a facility may deny a resident's request for his/her health records.
reasons for denial;
1. the requested info does not exist(self explanatory)
2. the info includes psychotherapy notes that may harm the resident's well-being (interesting isn't it?)

do you feel safer?

You can thank lawyers for this. References are also going away since any negative comment leaves you open to litigation.

Quoted Text

HIPAA Audit Program Details Emerge

KPMG Wins Contract; 150 On-Site Audits Anticipated

By Howard Anderson, July 11, 2011. Credit Eligible



The long-overdue HITECH-Act mandated HIPAA compliance audit program will begin soon, with about 150 on-site audits of covered entities and business associates anticipated by the end of 2012.

The Department of Health and Human Services has awarded a $9.2 million contract to the consulting firm KPMG to develop the protocols and conduct the HIPAA audits. "Site visits conducted as part of every audit would include interviews with leadership (e.g., CIO, privacy officer, legal counsel, health information management/medical records director); examination of physical features and operations; consistency of process to policy; and observation of compliance with regulatory requirements."



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Every site visit will result in a detailed audit report. The HHS Office for Civil Rights will oversee the audit program.

Time to Prepare
Adam Greene, formerly of OCR and now a partner at the Washington law firm Davis Wright Tremaine LLP, notes, "In light of the large numbers of HIPAA covered entities and business associates, the likelihood of being audited will be small. Nevertheless, now is a good time for covered entities and business associates to review their HIPAA privacy and security programs, ensure that their documentation is up to date and assess whether their programs are effectively protecting protected health information."
Greene notes that because the program is funded through the HITECH Act, "It is not clear whether the audit program will continue after HITECH Act funds expire in 2012."

The KPMG contract announcement "raises as many questions as it answers," Greene says. "We do not know the scope of the audits, such as whether KPMG will review general compliance with the privacy and security rules or whether the audits will be focused on specific issues." And although the contract says entities varying in size and scope will be audited, "we do not know how entities will be selected for audit," Greene adds. "Most importantly, we do not know whether the audit program will be used as an enforcement tool (leading to resolution agreements or civil monetary penalties), or whether it will be used strictly as an educational tool to improve general compliance."

Greene notes that HHS also awarded a $180,000 contract to Booz Allen Hamilton for "audit candidate identification." He adds, "While limited information has been released about this contract, it is presumably for the purpose of identifying the universe of covered entities and business associates. Especially with respect to business associates, it may prove impossible for Booz Allen to generate a truly comprehensive list of candidates."

The Relationship Between Medical Coding and HIPPA

By Jacqueline Wilson, eHow Contributor

Print this article
Medical coding professionals are required to use standard coding systems as named by HIPAA.



The Health Care Insurance Portability and Accountability Act, or HIPAA, became law in 1996. Initially started to allow individuals to carry health insurance between employers, it later expanded to include issues like the privacy and security of patient health information, health care fraud and abuse and standard elements used when transmitting electronic patient health information, or e-PHI, for reimbursement. The e-PHI elements relate directly to medical coding.

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ICD 9 Coding

About Medical Coding



Medical coding assigns numerical and alphanumerical codes to patient diagnoses and procedures for reimbursement and reporting purposes. Medical codes provide a condensed way to report lengthy and detailed medical information. For example, 943.11 represents the code for a first-degree burn to the forearm. Converting medical diagnoses and treatments into numerical formats allows for the easy search, retrieval and submission of data.


Electronic Data Interchange



Before HIPAA, health care organizations were behind other businesses and technology in processing information. As industries like banking moved to electronic formats for information, the health care industry still processed much of its information via paper. Paper-based information exchange is costly, and health care needed a way to save money and provide a more efficient way of doing business. Electronic data interchange, or the electronic format of "data elements that assist in identifying the contents of a transaction," provided a way to work more effectively. According to the Centers for Medicare and Medicaid Services, EDI covers "claims and encounter information, payment and remittance advice, claims status, eligibility, enrollment and disenrollment, referrals and authorizations, and premium payment" information, which correlates with the medical coding process.






Transaction and Code Set Rule



As part of HIPAA's Administrative Simplification Title II, a "Transaction and Code Set Rule" exists. "Covered entities," or any health care organization falling under HIPAA law, are required to follow the standard set of coding. Under this portion, HIPAA also sets forth requirements for standard medical diagnosis and procedure codes.


HIPAA's Adoption of Coding Systems



The medical coding and billing industry had established coding systems prior to HIPAA. Because of this, HIPAA law named the well-known coding systems as the standard for reporting diagnoses, procedures and drugs. For physician office procedures, the Current Procedural Terminology, or CPT-4, system is used. ICD-9, or International Classification of Diseases-Ninth Revision, codes identify hospital diagnoses and inpatient procedures. Current Dental Terminology, or CDT, and National Drug Codes, or NDC, are standards for the dental and drug industries. Under HIPAA, any covered entity reporting e-PHI reimbursement information must adhere to the standard coding systems listed here.


HIPAA and ICD-10



In October 2013, the ICD-9 system updates to ICD-10. Foreseeing the change, HIPAA included terminology in the law to name the updated ICD-10 as one of the required standard code systems once implemented. The updated ICD-10 system provides better detail in codes for easier sharing and accessibility of patient health information.





what a JOKE.....so do you feel like a safer INDIVIDUAL????? currently the only way to FEEL like an individual would be to complain that the sheets are too rough and throw a tantrum and get a different set of sheets with
a complimentary pizza brought by administration as an "I'm sorry we are such idiots".......

YOU ARE A NUMBER.....NOTHING MORE

'HIDING' your procedure/diagnosis does nothing for your 'security'.....people could care less what our diagnosis are......the ONLY thing hidden , is from you ,as to the definition of the code applied to YOU.....

anyone remember the stupid AIDS 'scare'......that was an F'EN joke......you cant count AIDS diagnosis if folks dont report it, not to mention who they 'party with'.....

here is a chain of events:

public schools become quasi healthcare clinics via legislation(autism just the beginning)
child going to public school (doesn't quite fit in) referred to child psychologist
child then referred to psychiatrist (after parent decides school MUST  be right)
child gets labeled ADD/ADHD/Depression or whatever stupid diagnosis other stupid humans who think they know all about the human brain/function/body etc
child gets 'medicated' to fit in
child grows to adult and hasn't been on meds and doesn't remember their diagnosis/treatment from the past
adult now has no medication, has a traumatic event happen in their life of which affects their personality that everyone thinks is wrong(no one should be depressed/mourn)
adult goes to another F'EN expert(who now knows their 'label')
adult trys to get job and cant because of 'codes' labeled to them....however, they did pass the credit check and background criminal check

so if anyone thinks this is conspiracy, let me know.....or is this just safety?????

I think I would feel safer slitting my own wrists......

Quoted from senders

a facility may deny a resident's request for his/her health records.
reasons for denial;
1. the requested info does not exist(self explanatory)
2. the info includes psychotherapy notes that may harm the resident's well-being (interesting isn't it?)

do you feel safer?

I know this first hand!!! And it is even worse then this!! REALLY!!
You folks have no idea the damage obamacare/government health care/romneycare has caused to YOUR health care!! You's have NO IDEA!!!

Ya all better hope you die young...cause that's exactly what they are banking on!! REALLY!!!

YOU ALL HAVE NO IDEA!!!!

Quoted from bumblethru

I know this first hand!!! And it is even worse then this!! REALLY!!
You folks have no idea the damage obamacare/government health care/romneycare has caused to YOUR health care!! You's have NO IDEA!!!

Ya all better hope you die young...cause that's exactly what they are banking on!! REALLY!!!

YOU ALL HAVE NO IDEA!!!!

Don't forget the expansion for the kiddies, NewtCare.

REALLY??????????????? ARE WE ALL THAT MEDICATED THAT WE CANT RESPOND?????? WTH!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

REALLY?????

REALLY?????

REALLY?????