Most physicians are familiar with the MIPS quality models: These are the Physician Quality Reporting System (PQRS) measures that we’ve been reporting for years with the old Medicare value-based purchasing program. What we don’t know much about are the new cost efficiency models in MIPS, which are based solely on hospital and physician ICD-10-CM/CPT claims data rather than a clinical abstraction of our medical records.
Documentation and coding based on time requires knowledge about the general principles of E/M documentation, common sets of codes used to bill for E/M services, and E/M services providers.
OCR’s 2016 guidance on patient access opened up a debate in the industry and brought questions about fulfilling patient access requests to the foreground.
This month's security Q&A answers readers' questions on incidental disclosures, sending protected health information in the mail, and addressing vulnerabilities identified in a risk analysis.
The general rules for security, risk analysis, and risk management implementation specifications, and evaluation standards are key directives for ongoing compliance assurance. Although risk analysis concepts guidance appears in the Security Rule, many organizations use it for auditing Privacy Rule processes as well.
Handling requests for information from law enforcement can throw staff for a loop. Most staff are aware of their organization’s policies and the basic HIPAA requirements for disclosing patient information to family members, friends, and other individuals such as legal guardians. But handling requests from law enforcement officials can be a different matter.
Patient care continues to move from the inpatient setting to outpatient. With this change, the challenge of securing comprehensive documentation that articulates the services rendered and the patient care provided now needs to extend across the care continuum.
Q: It is my understanding that we can make PHI disclosures using our EHR for payment/treatment/healthcare operations without a consent and that we do not need to track these requests for an accounting of disclosures. Has this changed?
