The utilization review (UR) process is a required process to determine if the care a physician provides the patient is medically necessary and reimbursable by the payer source. While the exact definition of medical necessity varies amongst insurers and government agencies, section 1862 (a)(1)(a) of the Social Security Act provides the basic groundwork, stating, "Notwithstanding any other provisions of this tile, no payment may be made … for any expenses incurred for items or services, which are not reasonable and necessary for the diagnosis or treatment of illness or injury or to improve the functioning of a malformed body member."
Identify the new audit process that will be used by one of the two quality improvement organizations in charge of short stays under the 2-midnight rule.
Ah. Breathe a sigh of relief, Mr. and Mrs. HIPAA privacy and security officer. Another year is winding down, and your facility hasn't suffered a major breach of patient information.
If you need to copy some medical records that include PHI, you're probably on point when taking steps to ensure privacy. You make sure no one's around. You grab the documents right from the copier when you're done, you don't forget the originals, and you take the records where they need to go. No one sees them. No HIPAA violations here.
Q: When you refer to a laptop being encrypted for security reasons, is that the same as password protected? We have a number of employees with laptops who transport them from work to home and are concerned about a breach if a laptop is stolen.
