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  Articles
Are You HIPAA Complaint?
Marianne Harper

You may believe that your practice is HIPAA complaint but, in actuality, it may not be. In addition, are you aware of the steps that must be taken in the event of a security breach of protected health information (PHI)? The federal government, in 2009, passed a law requiring health care providers to notify patients of any security breaches that affect those patients as well as reporting any breach to the federal government. In addition, these laws were expanded upon since then and September 25, 2013 is the new enforcement date for the latest changes in that law. You are required to know what to do in the event of a breach. According to http://www.hhs.gov/ocr/privacy/hipaa/administrative/breachnotificationrule/index.html, "a breach is, generally, an impermissible use or disclosure under the Privacy Rule that compromises the security or privacy of the protected health information such that the use or disclosure poses a significant risk of financial, reputational, or other harm to the affected."

So what must you do to be prepared if a breach occurs? The following details the steps that must be taken:
Patient data must be encrypted. This includes emails that transmit patient data. Modern dental practices are becoming more and more digitized. These practices are quite often sending patient data, including x-rays, via email to other dental practices. You need to determine if your email is encrypted.
If you discover a breach, your first action should be to contact your attorney or a company, such as Total Medical Compliance, that specializes in HIPAA compliance. These sources will know far better than you how to file a breach report.
The regulations dealing with business associates who have access to your patient information have changed. You need to stay updated on these changes. Review your current business associate agreement to determine if it is compliant with the current regulations. Once it is updated, make sure to send it to all of those business associates for signatures.
Follow the regulations regarding the destruction of patient records. Check both federal and state regulations regarding this. If you use a shredding service, make sure that you have a business associate agreement with them.
There are three exceptions to the breach definition. They are as follows:
The unintentional acquisition, access, or use of protected health by a staff member
Inadvertent disclosure of PHI from a person authorized to access PHI and to another person authorized to access PHI at a covered entity or business associate
If any doctor or staff member has a good faith belief that an unauthorized individual who received the information would not have been able to retain the information
This article only provides a brief look at part of the changes regarding HIPAA compliance. My suggestion is to take the time to learn about HIPAA rules and regulations. The HIPAA website already mentioned provides a great deal of information. Also, companies such as Total Medical Compliance can help practices to become compliant and stay compliant. I have read that the federal government has hired and paid a huge sum to a private corporation to help with the process of identifying practices that are not compliant and to prosecute them. They are out there doing their job. Also, don't be fooled into believing that your patients aren't aware of these HIPAA rules and regulations. The same website listed above also provides much information for patients. Make it a point to check into your level of compliance. Work with a company that can help your practice understand the rules and offer you the assurance that, yes, you are compliant.

Uncovering the Evidence During a Periodontal Screening
Colleen Rutledge, RDH

Identifying the need for occlusal guards is an essential, yet under diagnosed part of a comprehensive preventive care appointment. Effectively communicating the value of occlusal guards can be easily achieved with ample evidence. Uncovering the evidence during a periodontal screening is the key to increasing patient compliance and practice profitability.

Consistent documentation of bruxing indicators during a 6 point periodontal screening includes recession, incisal chips, wear facets and abfraction lesions. These 'clues' support the reasons for occlusal therapy intervention. Wearing magnification loupes help clinicians find these 'clues' with the greatest of ease!

Diagnosing as few as two occlusal guards per week at $350 per guard, hygiene production will increase $38,600.00 annually. Educating the hygiene team to better identify evidence of occlusal trauma can dramatically increase hygiene production and provide an added value to the recare appointment!

10% OFF SALE on every product in our store until July 15, 2013! Use code JUNE13 at checkout. Please visit www.PerioAndBeyond.com to shop now!
  Insurance Alert
Dental – You may have heard or read about some future changes requiring diagnosis codes for dental claims. At present, diagnosis codes are only required when filing for such treatments as more frequent prophies for patients with diabetes or for patients who are pregnant. However, diagnosis coding for dental insurance is on the horizon.
Medical
Breaking news – On June 17th, CMS announced that the CMS-1500 claim form has been revised and the revised form is the CMS-1500(02/12). There was a delay in the release of this form which has resulted in a delay in the date when this form will be mandatory. Details on the new form and dates for implementation will be covered in my next newsletter.
When contacting medical insurance carriers to determine eligibility, coverage, and the possible need for pre-authorization, do you ask if they will accept CDT codes? Some carriers will accept these and, if they do, using them will take the guess work out of using non-specific medical codes for dental work. So make it a point to ask that very important question. Using CDT codes on medical claims can simplify cross coding, if accepted by the carrier.
  Time Line
Update Time is Past Due – Medical Codes and Dental Codes for 2013
And your updated medical coding manual contains the new CDT codes also
CPT Code (medical procedure code set) will update as of January 1, 2013. Purchasers of "CrossWalking – A Guide Through the CrossWalk of Dental to Medical Coding" and/or the "Quick Look Up Cross Code List" – you should have received an email that provides information on the way to order the update. Medical insurance carriers will not accept outdated codes and will deny claims for that reason. I am offering a less expensive update to the paper manual this year in an electronic format. So take advantage of the savings and keep your codes up to date.
CDT Code UpdatePast Due – The ADA has announced that CDT codes will update on January 1st of every year. If you haven't already purchased your 2013 code set, now is the time. I recommend Dr. Charles Blair's "Coding with Confidence." It is the best source for all the detail that you need to understand the CDT codes. In addition, consider a subscription to "Insurance Solutions Newsletter." Not only will you receive a newsletter packed full of great coding information but the subscription also includes a coding support service. You can't go wrong with that kind of help. To order either or both of these, please click here.
September 23, 2013 – HIPAA Omnibus Final Rule – The updates to this rule were published on January 25, 2013. The compliance date is September 23, 2013.
October 1, 2014 – The new date for ICD-10 implementation.

Favorite Quotes:
From "HIPAA Slogans, Mottos, Tag lines, Catch Phrases, Maxims..."
Show you care by keeping protected health information private. 
Make sure those passing by don't see PHI. 
Before leaving the scene, clear your desk and your screen. 
Protecting each person's privacy is a key part of quality care. 
We verify ... all requests for PHI.  
Privacy Matters. Don't discuss personal healthcare information in public or with those who do not need to know it.  
Say no to unauthorized requests for PHI.  
As everyone knows, PHI must not be improperly disclosed. 
You don't have to be a magician to ensure proper permission.  
Verify all requests for access to PHI.  
HIPAA: It's not just a good idea. It's the law.  
HIPAA: It's not just a law - it's how we show we care.  
Before sharing PHI, know who, what, and why.  
Because we care, we're HIPAA aware.  
Information about your medical care is something we don't share, unless you're aware (and have given written permission).  
We're not shy about protecting your PHI.  
To show our respect, we protect personal health information that we collect. 
HIPAA: We protect what we collect.  
There is no cure for data that's insecure. Protect each person's healthcare information from unneeded exposure.  
Protecting PHI is everyone's job; PHI is not everyone's business. 
Accessed from: http://www.nativeintelligence.com/ni-free/hipaa-poster-slogans.asp, 6/10/13

Tips:

Efficiency is the key to so many areas in dentistry. Here's a tip for those in the business office – shortcut keys:

Keyboard Shortcuts

Points of Interest:
Do you enjoy Sushi? Do you also enjoy dipping your Sushi in Wasabi? According to my favorite source of "Point of Interest" information, "Uncle John's Bathroom Reader" (don't laugh), you are probably not eating true Wasabi. True Wasabi is much more expensive and is made from a plant by the same name which is a horseradish-like root full of isothiocyanates which produce potent vapors that attack nasal passages. What you may be eating is simply a mixture of horseradish, mustard seed, and green food coloring. How disappointing!

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The contents of this publication reflect the opinion of the authors only. This publication is for informational purposes only.
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