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I would say that the largest potential impact of offshore keying is two fold: 1) Loss of Medicare billing privilege once the lack of support for and auditing of the offshore business associate compliance is made known. 2) Severe public backlash, including significant liability. I suspect that most patients would be very unhappy to be told their US Insurance company was shipping jobs overseas, where their privacy was not being protected. How can anyone comply with the privacy and security requirements shipping paper overseas, or even scanned images of the paper. That's not to say that they may not be compliance, but without the ability to validate that compliance, for all intents it would be the same as being non-existent. Further more, this would have to be explicitly disclosed to the patients in plain language. Remember that Accountability is a key component. I wonder how many state Insurance Commissioners, elected officials, in this labor market, would find this an interested issue! Tim McGuinness, Ph.D. -----Original Message----- From: Hazelrigs, Jim [mailto:[EMAIL PROTECTED]] Sent: Tuesday, September 03, 2002 5:00 PM To: [EMAIL PROTECTED] Subject: Privacy Issue - Data entry of paper claims outside the US One of the recent trends is to send paper claims offshore (outside of the US) for data entry. This is often done by sending scanned files of paper claims. This practice may even increase in the future due to the "paper backlash" some expect from providers who were electronic submitters and who decide to switch to paper due to HIPAA compliance expense or complications and other issues. I am interested in hearing some viewpoints on how HIPAA Privacy will affect this off shore keying practice. It seems that since HIPAA is a US law only, there will be no ability to enforce its' provisions outside of the US. Therefore no foreign company can be held to task for not protecting PHI or using it in a manner not allowed under HIPAA. I also have read of some off these off shore data entry companies (or their employees) selling social security numbers (they dealt with credit card data) to members of the Russian mafia who used it in identify theft and who knows what else. Does anyone know of a specific requirement in HIPAA or via other federal rules that claims can not be keyed off shore? For the lawyers in the audience - any commentary would be appreciated. Should a best practice be not to allow keying of PHI off shore? Jim Hazelrigs [EMAIL PROTECTED] 4905 Waters Edge Drive, Raleigh, NC 27606 tel: 919 233 6820 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/. Posting of advertisements or other commercial use of this listserv is specifically prohibited. <P>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/. Posting of advertisements or other commercial use of this listserv is specifically prohibited.