Premium Essay

How Hippa Violations Affect the Medical Billing Process

In: Miscellaneous

Submitted By tight333
Words 840
Pages 4
How HIPPA Violations Affect the Medical Billing Process
Ronnie Ward
HCR/220
02/12/2012
Regina Kraus

How HIPPA Violations Affect the Medical Billing Process

Through making sure that a patient demographics are accurate and kept confidential HIPPA is able to affect the medical billing process, this authorization which allows a practice to use the confidential information and to bill that patient information to carriers for services should be placed in the patient file. When pertaining to people infected with this deadly and sometimes fatal disease or virus, AIDS and HIV can be a very touching and secretive issue. This is mostly because those who are affected with the disease are fearful of a breach in confidentiality. The patient fear can directly affect his or her health because the patient will not be seeking medical treatment for his or her illness. HIPPA is an organization charged with the responsibility of making sure patient confidentiality is upheld and that the services he or she is receiving is protected. Because of the patient fear of breach in confidentiality, HIPPA has set rules and regulations in place with criminal and civil penalties for those who violate the patient rights and to ensure that his or her right to confidentiality is protected. Patients who are affected with HIV and AIDS information is not separately addressed by HIPPA, never-the-less general guidelines pertaining to the release of personal health information including the HIV status of a patient, is still protected according to HIPPA rules and regulations on patient confidentiality. In an effort to ensure that patient confidentiality is upheld advocates are encouraging patients to embrace to opportunity to exercise this as a means of talking with his or her healthcare provider about patient information confidentiality and to see if the information is shared with others, and if...

Similar Documents

Premium Essay

How Hippa Violations Affect the Medical Billing Process, Part Two

...How HIPPAA Violations Affect the Medical Billing Process, Part Two Amber Padgett HCR/220 October 19, 2014 Felecia Pettit-Wallace The purpose of this paper is to relate to ways that the Health Insurance Portability and Accountability Act (HIPAA) violations may affect the medical billing process. While researching, the findings conclude that confidentiality of health information was adopted centuries ago. The findings of the research show that although, HIPAA laws have been put into place to protect the privacy and confidential heath information of patients; HIPAA laws are sometimes violated. The medical billing coders are sometimes careless when handling confidential information; however medical health records should be protected adequately. The coder that violates the HIPAA laws concerning the confidentiality and privacy of patient health information can suffer serious ramifications. The ramifications of these violations could result in serious penalties such as disciplinary actions by the employer, monetary fines, and jail time, or both. HIPAA violations ranks number one among the complaints received by the Office of Civil Rights each year. Humans take pleasure in the right to privacy in every aspect of life. The right of protecting the confidentiality and privacy of identifiable personal health information takes first priority and is greatly cherished among most. The Hippocratic Oath, dating back centuries required physicians to keep medical information......

Words: 1823 - Pages: 8

Free Essay

How Hipaa Violations Affect the Medical Billing Process

...How HIPAA Violations Affect the Medical Billing Process HCR/220 October 7, 2012 How HIPAA Violations Affect the Medical Billing Process In this paper we will discuss how HIPAA violations affect the medical billing process and why HIV and AIDS information is more sensitive than other types of health conditions. We will also examine the social, legal, and ethical ramifications of improper information disclosure. In 1996 on August 21, the Health Insurance Portability and Accountability Act (HIPAA) was enacted by the Federal Government and signed into law by President Bill Clinton (HIPAA – The Health Insurance Portability and Accountability Act, 2011). According to “Health Insurance Portability and Accountability Act” (2012), “HIPAA does the following; provides the ability to transfer and continue health insurance coverage for millions of American workers and their families when they change or lose their jobs, reduces health care fraud and abuse, mandates industry-wide standards for health care information on electric billing and other processes, and requires the protection and confidential handling of protected health information” (What is HIPAA?). The main reason HIPAA was enacted was to protect patient’s personal health information regardless of its severity. Their personal health information is just that, theirs! For that reason, among many other, it is very important to know that a patient’s personal health information is not to be shared with any......

Words: 1705 - Pages: 7

Premium Essay

Week Nine Final Project

...How HIPAA Violations Affect the Medical Billing Process Kathleen Davis HCR/220 7/22/2012 Lydia Cavieux HIPPA HIV and AIDS Keywords: HIV, AIDS, HIPPA One of the most sensitive of all disease is HIV and AIDS. These diseases keep many people from receiving treatment due to the fear of breach of confidentiality. This fear directly affects their health, because they do not receive the treatment they so desperately need. If any organization or doctor’s office breaches a patient confidentiality they could face civil or criminal penalties. HIPPA does not separate HIV/AIDS, but an individual is still protected under set guidelines. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) attempts to address some of the barriers to healthcare coverage and related job mobility impediments facing people with HIV as well as other vulnerable populations. HIPAA has three main goals. The first is to provide persons with group coverage new protections from discriminatory treatment. The second is to enable small groups (such as businesses with a small number of employees) to obtain and keep health insurance coverage more easily. The third is to give persons losing/leaving group coverage new options for obtaining individual coverage. This law provides several protections important to people with HIV/AIDS. The first is it limits (but does not wholly eliminate) the use of pre-existing condition exclusions. HIPPA also allows a patient to be aware of who will......

Words: 1622 - Pages: 7

Premium Essay

Legal Issues in Business

...Sunshine State Medical Billing Service Legal Issues in Business BUSI 561-D05 LUO 12/16/2011 This paper explores the legal challenges faced when forming and operating the Sunshine State Medical Billing Service. The legal issues surrounding the business will be analyzed using a business law perspective, as well as a Christian worldview. This legal business plan was prepared by Karri-Marie Baskin, Suzanne Ludikhuize, Renada Manning, Susan Schaeffer, and Dixie Wallace. Executive Summary Sunshine State Medical Billing Service’s physical location is in Tampa, Florida. Because the billing company utilizes the internet, it is able to provide services to many doctor’s offices across the United States. Sunshine State Medical Billing Service selected the Tampa site for several reasons: Low corporate and unemployment taxes, no individual income tax, large hiring base and new business incentive programs. http://www.tampaedc.com/site-selection/business-incentive.aspx; http://money.usnew.com/money/business-economy/small-business/articles/2009/01/06 Sunshine State Medical Billing Service offers the best streamlined billing service via the latest technology in the nation. Our clients are licensed doctors, who choose to use an outside billing company to act as their agent to bill and collect fees due them for services rendered. While there is a growing trend of medical billing services being offered as a home business, our clients can be assured that all of our employees......

Words: 8372 - Pages: 34

Premium Essay

Health Care Essay

...Healthcare Fraud and Abuse Under HIPPA, “fraud is defined as knowingly, and willfully executes or attempts to execute a scheme… to defraud any healthcare benefit program or to obtain by means of false or fraudulent pretenses, representations, or promises any of the money or property owned by…any healthcare benefit.” Unlike Fraud, abuse is, “means that are improper, inappropriate, outside of acceptable standards of professional conduct or medically unnecessary.” Health care fraud arises from an individual or group of individuals filing of a dishonest health care claim in order to turn it into a profit. Abuse; however, is harder for the investigator to identify and establish if the act was committed knowingly, willfully, and intentionally. Healthcare industry is one of the fastest growing sectors of the US economy; almost 10% of the US’s national GDP is consumed by the health care industry. According to Forbes’s report, the US National Healthcare expenditure of 2012 was nearly $3 Trillion. According to the National Healthcare Anti-Fraud Association, nearly $60 Billion is lost to healthcare fraud each year. The healthcare industry is an enormous market; therefore, making it easier for healthcare providers to take advantage of the American population. This paper will focus on why fraud and abuse occurs, different types of fraud, example cases of fraud and abuse, impact to present day healthcare industry, and potential solutions to fixing and preventing fraud and abuse......

Words: 4007 - Pages: 17

Premium Essay

Managerial Applications of Information Technology

...Clinic Janet Bermudez Managerial Applications of Information Technology October 12, 2014 Table of Contents Abstract ………………………………………………………………………………… 3 Brief Company Background ……………………………………………………………. 4 Discussion of business problem(s) ……………………………………………………… 4 High-level solution ……………………………………………………………………… 5 Benefits of solving the problem ………………………………………………………… 6 Business/technical approach ……………………………………………………………. 7 Business process changes ………………………………………………………………. 8 Technology or business practices used to augment the solution ……………………….. 8 Conclusions and overall recommendations …………………………………………….. 10 High-level implementation plan ……………………………………………………….. 11 Summary of project ……………………………………………………………………. 12 Abstract The arrival of information technology some decades ago has contributed to the various developments on how information is being diffused and fluctuated among people, nations and around the world. The controversy of information “theft” and data loss has unfolded all around the world and interests on how to solve this issue are capturing the scrutiny of experts of Information Security. In the present day, with the ongoing reproduction of new invented techniques in cryptanalysis, we can acknowledge that information security is the remedy. In this paper, I propose a panacea that can be used to solve multiple issues that clinics such as New Direction can face when using online storages like Drop Box. This paper will also discuss why......

Words: 3536 - Pages: 15

Premium Essay

5w's Behind Healthcare Reform Initiatives and How They Affect Him Pro's.

...The 5W’s behind recent healthcare reform initiatives and how they have, are or can impact the delivery of healthcare and HIM professionals. There have been many controversies over healthcare reform ideas and all the issues that may or may not arise affecting everything from the delivery and costs to the patients, HIM and surrounding professionals roles, and the politicians and the different ideas they stand behind. Examples of some of the most influential and recent initiatives are HIPAA (Health Insurance Portability and Accountability Act)enforced in 1996 and ARRA (American Recovery and Reinvestment Act) and its revision HITECH(Health Information Technology for Economic and Clinical Act) of 2009 Each of these reforms have impacted the delivery of healthcare and therefore everyone in the U.S and especially with each reform new challenges, changes, benefits and/or problems for the HIM professionals and their roles and all they consist of. An HIM professional can work in many environments, including from home, private offices, doctors offices, nursing homes, hospitals and anywhere else that healthcare and/or PHI and/or EHR are handled. The HIM profession not only exists physically in numerous healthcare places but can work in numerous areas in the field such as medical billing and coding, a secretary, in any health area as a clerk, with many electronic systems such as HHS, MPI, HER, RIS and so many more and as the medical world changes so does the roles, jobs and duties of......

Words: 2568 - Pages: 11

Premium Essay

Pharmacy Law

...“Practice of Pharmacy”*DOES NOT INCLUDE: other providers dispensing drugs (including nurses), hospitals engaged in compounding/ dispensing, etc | a. the interpretation, evaluation, and implementation of a medical order, b. the dispensing of drugs and devices, c. drug product selection, d. the administration of drugs or devices e. drug utilization review, f. patient counseling, g. the provision of pharmaceutical care, and h. the responsibility for compounding and labeling of dispensed or repackaged drugs and devices, proper and safe storage of drugs and devices, and maintenance of proper records.  | “active practice of pharmacy” | the performance of the functions set out in this section by a pharmacist as his or her principal or ordinary occupation | “pharmaceutical care”Note: CAN enter into practice agreement | the provision of drug therapy for the purpose of achieving therapeutic outcomes that improve a patient's quality of life, including include a. the cure of disease b. the elimination or reduction of a patient's symptomatology c. the arrest or slowing of a disease process d. the prevention of a disease or symptomatology | Equipment and Reference material requirements for operating a pharmacy | * Not very specific anymore * Up to judgment of pharmacist based on what they will be doing in the pharmacy * References must be up to date, in either printed or electronic form, and......

Words: 7455 - Pages: 30

Premium Essay

Scavenger Hunt Questions and Answers

...2012 Catalog Volume 20 Issue 1 March 5, 2012 – December 31, 2012 This Catalog contains information, policies, procedures, regulations and requirements that were correct at the time of publication and are subject to the terms and conditions of the Enrollment Agreement entered into between the Student and ECPI University. In keeping with the educational mission of the University, the information, policies, procedures, regulations and requirements contained herein are continually being reviewed, changed and updated. Consequently, this document cannot be considered binding. Students are responsible for keeping informed of official policies and meeting all relevant requirements. When required changes to the Catalog occur, they will be communicated through catalog inserts and other means until a revised edition of the Catalog is published. The policies in this Catalog have been approved under the authority of the ECPI University Board of Trustees and, therefore, constitute official University policy. Students should become familiar with the policies in this Catalog. These policies outline both student rights and student responsibilities. The University reserves the right and authority at any time to alter any or all of the statements contained herein, to modify the requirements for admission and graduation, to change or discontinue programs of study, to amend any regulation or policy affecting the student body, to increase tuition and fees, to deny admission, to revoke an offer...

Words: 130938 - Pages: 524

Premium Essay

Form

...OFFICIAL CATALOG This Catalog contains information, policies, procedures, regulations and requirements that were correct at the time of publication and are subject to the terms and conditions of the Enrollment Agreement entered into between the Student and ECPI University. In keeping with the educational mission of the University, the information, policies, procedures, regulations and requirements contained herein are continually being reviewed, changed and updated. Consequently, this document cannot be considered binding. Students are responsible for keeping informed of official policies and meeting all relevant requirements. When required changes to the Catalog occur, they will be communicated through catalog inserts and other means until a revised edition of the Catalog is published. The policies in this Catalog have been approved under the authority of the ECPI University Board of Trustees and, therefore, constitute official University policy. Students should become familiar with the policies in this Catalog. These policies outline both student rights and student responsibilities. The University reserves the right and authority at any time to alter any or all of the statements contained herein, to modify the requirements for admission and graduation, to change or discontinue programs of study, to amend any regulation or policy affecting the student body, to increase tuition and fees, to deny admission, to revoke an offer of admission and to dismiss from......

Words: 149595 - Pages: 599

Premium Essay

Textile

...Comprehensive Business Process Review and Audit Final Report Prepared for Vermont Electric Cooperative, Inc. December 24, 2007 Proprietary & Confidential This document includes information that is proprietary and confidential to Stone & Webster Management Consultants, Inc. (Stone & Webster Consultants) and shall not be disclosed outside the Recipient’s organization. This document shall not be duplicated, used, or disclosed – in whole or in part – for any purpose other than evaluation of this document by the Recipient. This restriction does not limit the Recipient’s right to use information contained in this document, if it is obtained from another source without restriction. The information subject to this restriction is contained in pages of this document marked “Proprietary & Confidential”. This document shall be returned to Stone & Webster Consultants upon its request. Mr. David Hallquist CEO Vermont Electric Cooperative, Inc. 42 Wescom Road Johnson, Vermont 05656-9717 Subject: Final Report of the Comprehensive Business Process Review and Audit (BPRA) Efforts December 24, 2007 Dear Mr. Hallquist: Stone & Webster Management Consultants, Inc. (Stone & Webster Consultants) is pleased to submit our team’s report resulting from our efforts to provide a Comprehensive Business Process Review and Audit (BPRA) to the Vermont Electric Cooperative, Inc. (VEC). We have incorporated those comments that we felt were appropriate in this final version of the report...

Words: 50648 - Pages: 203

Premium Essay

Quality Award Application

...Application TABLE OF CONTENTS Glossary of Terms and Abbreviations Organizational Profile i Responses Addressing All Criteria Items Category 1: Leadership 1 Category 2: Strategic Planning 6 Category 3: Customer Focus 10 Category 4: Measurement, Analysis, and Knowledge Management 14 Category 5: Workforce Focus 18 Category 6: Process Management 23 Category 7: Results 7.1: Best Quality (Healthcare Outcomes) 27 7.2: Best Customer Service (Customer Focused Outcomes) 32 7.3: Best Financial Performance & Growth (Financial & Market Outcomes) 35 7.4: Best People and Workplace (Workforce Focused Outcomes) 38 7.5: Best 5 Bs (Process Effectiveness Outcomes) 41 7.6: Best 5 Bs (Leadership Outcomes) 45 GLOSSARY OF TERMS AND ABBREVIATIONS APP: Annual Planning Process 5Bs: AtlantiCare’s five “Bests” or performance excellence commitments – Best People and Workplace, Best Quality, Best Customer Service, Best Financial Performance, Best Growth ARMC : AtlantiCare Regional Medical Center ASC: Ambulatory Surgery Center ASPP: Annual Strategic Planning Process A AAAHC: Accreditation Association for Ambulatory Health Care AAI: AtlantiCare Administrators Incorporated AAP: Annual Action Plan B BFP: Best Financial Performance Big Dots: The system-level measurements or targets for each of the 5 Bs (performance excellence commitments). Business units (and their departments) have measurable......

Words: 41167 - Pages: 165

Premium Essay

Loma Level 1 Essays

...INSURANCE INDUSTRY 5 CHAPTER 3: INTRODUCTION TO RISK AND INSURANCE 9 CHAPTER 4: MEETING NEEDS FOR LIFE INSURANCE 15 CHAPTER 5: THE INSURANCE POLICY 19 CHARTER 6: PRICING LIFE INSURANCE. 22 CHAPTER 7: TERM LIFE INSURANCE 26 CHAPTER 8: PERMANENT LIFE INSURANCE AND ENDOWMENT INSURANCE 30 CHAPTER 9: SUPPLEMENTARY BENEFITS 37 CHAPTER 10: LIFE INSURANCE POLICY PROVISIONS 44 CHAPTER 11: LIFE INSURANCE BENEFICIARY POLICIES 50 CHAPTER 12: ADDITIONAL OWNERSHIP RIGHTS 52 CHAPTER 13: PAYING LIFE INSURANCE POLICY PROCEEDS. 59 CHAPTER 14: PRINCIPLES OF GROUP INSURANCE POLICY 63 CHAPTER 15: GROUP LIFE INSURANCE. 68 CHAPTER 16: ANNUITIES AND INDIVIDUAL RETIREMENT SAVINGS PLANS 73 CHAPTER 17: GROUP RETIREMENT AND SAVINGS PLAN. 84 CHAPTER 18: MEDICAL EXPENSE COVERAGE 90 CHAPTER 19: DISABILITY INCOME COVERAGE. 94 CHAPTER 20:TRADITIONAL GROUP HEALTH INSURANCE PLANS 98 CHAPTER 21: TRADITIONAL INDIVIDUAL HEALTH INSURANCE POLICIES 104 CHAPTER 22: MANAGED CARE PLANS 109 CHAPTER 23: REGULATION OF HEALTH INSURANCE 113 CHAPTER 1: INTRODUCTION AND INDIVIDUAL LIFE INSURANCE Insurance companies are organized as either • Stock Insurance companies Company has stock that is bought by shareholders. So company is owned by shareholders. These share holders get dividends. No. of companies: 1604 Income from Premium: 226 billion Dollar amount of Life Insurance in force: 9.8 trillion • Mutual Insurance companies This type of company is owned......

Words: 39952 - Pages: 160

Premium Essay

Paper

...Management of Information Security Third Edition This page intentionally left blank Management of Information Security Third Edition Michael Whitman, Ph.D., CISM, CISSP Herbert Mattord, M.B.A., CISM, CISSP Kennesaw State University ———————————————————————— Australia • Brazil • Japan • Korea • Mexico • Singapore • Spain • United Kingdom • United States Management of Information Security, Third Edition Michael E. Whitman and Herbert J. Mattord Vice President, Career and Professional Editorial: Dave Garza Executive Editor: Stephen Helba Managing Editor: Marah Bellegarde Product Manager: Natalie Pashoukos Developmental Editor: Lynne Raughley Editorial Assistant: Meghan Orvis Vice President, Career and Professional Marketing: Jennifer McAvey Marketing Director: Deborah S. Yarnell Senior Marketing Manager: Erin Coffin Marketing Coordinator: Shanna Gibbs Production Director: Carolyn Miller Production Manager: Andrew Crouth Senior Content Project Manager: Andrea Majot Senior Art Director: Jack Pendleton Cover illustration: Image copyright 2009. Used under license from Shutterstock.com Production Technology Analyst: Tom Stover © 2010 Course Technology, Cengage Learning ALL RIGHTS RESERVED. No part of this work covered by the copyright herein may be reproduced, transmitted, stored, or used in any form or by any means graphic, electronic, or mechanical, including but not limited to photocopying, recording, scanning, digitizing, taping, Web distribution,......

Words: 229697 - Pages: 919

Premium Essay

Test Paper

...Checklists • Charts • Common Instructions • And Other Good Stuff! To access the Cheat Sheet created specifically for this book, go to www.dummies.com/cheatsheet/cloudcomputing Get Smart at Dummies.com Dummies.com makes your life easier with 1,000s of answers on everything from removing wallpaper to using the latest version of Windows. Check out our • Videos • Illustrated Articles • Step-by-Step Instructions Plus, each month you can win valuable prizes by entering our Dummies.com sweepstakes. * Want a weekly dose of Dummies? Sign up for Newsletters on • Digital Photography • Microsoft Windows & Office • Personal Finance & Investing • Health & Wellness • Computing, iPods & Cell Phones • eBay • Internet • Food, Home & Garden Find out “HOW” at Dummies.com *Sweepstakes not currently available in all countries; visit Dummies.com for official rules. Cloud Computing FOR DUMmIES ‰ Cloud Computing FOR DUMmIES ‰ by Judith Hurwitz, Robin Bloor, Marcia Kaufman, and Dr. Fern Halper Cloud Computing For Dummies® Published by Wiley Publishing, Inc. 111 River Street Hoboken, NJ 07030-5774 www.wiley.com Copyright © 2010 by Wiley Publishing, Inc., Indianapolis, Indiana Published by Wiley Publishing, Inc., Indianapolis, Indiana Published simultaneously in Canada No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording,...

Words: 96278 - Pages: 386