Subtitle F of title II of HIPAA is entitled “Administrative Simplification.” Let’s just stop right there. Does anyone else find the title of this section of government imposed, convoluted and often times majorly confusing act to be bit of an oxymoron? The passage of the Administration Simplification was completely warranted because by design it’s supposed to improve the Medicare program, the Medicaid program, and the healthcare system by encouraging the development of a health information system through the establishment of standards and requirements through the establishment of standards and requirements for the electronic transmission of certain health information. The confusion often comes into play when deciphering who exactly must comply with the HIPAA regulations. The requirements of HIPAA apply to any entity storing and/or transmitting patient identifiable information on electronic media. This means compliance must be followed by virtually all health care organizations from physicians and insurance companies to health care support organizations and even small and large companies who offer medical plans to their employees.
Administrative Simplification is intended to reduce the costs and administrative burdens of health care by making possible the standardized, electronic transmission of many administrative and financial transactions that are currently carried out manually on paper. This means your office or facility needs to have a procedure in order to be compliant under HIPAA. While it may seem like quite the undertaking, it is important to remember that everyone will benefit from implementation of the HIPAA standards. Electronic data exchange will save time, increase efficiency and reduce administrative costs. In the meantime, HIPAA is causing a great deal of stress for many people. The HIPAA rules and the standards adopted by Department of Health and Human Services are complicated, and the threat of penalties makes HIPAA all the more freighting.
For my own practice, I purchased the HIPAA Compliance Tools software produced by HJ Ross Company. After attending multiple seminars and trying to navigate the HIPAA maze on my own, I came to the conclusion I needed a little extra help. My administrative assistant was able to navigate the program on her own, create a customized policy and procedures manual, and subsequently provide an in-service training for myself and the rest of the staff. However, my method is just the path that worked out best for me. There are many routes that a facility can take to ensure compliance; the important part is that you need to do something! Your Procedure needs to be documented in case that day ever comes when you are faced with an audit, a civil claim, or a criminal charge. It is imperative that your facility has evidence that there is a procedure in place and training was administered and that every precaution to avoid a HIPAA infraction was taken.