Eggleston & Eggleston is proud to serve medical practice and hospitals in Virginia by providing an integrated approach to practice management with a personal touch. Here are our tips for Quarter 1 to keep your medical practice on track in 2022.
During Quarter 1
- Confirm physician and team continuing education plans for the year
- Review your EOBs for fee schedule changes
- Review HIPAA/OSHA compliance
- Update your HIPAA Disaster Recovery Plan
Confirm Physician And Team Continuing Education Plans For The Year
Continuing Education is required for physicians and many other certified medical professionals to keep their certifications current. Educational activities are used to maintain, develop, or increase knowledge, skills, and expertise. In Virginia, physicians are required to complete 60 hours of continued medical education every two years; 30 must be Category 1, of which 2 hours must be in pain management, proper prescribing of controlled substances, and the diagnosis and management of addiction.
Keep your team’s certifications up to date by confirming everyone’s plans for 2022.
Review Your EOBs For Fee Schedule Changes
It’s the time of year to update your fee schedule. Do you know where to find your contracted rates?
Your contracted rate fee schedule is what you are contracted to be paid by your payers. This fee schedule is also what you use to calculate co-insurance and deductible amounts when your patients are paying at the time of service. The fee schedule can be found in your contract with the payer.
Once you have the fee schedule, you need to review the payments coming in. If you notice that a payer is not paying you properly, get on the phone with them immediately. Do this for every payer until you are confident you are being paid correctly, and then spot-check once you have everything under control.
The other area that a fee schedule will help you with is to help you decide if you are charging enough for your services. If you notice that a payer is paying the claim in full or one to two codes in full, you need to raise your rates on your fee schedule. Find out how much their reimbursement rate is, and be sure you are charging 20-30 percent more than that amount. With reimbursement rates constantly shrinking, this is an area that can immediately increase your inflow.
Just be sure you have a fee schedule and that your front and back-office staff have a copy so that they can perform the functions of their jobs at the highest level.
Review HIPAA/OSHA Compliance
Both HIPAA and OSHA have mandatory training requirements that can be a source of confusion for medical and dental practices. Here are some important things to remember:
- Annual OSHA training for all employees is mandatory, including the doctor, nurses, receptionists and part-time employees. Training for new-hire employees must be completed within ten days of hire.
- HIPAA training is mandatory for anyone who comes into contact with protected health information (PHI) including doctors, dentists, nurses, receptionists and part-time employees/interns.
- Training must be documented for OSHA and HIPAA. Records provide evidence of the employer`s compliance with OSHA standards. Training records should include: dates, content, names and qualifications of trainers, names and job titles of attendees
- OSHA penalties can range from $0-$70,000 for failure to train citations. HIPAA issues penalties of up to $1.5 million depending on the provision of HIPAA violated. Doctors and nurses can also be charged with ethical violations and might risk sanction or loss of license.
Update Your Disaster Recovery Plan
A HIPAA data backup plan is a component of the administrative safeguards that must be implemented under the HIPAA Security Rule. The data backup plan, which is part of the administrative safeguard requirement to have a contingency plan, consists of establishing and implementing procedures to create and maintain retrievable, exact copies of electronic protected health information (ePHI).
A HIPAA Disaster Recovery Plan ensures that the data that is secured and backed up can be recovered and used. Under a disaster recovery plan, a covered entity or business associate establishes and implements procedures to restore any loss of data.
There are four essential steps to complete in the disaster recovery planning process.
- Performing a Business Impact Analysis (BIA)
- Performing a Risk Assessment
- Create a Risk Management Strategy
- Configure and Run Testing Exercises on Your Disaster Recovery Plan
How We Can Help
Eggleston & Eggleston’s Efficiency & Reimbursement Review Services are designed to help you determine appropriate reimbursement for your services while minimizing overhead. Our experience and information will help you identify areas of reimbursement weaknesses and opportunities to improve cash flow.
Our specialty service can also help you assess and implement your HIPAA/OSHA standards and develop a HIPAA disaster recovery plan.
Need our services? Wonder what we can do to help you serve your patients and your team?
Contact Eggleston & Eggleston Today!