medical complianceMedical compliance can be a problem for smaller medical practices. These are the ones that may have just minimal front- and back-office staff and may not be aware of all of the regulatory requirements for that practice. There are myriad of minefields that a small practice may not be familiar with.

Bio-hazardous waste: So in a medical practice or a dental practice, you have to make certain that it is a healthy and safe environment. An example would be: how are you disposing of bio-hazardous waste? If you are drawing blood, then you have regulations under CLIA in the proper handling of body fluid. You need to ensure you’ve got proper needle disposal.

Scope of practice: The compliance falls into the skill set, and the licensure, of each individual. There’s a scope of practice for each license that’s held, and so the assurance that nobody is functioning outside of their scope of practice. If you’ve got a CNA doing nursing duties, that physician can be personally liable for anything that happens to that patient, because somebody was unskilled to perform that. Because in actuality, they’re performing/practicing medicine.

Medical billing: That is the transition from ICD-9 Codes – which physicians have been using since 1979 – the transition finally to ICD-10. This moves from 14,000 diagnostic codes to in excess of 70,000, with more specificity. This is a monumental undertaking, but October 1 is the deadline for that implementation.

Patient information (HIPAA): How well do you have that secure? Whether it’s in paper files? Who has access to it? You know, how have you screened the individuals who are actually coming in contact with patient information? You know, because you’ve got all of their vital information. And, even on the billing side: have you effectively bonded the individuals who are taking patient payment?

So, those are the types of things that we take a look at in the compliance area, and then the assurance that all of the regulations with regards to HIPAA are being adhered to, inclusive of that you have firewalls. When you’re sending information, is it encrypted? When you’re sending information that has any kind of patient information on it to another fax machine or a referring fax machine have you validated that it is encrypted fax? Do you have agreements between other providers that you will be sharing patient information? Do you have authorization from your patients to do so?

So, it’s all of those areas that a smaller practice, simply because they don’t have the resources to do that, or don’t know how, may not understand that they may have convergence. These are the types of issues we help small medical practices with.

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This blog posting was taken from an interview with Beau Donegan, medical practice consultant with Developing Winners