RE: HIPAA and Government Entities

2003-03-06 Thread Artis, David (CC-Contractor)




Try 
hipaasecurerx.com

They 
have done a lot of work with government agencies.

They 
are heavly relied upon here in Nebraska and Iowa.

They 
are located in Jacksonville, Florida.

  -Original Message-From: Debbie Kerns 
  [mailto:[EMAIL PROTECTED]Sent: Wednesday, March 05, 2003 3:52 
  PMTo: WEDI SNIP Privacy Workgroup ListSubject: HIPAA and 
  Government Entities
  A month or so ago someone posted a link to a 
  website specifically dealing with HIPAA and government entities. Whoever 
  that was, could you please forward that website address to me. 
  
  
  Thank You 
  
  Debbie KernsHIPAA Compliance 
  OfficerSteele Memorial Hospital
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RE: Minimum necessary

2003-03-06 Thread David Blasi
A live person on the phone is not limited to what can be provided in a
271 response or a 277 or any other HIPAA required response.  Talking to
a person on the phone is not considered the use of electronic media,
as defined by 162.103.  Direct Data Entry, which is the subject of the
limitation to which you are referring, cannot have incentives for its
use (See 196.925(4)).  A prohibition on incentives for other modes of
electronic media communications are what is intended, not limiting
the usefulness of picking up a phone and trying to get a situation
resolved by speaking to a live person.  

 

 Schmidt, Lee M [EMAIL PROTECTED] 03/05/03 04:26PM

Assuming the inquiry was through a phone call and that the HMO Client
were
covered entities, the phone rep should provide the same level of
benefit
information made available through the 271 response and any HMO
eligibility
web applications to which the provider has access.  

In short, there can be no incentive for the provider to use one mode
of
inquiry over another which means all avenues of disseminating
eligibility
information must provide the same level of detail.

Understand that the 271 does provide comprehensive benefit information,
but
at this time the government regulates that the minimum response to an
eligibility inquiry is a yes/no. 

Thanks,
 
Lee M. Schmidt
Magellan Behavioral Health
HIPAA / I.T. Project Manager, Claims Applications 
Local: (314) 387-5445 
Toll Free (St. Louis): 1-800-450-7281 ext: 75445  
New Cell: (314) 960-0964 
Fax: 314-387-5655 or 314-292-1120 (Electronic)
E-Mail: [EMAIL PROTECTED]
mailto:[EMAIL PROTECTED] 


-Original Message-
From: Jonathan Fox [mailto:[EMAIL PROTECTED] 
Sent: Wednesday, March 05, 2003 1:04 PM
To: WEDI SNIP Privacy Workgroup List
Subject: Minimum necessary


Now that Privacy is right around the corner, a lot of people are
re-examining some of the Transactions work that has been done.

Here is a question that has privacy (minimum necessary) implications.

A provider performs an eligibility inquiry with their local HMO.  The
HMO responds with yes the member is eligible and here is a list of
their
benefits.  Clearly, the minimum requirements of the functionality of
the
transaction have been met, but how far can a payer go in giving
additional information (COB, HIC number, Group Number, Plan Number,
etc,
before you cross the minimum necessary (privacy) line.

Certainly, many of these pieces of information are not needed to get a
claim paid by that payer.  Is it the 
responsibility of the payer and/or is it within their right to divulge
information about other policies they may have.  

This is not a question about transaction functionality, as the
transaction clearly accommodates this data, but there seems to be a
slight contradiction with the minimum necessary clause of the Privacy
rule.

Thoughts please???

Jonathan Fox
Independent Health

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Re: mail filtering

2003-03-06 Thread Mimi Hart
Sorry to be naive, but how is this different then expecting my
colleagues to follow other procedures? Cover sheets on faxes? Not taking
PHI home? Not discussing PHI in the lunch room? They are professionals,
there are certain professional rules they have to follow like wearing
gloves around blood borne pathogens and the like, why is privacy
different?

It is my responsibility to get a system that works for my staff. It is
their responsibility to follow any accompanying policies and procedures
that support/surround the system.

My opinion only...Mimi


Mimi Hart Ó¿Õ*
Research Analyst, HIPAA
Iowa Health System
319-369-7767 (phone)
319-369-8365 (fax)
319-490-0637 (pager)
[EMAIL PROTECTED]

 Jim Hewitt [EMAIL PROTECTED] 03/04/03 09:05PM 
I agree with most of Bill Kammerer's contributions on
this forum, but disagree with this one:
 do we need any more proof that email filtering
doesn't work?

Filtering isn't a silver bullet, but it's part of the
solution.  
 ...rely on users' training and intelligence.  
That won't work.  Taking email encryption as an
analogous example, you've probably seen the Carnegie
Mellon paper from a few years ago, Why Johnny Can't
Encrypt.  They studied a group of fairly high-skill
users (CS researchers), and gave them the task of
sending and receiving encrypted email.  Most of them
had trouble with the software (PGP 5.1, I think), but
more importantly they consistently forgot to click on
encrypt when they had a confidential message to
send. 

If you're relying on users' training and intelligence
ALONE you're almost certainly not compliant.  You
don't rely on that alone.  As one user told me, It
would be insane to install a bunch of keyword
triggers, sit back and assume you're compliant.  It
would also be insane to base your compliance on users
remembering to do the right thing.

Email filtering is similar to IDS.  You have to buy a
good commercial package, spend a lot of time tuning it
for your organization, install update almost daily,
and put in a lot of maintenance by a live sysadmin. 
Nobody said it was cheap, and the false positives
certainly are annoying, but it's necessary, in my
view.

By the way, I've seen a lot of unanswered requests for
lists of PHI keywords.  I don't think anybody has a
list they are happy with.  Anybody who has, please
chime in.

__
Do you Yahoo!?
Yahoo! Tax Center - forms, calculators, tips, more
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Notice for indirect health care providers?

2003-03-06 Thread LAURA HEMINGWAY
I was training some of our staff last week and was asked a question that I
did not know how to answer.  I'm sure someone out there has an answer.

What if I as a customer in a doctor's office become aware of the doctor's
office disclosing some aspect of another customer's PHI information without
their knowledge.  For example, the receptionists are talking openly about
the other customer's condition, economics, etc.  Can I file a complaint
with the OCR on behalf of the other customer?

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RE: Notice for indirect health care providers?

2003-03-06 Thread Vikas Budhiraja
Laura,
Yes you can file a complaint as a 'whistleblower'. Complaints can be filed
by patients, workforce members or others who become aware of or suspect
violation of privacy regulations by a provider.

Regards,
Vikas

-Original Message-
From: LAURA HEMINGWAY [mailto:[EMAIL PROTECTED]
Sent: Thursday, March 06, 2003 10:57 AM
To: WEDI SNIP Privacy Workgroup List
Cc: WEDI SNIP Privacy Workgroup List
Subject: Notice for indirect health care providers?


I was training some of our staff last week and was asked a question that I
did not know how to answer.  I'm sure someone out there has an answer.

What if I as a customer in a doctor's office become aware of the doctor's
office disclosing some aspect of another customer's PHI information without
their knowledge.  For example, the receptionists are talking openly about
the other customer's condition, economics, etc.  Can I file a complaint
with the OCR on behalf of the other customer?

---
The WEDI SNIP listserv to which you are subscribed is not moderated. The
discussions on this listserv therefore represent the views of the individual
participants, and do not necessarily represent the views of the WEDI Board
of Directors nor WEDI SNIP. If you wish to receive an official opinion, post
your question to the WEDI SNIP Issues Database at
http://snip.wedi.org/tracking/.   These listservs should not be used for
commercial marketing purposes or discussion of specific vendor products and
services.  They also are not intended to be used as a forum for personal
disagreements or unprofessional communication at any time.

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Re: Notice for indirect health care providers?

2003-03-06 Thread Patricia Conroe
My understanding is that the answer to that is a big YES and that's why HIPAA can be 
such a pain and why there will be complaints received.

 LAURA HEMINGWAY [EMAIL PROTECTED] 03/06/03 10:56AM 
I was training some of our staff last week and was asked a question that I
did not know how to answer.  I'm sure someone out there has an answer.

What if I as a customer in a doctor's office become aware of the doctor's
office disclosing some aspect of another customer's PHI information without
their knowledge.  For example, the receptionists are talking openly about
the other customer's condition, economics, etc.  Can I file a complaint
with the OCR on behalf of the other customer?

---
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you wish to receive an official opinion, post your question to the WEDI SNIP Issues 
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RE: Notice for indirect health care providers?

2003-03-06 Thread Noel, Linda A.
You should first bring this to the attention of the physician's privacy officer.  

Linda Noel
Corporate Privacy Officer
Corporate Compliance
Orlando Regional Healthcare
321-843-8693



-Original Message-
From: LAURA HEMINGWAY [mailto:[EMAIL PROTECTED]
Sent: Thursday, March 06, 2003 10:57 AM
To: WEDI SNIP Privacy Workgroup List
Cc: WEDI SNIP Privacy Workgroup List
Subject: Notice for indirect health care providers?


I was training some of our staff last week and was asked a question that I
did not know how to answer.  I'm sure someone out there has an answer.

What if I as a customer in a doctor's office become aware of the doctor's
office disclosing some aspect of another customer's PHI information without
their knowledge.  For example, the receptionists are talking openly about
the other customer's condition, economics, etc.  Can I file a complaint
with the OCR on behalf of the other customer?

---
The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions 
on this listserv therefore represent the views of the individual participants, and do 
not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If 
you wish to receive an official opinion, post your question to the WEDI SNIP Issues 
Database at http://snip.wedi.org/tracking/.   These listservs should not be used for 
commercial marketing purposes or discussion of specific vendor products and services.  
They also are not intended to be used as a forum for personal disagreements or 
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RE: Internet Pagers Privacy

2003-03-06 Thread Clay, Roy III (NO)
Title: RE: Internet Pagers  Privacy





If all that is sent is the patient's name and address, that should be fine. If there is additional information that would allow someone to infer some about the patient's health status, something like:

To: HIV On Call Nurse.
Call patient John Doe at 555-.


That would be considered PHI. However, I am pretty sure the paging company would be considered a pass-through similar in nature to the phone company one leases network lines from. 

-Original Message-
From: Paul Weber [mailto:[EMAIL PROTECTED]]
Sent: Wednesday, March 05, 2003 1:51 PM
To: WEDI SNIP Privacy Workgroup List
Subject: Internet Pagers  Privacy



I'm looking for some input on a scenario that was recently presented. To wit...


What are the ramifications relative to HIPAA Privacy where communications containing PHI to alphanumeric pagers held by remote nursing staff are initiated via internet e-mail?

For example, a patient coordinator sends an e-mail containing PHI (say patient name  address) to a nurse's pager or cell phone screen through a third party such as ATT, Skypage, Arch Wireless, etc.

Thoughts?


Thank you in advance,
Paul Weber
[EMAIL PROTECTED]
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RE: Notice for indirect health care providers?

2003-03-06 Thread Craig Moen
Ineteresting question.  I would say yes they have the right.  For the same
reason we as employers need to worry about the disguntled employee

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-Original Message-
From: LAURA HEMINGWAY [mailto:[EMAIL PROTECTED]
Sent: Thursday, March 06, 2003 9:57 AM
To: WEDI SNIP Privacy Workgroup List
Cc: WEDI SNIP Privacy Workgroup List
Subject: Notice for indirect health care providers?


I was training some of our staff last week and was asked a question that I
did not know how to answer.  I'm sure someone out there has an answer.

What if I as a customer in a doctor's office become aware of the doctor's
office disclosing some aspect of another customer's PHI information without
their knowledge.  For example, the receptionists are talking openly about
the other customer's condition, economics, etc.  Can I file a complaint
with the OCR on behalf of the other customer?

---
The WEDI SNIP listserv to which you are subscribed is not moderated. The
discussions on this listserv therefore represent the views of the individual
participants, and do not necessarily represent the views of the WEDI Board
of Directors nor WEDI SNIP. If you wish to receive an official opinion, post
your question to the WEDI SNIP Issues Database at
http://snip.wedi.org/tracking/.   These listservs should not be used for
commercial marketing purposes or discussion of specific vendor products and
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not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If 
you wish to receive an official opinion, post your question to the WEDI SNIP Issues 
Database at http://snip.wedi.org/tracking/.   These listservs should not be used for 
commercial marketing purposes or discussion of specific vendor products and services.  
They also are not intended to be used as a forum for personal disagreements or 
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Public Health Disclosures

2003-03-06 Thread Karen Williamson
When we are intervening in an event that threatens Public Health (eg, a restaurant 
employee who has HEP-A) it is most likely necessary that we disclose PHI (eg, tell the 
restaurant manager the name of the employee who has HEP-A). My reading of 160.203(c), 
as well as 164.512(b), permits this.

Should this type of disclosure be included in our NOPP? 


Karen Williamson
Lead System Project Manager, Privacy Officer
El Paso County Dept. of Health and Environment, CO
719 575-8468 

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CLAIMS ADJUSTMENT CODES

2003-03-06 Thread Dee Warrington



My question relates to the transaction and 
code sets rule -- but I am hoping one or more of you privacy gurus may be versed 
in TCS as well.

I was advised there are standard claim 
adjustment codes and was wondering if these codes are the only adjustment codes 
that can be used after 10/16?

Any response is appreciated.

Thank you.


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Non-routine and need for Authorization

2003-03-06 Thread Craig Moen

We are stumped on the language for authorization.  My current understanding
is that we are allowed to share information outlined in our Notice of
Privacy Practice for purposes of TPO.  The sticking point in my mind is what
is needed for non-routine disclosures of TPO.  Our day to day operation
includes sharing information with the ordering physician, external case
manager etc.  Non-routine occurrences may be requests for summaries of
treatment/progress by child protective services, united cerebral palsy,
Lutheran Social Services etc etc.  It doesn't seem that authorization as
defined applies to the above scenario.  Currently those entities will call
and we ask them to get a release of information form signed by the parent.
After receiving the release we verify with the family that they are wanting
us to release the information.  It would seem then that we would simply log
this disclosure in the patient chart.  Correct?

Another example.  We will treat in the school setting in some of the smaller
rural areas.  What is the school system in this scenario?  Certainly not a
BA?  Also if our therapist needs to discuss a positioning program with the
teacher is this allowable and would that need to be logged as non-routine?
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