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Governmental Audit Toolkit

Author: AHIMA

Source: AHIMA toolkit

Publication Date: December 02, 2011

This toolkit is designed to provide guidance to HIM professionals on how to prepare for and ensure compliance in managing governmental audits.

2004 HIPAA Privacy & Security Compliance Survey

Author: AHIMA

Source: AHIMA

Publication Date: April 12, 2004

The results of a survey conducted by AHIMA to assess the current state of HIPAA privacy within the healthcare industry. These results are being released in conjunction with the first annual National Health Information Privacy and Security Week.

HIPAA: 43,691 Privacy Complaints and Counting

Author: AHIMA

Source: Journal of AHIMA

Publication Date: June 2009


For those wondering what progress the Office for Civil Rights makes as it works through HIPAA privacy rule complaints, the numbers are easy to find. Each month OCR reports top-line results of the HIPAA cases it has received and resolved.

OCR has logged approximately 43,700 complaints....

Top RAC Target Areas

Author: AHIMA

Source: Journal of AHIMA

Publication Date: July 2012


If you bill fee-for-service programs, your claims will be subject to review by the Recovery Audit Contractor Program (RAC). That was the promise made by the Centers for Medicare and Medicaid Services when it expanded its once-experimental program to all 50 states in 2010. The RAC's mission....

Conference Handouts

Author: AHIMA

Source: HIPAA Conference 2000

Publication Date: March 13, 2000






 

Conference Handouts


If you weren't able to attend the HIPAA Conference in March, you can review the text of handouts and presentations provided at the sessions.

....

HIPAA Violation? Sue Me

Author: AHIMA

Source: Journal of AHIMA

Publication Date: March 2011


This is a true story that occurred recently in Indiana. Failing to collect payment for treatment, a medical group sent a patient to collections. In providing the unpaid bills to the collections attorney, practice staff failed to redact sensitive information. When the attorney filed the bills wi....

State of HIPAA Privacy and Security Compliance 2005

Author: AHIMA

Source: AHIMA report

Publication Date: April 11, 2005

The results of a survey to assess the current state of HIPAA privacy and security within the healthcare industry.

AHIMA releases the results of this research in conjunction with the second annual National Health Information Privacy and Security Week, April 10-16, 2005. AHIMA is sponsoring National Health Information Privacy and Security Week to raise awareness among healthcare professionals, their employers, the media, and the public regarding the importance of protecting the privacy, confidentiality, and security of personal health information (PHI).

HIM Staff RACing Up Record Requests

Author: AHIMA

Source: Journal of AHIMA

Publication Date: April 2013


Healthcare claims auditors have inundated release of information staff and vendors this year with record requests, in part due to the aggressive Centers for Medicare and Medicaid Services’ (CMS) Recovery Audit Contractor (RAC) initiative. RACs review provider bills and medical records to....

RAC Reform Awaits Government Action

Author: AHIMA Advocacy and Policy Team

Source: Journal of AHIMA

Publication Date: November 2013



Although the First session of the 113th Congress is coming to a close, plenty of work remains for the members of Congress to accomplish in the coming year. AHIMA has worked closely with federal legislators to raise awareness on key initiatives that affect health information management (HIM....

Journal Q&A (10/00)

Author: AHIMA Professional Practice Team

Source: AHIMA Q and A

Publication Date: October 02, 2000

Q: What is the retention period for billing records, such as explanations of benefits, charge slips, invoices, etc.?
A: Most states have established a retention period for medical records, but many have not addressed other type of records like billing documents. The Medicare program m....

Journal Q&A (4/00)

Author: AHIMA Professional Practice Team

Source: AHIMA Q and A

Publication Date: April 02, 2000

Q: When are rubber-stamp signatures acceptable? I read in a Part A newsletter that Medicare no longer accepts rubber-stamp signatures on documents that certify, order, or justify a service billed to Medicare. The newsletter cited the Medicare Conditions of Participation for hospitals (42CFR482.....

Journal Q&A (7/03)

Author: AHIMA Professional Practice Team

Source: AHIMA Q and A

Publication Date: July 02, 2003

Q: When is a new history and physical (H&P) needed when moving a patient between an acute care bed to a swing bed?

A: The key to determining when an H&P is needed is to find out how the swing bed is being used and the regulations that apply. Section 1883 of the Social Security Ac....

Journal Q&A (7/03)

Author: AHIMA Professional Practice Team

Source: AHIMA Q and A

Publication Date: July 02, 2003

Q: How can I find the Medicare manuals, program memorandums, and the Conditions of Participation on the new CMS Web site?

A: After the Health Care Financing Administration (HCFA) changed its name to CMS, it moved all its resources to its new site at www.cms.gov/manuals.


....

Journal Q&A (5/00)

Author: AHIMA Professional Practice Team

Source: AHIMA Q and A

Publication Date: May 02, 2000

Q: Does the Joint Commission require an RHIT or RHIA to be employed in a hospital's HIM department?
A: The Joint Commission does not specifically require that a RHIT or an RHIA be employed in the HIM department. However, in the Accreditation Manual for Hospitals, standard IM.4 require....

Journal Q&A (5/00)

Author: AHIMA Professional Practice Team

Source: AHIMA Q and A

Publication Date: May 02, 2000

Q: Is electronic record storage legal?
A: HCFA authorizes computerized health records as long as they are maintained in a form that can be reproduced legally. In addition, the Medicare Conditions of Participation for Hospitals, Medical Records Services specify that hospitals must use....

Journal Q&A (10/00)

Author: AHIMA Professional Practice Team

Source: AHIMA Q and A

Publication Date: October 02, 2000

Q: Can an emergency room exam serve as an inpatient history and physical?
A: It's important to understand the intent of the standards and regulations for hospitals and the practice standards for content of a history and physical (H&P) exam. The 2000 Joint Commission on Accreditation ....

Journal Q&A (11/02)

Author: AHIMA Professional Practice Team

Source: AHIMA Q and A

Publication Date: November 02, 2002


Q: Where can I find federal regulations, interpretive guidelines, and Medicare manuals online?


A: The Centers for Medicare & Medicaid Services (CMS) has a number of manuals available online including the federal regulations for various settings, interpretive guidelines, Med....

Journal Q&A (5/03)

Author: AHIMA Professional Practice Team

Source: AHIMA Q and A

Publication Date: May 02, 2003


Q: What is an organized health care arrangement (OHCA) and what are its advantages?


A: The privacy rule defines an OHCA as:

a clinically integrated care setting in which individuals typically receive healthcare from more than one healthcare provider

an org....

Journal Q&A (7/00)

Author: AHIMA Professional Practice Team

Source: AHIMA Q and A

Publication Date: July 02, 2000

Q: My state's laws say that health information may be made available to researchers who provide written evidence of approval of their projects by an institutional review board (IRB).

What is an IRB?
A: An IRB is any board, committee, or other group formally designated by....

Journal Q&A (5/00)

Author: AHIMA Professional Practice Team

Source: AHIMA Q and A

Publication Date: May 02, 2000

Q: Within what time frame are verbal orders required to be authenticated?
A: The Joint Commission on Accreditation of Healthcare Organizations' standard IM.7.7 for hospitals requires that "each verbal order must be dated and identified by the names of the individuals who gave it and....

Journal Q&A (7/01)

Author: AHIMA Staff

Source: AHIMA Q and A

Publication Date: July 02, 2001


Q: How does a healthcare organization deal with conflicting directives between HCFA regulations and Joint Commission standards when obligated to abide by both?


A: While one doesn't preclude the other, HCFA coordinates with accrediting organizations (Joint Commission, AOA, AAAHC....

Journal Q&A (7/01)

Author: AHIMA Staff

Source: AHIMA Q and A

Publication Date: July 02, 2001


Q: It's difficult to research and write organizational policies because of the myriad external forces governing the same healthcare issues. Do you have guidelines to help ensure we don't miss any mandates?


A: A healthcare organization is normally obligated to simultaneously fol....

Journal Q&A (2/01)

Author: AHIMA Staff

Source: AHIMA Q and A

Publication Date: February 02, 2001

Q: Where can I find information on the interpretation of Joint Commission on Accreditation of Healthcare Organization standards?

A: Information on the interpretation or intent of Joint Commission standards can be found in each accreditation program manual. The accreditation manual provides....

Journal Q&A (6/00)

Author: AHIMA Staff

Source: AHIMA Q and A

Publication Date: June 02, 2000

Q: Where I can access the Medicare Conditions of Participation online?
A: You can access the Medicare Conditions of Participation at www.access.gpo.gov/nara/cfr/index.html.    Then, Select "Search or browse your choice of CFR titles and/or volumes"

From the "Available CFR....

Journal Q&A (6/01)

Author: AHIMA Staff

Source: AHIMA Q and A

Publication Date: June 02, 2001

Q: What are the Joint Commission definitions of a sentinel event and root cause analysis?

A: The Joint Commission defines a sentinel event as "an unexpected occurrence involving death or serious physical or psychological injury, or risk thereof. Serious injury specifically includes loss o....

Journal Q&A (6/01)

Author: AHIMA Staff

Source: AHIMA Q and A

Publication Date: June 02, 2001

Q: Are there new Joint Commission hospital standards that address patient safety?

A: The Joint Commission's Board of Commissioners recently approved standards focused on patient safety and medical and healthcare error reduction in hospitals. These new standards are in addition to the curr....

Journal Q&A (9/01)

Author: AHIMA Staff

Source: AHIMA Q and A

Publication Date: September 02, 2001

Q: I work in a home care agency and am developing a procedure on correcting errors on OASIS to comply with the Centers for Medicare and Medicaid Services' (CMS, formerly HCFA) new correction policy. Is it necessary to make a separate entry in the medical record? Our agency would like to make the co....

Journal Q&A (5/01)

Author: AHIMA Staff

Source: AHIMA Q and A

Publication Date: May 02, 2001

Q: Does the new HIPAA privacy rule require hospitals to obtain patient consent prior to sending copies of dictated reports and test results to the patient's physician?

A: Unless the HIPAA privacy rule published on December 28, 2000 (45 CFR Parts 160 through 164) is modified by the Bush ad....

Journal Q&A (5/02)

Author: AHIMA Staff

Source: AHIMA Q and A

Publication Date: May 02, 2002

Q: In light of HIPAA restrictions on protected health information, I’m concerned about our HIM department’s practice of accepting HIM students for professional practice experience. What should be considered in deciding whether to continue this practice?


A: HIPAA’s pr....

Journal Q&A (6/01)

Author: AHIMA Staff

Source: AHIMA Q and A

Publication Date: June 02, 2001

Q: Where can I find information on completion of the medical record statistics form to determine compliance with Joint Commission standard IM.7.6?

A: Standard IM.7.6 of the Joint Commission Accreditation Manual for Hospitals requires that medical record data and information are managed in....

Journal Q&A (4/02)

Author: AHIMA Staff

Source: AHIMA Q and A

Publication Date: April 02, 2002

Q: I have been asked to identify all of my organization’s business associates so we can update their contracts prior to the April 2003 HIPAA privacy rule compliance date. Unfortunately, existing contracts are not maintained in one place. How should I tackle this project?


A: At....

Implementing Electronic Signatures - Retired

Author: AHIMA Task Force

Source: AHIMA practice brief

Publication Date: October 2003

Implementing Electronic Signatures (AHIMA Practice Brief)
Editor's note: The following information supplants information contained in the practice brief "Electronic Signatures (Updated)" published in the October 1998 Journal of AHIMA.
Electronic health records may provide the ability to....

Reporting Security Incidents

Author: Amatayakul, Margret

Source: Journal of AHIMA

Publication Date: March 2005


HIPAA requires covered entities “implement policies and procedures to address security incidents.” There is one implementation specification: to “identify and respond to suspected or known security incidents; mitigate, to the extent practical, harmful effects of security inci....

What is Security Auditing?

Author: Amatayakul, Margret

Source: Journal of AHIMA

Publication Date: November 2004


The HIPAA security rule includes a requirement for audit controls and to monitor and manage ongoing security for a variety of processes. But the requirement for internal audit was changed to “information security activity review,” and there is no other specific reference to auditin....

Trouble with Audit Controls

Author: Amatayakul, Margret

Source: Journal of AHIMA

Publication Date: October 2004


The 2004 Phoenix Health System/HIMSS HIPAA compliance survey indicates that providers find audit controls the most difficult of the HIPAA security standards to implement.
While it is recognized that every organization must conduct a risk analysis to determine the systems or activities th....

Access Controls: Striking the Right Balance

Author: Amatayakul, Margret

Source: Journal of AHIMA

Publication Date: January 2005


As healthcare organizations put the finishing touches on their HIPAA security compliance plans, many are finding that updating access controls is not easy. Clinicians often scoff at the word “control” in general and at “access control” in particular. Not all products ar....

Kick Starting the Security Risk Analysis

Author: Amatayakul, Margret

Source: Journal of AHIMA

Publication Date: July 2004


Many covered entities are just now starting to approach the compliance aspects of the HIPAA security rule. Why discuss “compliance aspects” and not standards or controls, as we did when preparing for the privacy rule? Privacy and security are long-standing concepts to healthcare,....

Fundamentals for the Newly Initiated

Author: Amatayakul, Margret

Source: HIPAA Conference 2000

Publication Date: March 14, 2000

2000 HIPAA Conference Presentation
Fundamentals for the Newly Initiated
Margret Amatayakul, Margret\A Consulting, LLC Session Objectives
Get an overview of the original legislation, processes, and timelines Examine the scope and impact of the new regulations Review ongoing HIPAA impl....

Security Awareness: The Right Messages

Author: Amatayakul, Margret

Source: Journal of AHIMA

Publication Date: April 2004


How many of you have warned your e-mail users about “phishers”—e-mail that appears to come from a trusted source asking the recipient to click on a link to update personal details? But the site is really a fake, and the e-mail is a scam to steal personal information.

Medical Identity Theft and the Red Flags Rule

Author: Apgar, Chris

Source: Journal of AHIMA - website

Publication Date: April 2009


Continuing our Health Information Privacy and Security Week series, today Chris Apgar, CISSP, president of Apgar & Associates LLC, takes a look at medical identity theft within the context of the Red Flags Rule.

Much is reported in the news about identity theft including new cat....

Industry Awaits Phase 2 of HIPAA Audit Program

Author: Asmonga, Donald D.

Source: Journal of AHIMA

Publication Date: January 2015



The wait for the second round of mandated privacy and security audits from the Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) continues. OCR is currently working through final details for the revised audit plan as they await finalization of new technolog....

Smart Training on Privacy and Security (expanded version)

Author: Bacik, Sandy

Source: Journal of AHIMA

Publication Date: April 2010



There is plenty of privacy and security training to be done, and many trainers struggle to get resources from their organizations and attention from their audiences. Sandy Bacik, CISSP, ISSMP, CISM, CGEIT, is a principal consultant at EnerNex and a former chief security officer. Here she o....

Smart Training on Privacy and Security

Author: Bacik, Sandy

Source: Journal of AHIMA

Publication Date: July 2010


ARRA's modifications to the HIPAA privacy and security rules are setting off a new round of training in facilities large and small. Trainers must fit the new training into existing schedules that already include organizational policies and procedures, HIPAA, and other regulations such as the R....

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