There's a lot more to throwing away medical documents than bundling the papers in twine and putting them on the curb for the next day's garbage or recycling collection. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) mandates that you protect your patients' information at all times even when you're getting rid of it.

Your compliance program should be a "living" document that can constantly change. "A compliance program should evolve," says Aaron Krupp, JD, LLM. Krupp is the government affairs representative for the Medical Group Management Association (MGMA) in Washington, DC.

During a recent MGMA conference, TDO sat down with Krupp and attorney Robert Saner, Esq. for their take on how to build a successful compliance program.

Part IV of IV

By Barbara Eberly

When it comes to managed care contracts, there is a multitude of hidden “wrinkles” that may be a part of the contract language. The following are some of these wrinkles that may appear in contracts:

Gowns, lack of privacy violate certain faithsMariam Bhabha felt awkward and embarrassed when a woman handled her breasts during her first mammogram. She’s used to it now—well, as used to it as she can be. But she can’t get used to the feeling when she’s paraded through the waiting area, draped in a revealing gown that leaves her vulnerable.Bhabha is Muslim. The Islamic faith is among those that require women to be modest in what they wear. Women of Arab and South Asian descent also follow modest standards of dress and language in public places. In fact, she says

A coder at a family medicine practice in May received a questionable doctor’s note for an x-ray of the right knee. At issue was whether there was enough documentation in the note to support a separate evaluation and management (E/M) charge. The complete note appears below. Here is the coder’s assessment: “It is my opinion that there is not enough documentation to charge a separate E/M using the -25 modifier,” says Tammy Farris of Family Medical Specialties, a small physician practice in the Northeast. “The entire exam centers around the patient’s kne

Feds watching ‘personal injury protection mills,’ attorneys sayA neurologist blew the whistle on a Denver chiropractor last year in a case that illustrates the fragile nature of chiropractor and physician practice relationships.A jury found chiropractor Thomas Lawrence guilty this spring of robbing Medicare of more than $200,000 for nonexistent and uncovered treatments. Lawrence’s punishment: 10 years in prison and a $250,000 fine. Neither Lawrence nor his attorney would comment. Lawrence submitted false claims from a clinic he owned called Biological Medical Center.

Educate staff members to redisclose patient informationPhysician practices should be able to share patients’ protected health information (PHI) with anyone involved in the patients’ treatment if officials finalize pro posed changes to the privacy rule under the Health Insurance Portability and Accountability Act of 1996. This is important since most doctors have patient records that originated somewhere else. General practitioners of ten run tests on patients and send their records to other offices when they find conditions outside their expertise. Your staff must learn how

By Barbara EberlyThis is the final article in a three-part series.Most new employees in a medical practice mold themselves quickly to the style and work ethic of their coworkers. Dissatisfaction and low productivity set in for others. And it’s management’s job to help these employees adapt or prepare to leave. If you are in this position, it is vital to prevent wrongful termination lawsuits against your practice. Consider these three primary steps:1. Admit you have a problem employee who won’t change and try to help him or her 2. End it well, protecting yourself ag

A cryptic DOS-based computer program had the clerical team of Richard Ellison, MD, turning to the eye doctor for billing relief last year. So Ellison turned to the Ohio State Medical Association (OSMA) for help. The OSMA endorsed a Web system from Athena Health of Waltham, MA. And now, after nearly a year of orientation and trial and error, the new claims management system is paying off.“Athena puts our incomplete or improper claims on-hold and then helps us straighten them out,” says Ellison, who oversees Summit Ophthalmology’s business health.How it worksSummit has