Be aware of the maximum age for this benefit. In many cases this coverage will expire when the student reaches age 23 (or at another age as stated in the insurance policy).

Employer Group Coverage - Most employers provide health insurance to their full time employees and pay for most of the cost of this employee benefit. This is called group health coverage. This benefit is completely under the control of the employer. Many people do not realize that there is no requirement for an employer to provide this benefit. Most group health plans require that new employees wait a few months before becoming eligible for coverage.

School-Sponsored Coverage These are usually uninsured managed care arrangements to provide care to students in the local area of the college or university.

Student Medical Policies These are privately insured major medical policies designed specifically for students. These are portable and offer coverage to the student in any location in the U.S. These plans also cover graduate students, and are available regardless of age or health. In most parts of the U.S., students can buy a high quality health insurance plan for less than $70 per month at www.medsave.com.

Short Term Medical Policies - Interim or gap insurance policies are available to cover from one to 12 months. This coverage is inexpensive and easy to obtain online in most states. The quality of the coverage is excellent except that it does not cover pre-existing conditions. These provide coverage in the U.S. only.

Individual Medical Policies - Permanent policies that you buy directly from an insurance company offer excellent coverage, strongest financial guarantees, and the most stability. These often provide worldwide coverage. But all this comes at a higher price and coverage is issued for a minimum of 12 months.

Travel Coverage / International Policies - Students planning overseas travel should purchase a separate medical insurance plan for the time that they are traveling, since most student health plans do not cover charges incurred outside of the U.S. These policies are specifically designed to pay for medical expenses and deal with the other international complications (language, currency and business issues) typically incurred while obtaining medical treatment overseas.

Terms to Know
Deductible or Co-payment - this is the portion of the bill that you pay before the insurance comes into play. These help reduce the cost of the insurance.
HMO - stands for "health maintenance organization". The HMO may pay to keep you healthy, rather than only cover problems hen things go wrong. HMOs tend to be popular among young healthy people, but criticized by people receiving more serious medical care. Private physicians tend to feel that they lose control over the quality of a pateint's care when an HMO is involved.
Indemnity plan - means that the policy reimburses you for any ordinary and necessary medical expenses. This is the least restrictive type of coverage but also the most expensive.
Managed Care - this means that the insurer has some authority to influence the type of health care you are provided. This cuts healthcare costs but may also limit your treatment.
Pre-existing condition - a medical situation that started before your insurance policy that may not be covered by the health insurance policy.
Premium - the cost of the policy, usually ranging from $25 to over $200 monthly.
Tax-deductible - reduces your taxable income and thereby reduces your total tax due at the end of the year. Most health insurance is not tax deductible by individuals.
Tax-free - the benefit provided by health insurance is usually tax-free. This means the value of the coverage received as well as any cash benefit paid as the result of a claim.
Underwritten - this means that not everyone will be accepted because acceptance is based on individual medical history. The insurance company reviews each application and selects the healthiest applicants for enrollment. Premium rates are lower for those accepted, but these plans offer no solution for people with pre-existing health conditions.

Tony Novak, MBA, MT is a writer and financial adviser in Narberth, PA focusing on tax and employee benefit issues. His businesses www.MedSave.com and Freedom Benefits Association provide online benefits enrollment for thousands of individuals and businesses nationwide

How to Save Up to 70% on Health Insurance Premiums

Are you tired of paying too much for health insurance premiums?
Only 5 or 6 years ago health insurance seemed very affordable
with fantastic coverage to match. Well, if youre an individual
or family who pays for health insurance today chances are youre
literally getting punched in the pocket book, and it hurts.

Dramatically health insurance has changed over the last five years
and this article will no doubt arm you with the knowledge you need
to get the most out of your next health insurance plan. First,
an individual or family needs to identify with what they need out
of a health plan. Notice I say need, because unless you make more
money than you know what to do with there is no way in the world
most people can afford the "Perfect" plan with all the bells
and whistles.

Do you need a doctors office co pay?

Most people dont realize this will save you up to 30%
with some companies by cutting this benefit out of your
health insurance plan. Doctors continually raise their fees
for visits and most of the time the consumer will go much faster
to the doctor if he or she has a $10 co pay as opposed to paying
the $50 the doctor may charge. Insurance companies pay millions
for these fees and trust me, after the first 12 months of your
plan being in effect youre the one who will be paying by a
huge increase in your premium. Ive seen insurance plans go up
79% after the first twelve months. Totally ridiculous.
The consumers cannot afford this.

Another huge problem which Ill go more in depth
in another article is prescription drug cards.
I really cant see where the consumer wins here either.
Dont get me wrong, if youre on an employer sponsored
group health insurance plan your probably getting a good deal
but I can assure you that your company is paying out the nose
for the coverage youve come to love. I talk to people weekly
who literally work for their health insurance coverage.
If you can do without a prescription drug plan I would.
It can generally save you 20 to 40% off your premium by
not having this benefit.

Consumers usually pay 500 to 700 dollars a year
for this benefit alone while the average family who can
qualify for individual or family medical plans dont spend near
this amount of money. And, once again when you finally use your
card the insurance company will generally offset the cost at
your renewal date by raising your health insurance premium.
Cut out these things and go with a deductible of $1,000 or higher
and you will definitely save yourself money both in the short
and long term. Most of us can pay for the occasional doctor visit
and prescription rather than giving our money up front to the
Insurance Company. Just a little food for thought.
Only 5 or 6 years ago health insurance seemed very affordable
with fantastic coverage to match. Well, if youre an individual
or family who pays for health insurance today chances are youre
literally getting punched in the pocket book, and it hurts.

Dramatically health insurance has changed over the last five years
and this article will no doubt arm you with the knowledge you need
to get the most out of your next health insurance plan. First,
an individual or family needs to identify with what they need out
of a health plan. Notice I say need, because unless you make more
money than you know what to do with there is no way in the world
most people can afford the "Perfect" plan with all the bells
and whistles.

Do you need a doctors office co pay?

Most people dont realize this will save you up to 30%
with some companies by cutting this benefit out of your
health insurance plan. Doctors continually raise their fees
for visits and most of the time the consumer will go much faster
to the doctor if he or she has a $10 co pay as opposed to paying
the $50 the doctor may charge. Insurance companies pay millions
for these fees and trust me, after the first 12 months of your
plan being in effect youre the one who will be paying by a
huge increase in your premium. Ive seen insurance plans go up
79% after the first twelve months. Totally ridiculous.
The consumers cannot afford this.

Another huge problem which Ill go more in depth
in another article is prescription drug cards.
I really cant see where the consumer wins here either.
Dont get me wrong, if youre on an employer sponsored
group health insurance plan your probably getting a good deal
but I can assure you that your company is paying out the nose
for the coverage youve come to love. I talk to people weekly
who literally work for their health insurance coverage.
If you can do without a prescription drug plan I would.
It can generally save you 20 to 40% off your premium by
not having this benefit.

Consumers usually pay 500 to 700 dollars a year
for this benefit alone while the average family who can
qualify for individual or family medical plans dont spend near
this amount of money. And, once again when you finally use your
card the insurance company will generally offset the cost at
your renewal date by raising your health insurance premium.
Cut out these things and go with a deductible of $1,000 or higher
and you will definitely save yourself money both in the short
and long term. Most of us can pay for the occasional doctor visit
and prescription rather than giving our money up front to the
Insurance Company. Just a little food for thought.

Ryan Orrell has been a specialist in the field of
health insurance since 1996 counseling hundreds of individuals
and families on policies which may be right for them.
Ryan is president of http://www.quotemonster.com,
an online shopping service designed to help individuals
and families find affordable health insurance plans.
This article is also posted on the Web at
http://www.quotemonster.com/health-insurance-article-1.html

Where To Find Cheap Health Insurance

Health insurance costs are rising all the time. Many people feel they cannot afford health insurance. Others feel that they dont need it because they are healthy and have never had any major medical problems. This is definitely faulty thinking on their part. As a matter of fact, you do need health insurance, and there are a lot of ways to get affordable health insurance for yourself or your family. Health insurance is protection against the possible health problems that could happen in the future, and you have absolutely no way of knowing what those might be.

For people who are low income, every state has a Medicaid program that they could possible qualify for. The requirements vary form state to state, but all it takes is a trip to your local Division of Family Services office to get an application. You might be surprised at the number of people who would actually qualify for this service that dont think that they would. You will need to fill out the application and provide some documentation about your finances. This program can cover the health insurance needs of the entire family, including dental work, eye care, doctor visits, emergency care, prescriptions and more. For people with children who dont get insurance through their work, this is a very good option to check out. It is free and a fairly painless process, and if you qualify, it could make you like a lot easier.

Another option for cheap health insurance is to look on the Internet. There are a ton of companies that offer all types of health insurance plans, and it is very possible that you could find one that is perfect for your family and fits your pocketbook. The costs vary, so do plenty of research before choosing one or another. It is a smart idea to find out how long the company has been in business, and what kind of reputation they have. Ask for a quote from several sources, and see what kind of a deal they can get for you. Make sure they are also licensed in your state, because it does no good to get insurance if they cant operate in your state.

Still other options include your local insurance agencies. Ask around to find out about the different agents and their policies. Many agents will work very hard to get you an affordable health insurance plan for your family at a cost you can live with. Even if you cant get every type of coverage you want, some is better than none.

Follow up with advertisements for prescription card plans and alternative health care plans. While some of them wont be suited to your needs, there may be one that is perfect for you. An affordable health care insurance plan can be found, but you might have to do some searching.

Bob Hett offers great tips and advice regarding all aspects concerning Health Insurance.
Get the information you are seeking now by visiting http://www.healthinsurancejournal.info

HIPAA And How It Will Affect Your Office

This information is designed to help you better understand HIPAA and to assist your office in becoming HIPAA compliant. The information was obtained from a variety of sources and is not intended to be legal advice. If you are having difficulty understanding any portion of the HIPAA regulations you should consult your legal counsel. First, there are no HIPAA police. No one is going to come into your office to inspect you to see if you are HIPAA compliant. A complaint must be filed in order for any action to be taken.

What is HIPAA?

HIPAA stands for The Health Insurance Portability And Accountability Act. It was enacted by the federal government in 1996 as part of a healthcare reform effort. HIPAA is intended to ensure confidentiality of all patient related health care information. It also intends to simplify the administrative processes of health care, thereby reducing the costs and administrative burdens of health care.

One thing to remember is that the HIPAA Act uses the word ?reasonable? several times. You and your office staff must do whatever reasonable to protect your patient?s privacy. For instance, smaller medical offices do not have to take the same privacy measures as large hospitals do. That would not be reasonable.

Also, there are no ?privacy police.? No one is going to come in and inspect your office randomly. Someone must file a complaint first. The complaints will be handled by the Office of Civil Rights. If someone puts in a complaint, then it will be investigated. The fines are very high, so you will want to be sure that your office has good privacy practices and that they are followed all of the time.

Another thing to keep in mind is that the type of your practice may determine the level of privacy that you need to acquire. For example, patient?s in an optometrist?s office may not be as concerned about people knowing they are there, as opposed to patient?s in a mental health office. There are several different components of HIPAA, each one having its own implementation date.

Section 2: The Privacy Component : implementation date: April 2002

1. You must do everything within reason to protect your patient's privacy.

2. Patient's files and information should be kept in a secure section of your office, a section that is not accessible by other patients.

3. Charts should not be left lying around, open where someone can read it.

4. If you are making a phone call about a patient or to a patient, you need to do it from an area where you cannot be overheard if you will be giving out personal information. For example, if you are calling their insurance company, and you will be saying the patient's first and last name, date of birth, ID#, and/or a diagnosis, then you do not want to do it where others, perhaps in a waiting room, can hear you.

5. If patient's charts are ever removed from the office you need to have a policy in place. For example, you should have a sign out sheet which states the patient's name, date taken, by whom, and then signed back in when the chart is returned.

6. If charts are removed , they should be carried in a case that is marked ?confidential - medical records.? If you were ever involved in an accident, or separated from the bag for any reason, either authorities or medical personel would secure the information for you. Or you would have at least done whatever reasonable to protect that information.

7. If computer screens are in a position that patients can view them, you may want to move them, or get a screen cover. A screen cover makes it so that the computer screen can only be read when directly in front of it. The above are just some things that you will need to consider when becoming HIPAA compliant. Each office will have it?s own areas that need to be reviewed. The above are many of the common areas.

Section 3: Administrative Simplification: compliance date: October 2002

This component requires the standardization of data transmissions, or EDI, and procedure/diagnosis codes.

As for the standardization of procedure/diagnosis codes, this just means that you must use CPT-4 codes for procedure codes and ICD-9 codes for diagnosis codes.

As for the standardization of EDI, that refers to your electronic billing. In order to submit your claims electronically, you must do so in a HIPAA compliant format.

Section 4: Security Component: no implementation date set yet

This component requires that health care professionals, Billing Services, and clearing houses take appropriate security measures to assure that health information pertaining to an individual remains secure and is not accessible by others.

Things to consider:

Where is your fax machine? Is it in a place where only office staff can access incoming faxes? Is it on 24 hours a day? When you are not in the office (after office hours) can anyone else access your fax machine? Whenever you fax personal information about a patient you should use a fax cover sheet with a confidentiality statement. The statement should explain that the following fax contains personal medical information and that if the fax is received by anyone other than the intended party, that the fax should be destroyed and they should notify you that it was received in error.

Do you hire a cleaning person/crew? Are they in the office when you are not? Do they have access to the patient?s personal information? You may want to ask them to sign a confidentiality statement.

Do you rent office space? If yes, does your landlord have access to your office? Do they ever enter your office without you being present? If they do, you may want to ask them to sign a confidentiality statement.

By asking people who have access to your office to sign a confidentiality statement, you are making a reasonable attempt to protect your patient?s privacy. It is not always reasonable to never allow anyone access to areas that contain private information. If those people sign an agreement and then breech that agreement, you would not be held responsible.

If you do any business by email, you will need to use an encryption service. This will ensure that if anyone were to intercept your emails, they would not be able to read them.

Section 5: Privacy Officer

All offices must designate a mandated ?privacy officer.? This person would be responsible for making sure all staff are HIPAA trained and that privacy policies are typed up and followed. They would also be the person that staff members or patients could go to with any concerns or questions about HIPAA compliance. Even if you are a very small practice, you MUST have someone designated as the privacy officer. It may even be the Doctor themself.

Section 6: Release of Patient Information/Consent

You need to have the patient?s written consent in order to release any of their records/information.

(Exception: If request is due to immediate/urgent care of patient.)

You should review your current consent and authorization forms to make sure they are HIPAA compliant. HIPAA requires you to obtain consent for the use and disclosure of information from each of your patients. You may refuse to treat patients who will not sign the consent form.

Section 7: Unique Identifiers: No implementation date set yet

HIPAA will mandate the use of unique identifiers. More to come on this component. Most likely you will have one national provider number, instead of a different provider number for each insurance company.

Section 8: Policies and Procedures Required by HIPAA

1. Identify people on your staff who require access to protected health information.

2. Prevent access to protected health information by unauthorized persons.

3. Ensure that the ?minimum necessary? amount of information is released for routine disclosures (only release information pertaining to what is requested, not the patient?s entire file.)

4. Verify the identity of the requestor of information.

5. Provide patients access to their records, the opportunity to request corrections, and access to and accounting of disclosures.

6. Every office must have written policies regarding privacy practices.

Summary

Evaluate your physical office for potential privacy and security risks. One of the best things that you can do to become ?ready? for HIPAA is to walk through (better yet - have someone else walk through) your office as if you are a patient. Look around at EVERYTHING. What do you see? Do you see any personal patient information, charts in full view? Start right from the front door, and go through every room in your office, especially the rooms that patients have access to. Then continue to do periodic checks to ensure ongoing compliance.

Make sure that you have written policies regarding any privacy practices, such as removing charts from the office, faxing patient information, reviewing any complaints from patients, etc. Also, make sure you designate a ?privacy officer.?

Make sure all staff members are trained regarding HIPAA policies. Remember to train any/all new employees regarding HIPAA policies. You should also review your current HIPAA policies regularly.
Michele Redmond is co-owner of Solutions Medical Billing and has been in business since 1994. She has a bachelor?s degree in Computer Information Science and is responsible for the medical billing for over 50 providers. For more information on medical billing and HIPAA visit her website at http://www.solutions-medical-billing.com

Are you HIPAA Compliant?

A closer look at HIPAA
By - Matt Sears, Senior Vice President
Athens Benefits Insurance Services, Inc.
A division of The Jenkins Athens Group

HIPAA. Perhaps one of the most significant laws in recent memory; certainly one of the most complex. While this short article won't make anyone an expert, it will, hopefully, demystify this wide ranging set of laws and put you on the path towards compliance.

First, let's answer the question; “What is HIPAA?" HIPAA stands for the Health Insurance Portability and Protection Act of 1996. Although it purports to regulate health insurance, HIPAA provisions extend far beyond insurance. HIPAA introduced broad disclosure and privacy requirements. It also established civil and criminal penalties for each violation (up to $25,000 per person per year in civil penalties and up to $250,000 in criminal fines - along with imprisonment).

Title I of HIPAA deals with portability and special enrollment rights for health plans. Those conditions must have been incorporated into your plans by now (original compliance date was 1997). Title II of HIPAA governs a wide ranging set of conditions called, “Administrative Simplification". For those charged with compliance, the notion that HIPAA simplifies anything qualifies as “dark humor". Administrative simplification attempts to create a uniform system for processing and retention of health information and ensuring the security of that information.

For the purposes of this article, we're only concerned with those portions of the law impacting most employers...privacy. Notably the privacy of personal data defined by HIPAA as “Protected Health Information" or “PHI" - information that is personally identifiable. In the broadest summary possible, key components of HIPAA privacy requirements for a plan sponsor are fairly straightforward:

Generally, the employer (Plan Sponsor) is not a HIPAA “Covered Entity" - the Health Plan is. For fully insured plans, this typically means the health insurer, HMO, EAP provider, etc.
As the Covered Entities, health plans bear the brunt of compliance requirements (your responsibilities become exponentially larger as the quantity of data you receive increases)
Meet with every service provider, or ensure that your broker or consultant has reviewed compliance requirements with each
Use protected health information only for needed administration of the benefit programs (HIPAAspeak: “Treatment, Payment and Health Care Operations)
Collect (and release) only the minimum data required to “do the job" (e.g. enroll an employee, file claims, etc.)
Restrict the data to those persons who absolutely must use it
Establish “firewalls" and safeguards to protect the data (separate locked files, restricted access, password protect systems)
Appoint a Privacy Official (not required for fully insured plans that never receive PHI)
Create a Privacy Policy and distribute a Privacy Notice to participants
“Scrub" personally identifiable data from communications pieces, ID Cards, etc.

HIPAA, like COBRA before it, will continually change as new rules and regulations are released (for example, the U.S. Dept. of HHS has yet to release enforcement rules for HIPAA). Ongoing compliance will require vigilance in remaining up to date on the changing laws. It's vital your broker/consultant proactively work with your organization to review plans, identify problems and provide ongoing education to maximize the performance of your benefit plans.

HIPAA in a "Nutshell" - Guidelines for EMR and Paper Medical Records Compliance

HIPAA in a “nutshell”

There are two HIPAA rules requirements; privacy (2003) and security (2005). Both rules require:

-Identifying possible threats,
-Assessing specific vulnerabilities,
-Determining appropriate and reasonable safeguards and
-Implementing the necessary defense mechanisms and policies.

Using an EMR (electronic medical record) has no absolute right and wrongs in either computer equipment or software for HIPAA compliance. Usually there are four areas to examine:

-Physical Security – can your computers with patient data be stolen?
-User Security - can anybody log on to the patient database?
-System Security – what happens on a hard drive crash?
-Network Security – can unauthorized persons outside your facility access patient data?

Using paper medical records begs similar questions:

-Physical Security – how secure are the files from fire and theft?
-User Security - what access controls and logging is there?
-System Security – what happens in a fire or flood?
-Storage Access – are the files in a locked, secure area?

There are HIPAA penalties

The civil monetary penalty is up to $100 per person record per violation and up to $25,000 per year total for the same type of violation. There is 30 days to correct the problem if it is not through willful neglect.

The criminal penalties are for “misuse” and for obtaining or using health information by “false pretenses” or with the intent to sell, transfer or use it for commercial advantage, personal gain or malicious harm. These penalties are up to $250,000 and five years in jail.

Currently there is no real effective enforcement body.

HIPAA compliance "thumb rules"

With an EMR most of the requirements are common sense and providers do not need to be overly concerned but do require some basic steps like:

-Put your computer server in a secure room, locked,
-Use an EMR with user management and permissions,
-Make regular back-ups and store them in a secure place and
-Employ a computer specialist.

Most medical practices and clinics using paper records need to make physical changes to be HIPPA compliant. If you continue to use paper then there are a myriad of physical complexities to consider:

-How to monitor staff access,
-Fire and flood protection (insurance is not enough)
-A disaster plan (that has been documented and practiced.)

Finally, if there is a legal case brought forward a provider to protect themselves should have a trail of how the patient's individual information was accessed. For paper records this means at a minimum a monitored sign out sheet and for an EMR user logging of patient file access.

Michael Milne is the CEO of BrunMed, Inc. (http://www.brunmed.com), the developer of Medscribbler, the first handwriting embedded EMR for the Tablet PC. Visit http://www.medscribbler.com for more information on a handwriting enabled EMR.