Here’s What Thousands of Doctors Are Up Against, and How They Can Succeed

Here’s What Thousands of Doctors Are Up Against, and How They Can Succeed

RandallTech Provides Help for Doctors Battling Complex Compliance Regulation

Compliance in medical practice is a big issue for thousands of medical offices across the United States. Laws and requirements are constantly changing, and with it, bringing new and complex requirements for medical offices.

If you are a doctor, or medical professional in charge of your practice, this article is for you.

What Doctor’s Offices Are Up Against

There are many doctors and medical administrators who are considering shutting down their offices due to the growing pressure of compliance. With new laws passing recently, it’s more difficult – and therefore crucial – than ever for doctors to operate freely.

  • MIPS and HIPPA compliance
  • Regularly changing, or evolving laws
  • Complex implementation
  • Data tracking and storage
  • Coding and reporting

Randall Tech Medical Compliance00003 Here's What Thousands of Doctors Are Up Against, and How We Can Help

Culprit #1: MIPS

What Is MIPS?

MIPS is the law forming from what was previously three previously existing government programs, including: Medicare Meaningful Use (MU), Physician Quality Reporting System (PQRS), and Value-Based Modifier (VBM) programs.

How Does MIPS Work?

The MIPS program involves four performance categories for tracking medical offices. These performances will tally into a yearly score called the MIPS final score. Offices can achieve up to 100. These categories are:

  • Quality (was previously named PQRS, 60% for 2017)
  • Advancing Care Information (ACI, renamed from Meaningful Use) (25% for 2017)
  • Clinical Practice Improvement Activities (CPIA) (15% for 2017)
  • Resource Use (0% for 2017, but will be weighted for 2018 and beyond)

Source: SA Ignite

These scores are crucial since they will be determining how much Medicare reimbursement medical offices will receive later. That means, medical practices who do not properly manage their MIPS compliance are at risk of losing money.

Randall Tech Medical Compliance00002 Here's What Thousands of Doctors Are Up Against, and How We Can Help

Culprit #2: HIPPA

What Is HIPPA?

HIPPA stands for the Health Insurance Portability and Accountability Act passed in 1996. HIPPA is designed to protect and empower patients. But, it can be difficult for many doctor’s offices to comply with the strict, and often overly complex task of meeting HIPPA requirements. HIPPA requires four major capabilities be present and functioning at any given medical office. HIPPA requires the following major capabilities be present and functioning at any given medical office:

  • Risk Analysis: A thorough walkthrough of the clinic’s network is required to ensure the security of electronic personal health information (ePHI).  This document is used to guide the clinic through proper security standards in order to prevent data loss or theft.
  • Data Encryption: They must be able to encrypt patient data to prevent exposure if ePHI is lost or stolen, as well as provide procedures to be followed in the event data is suspected to be lost or stolen.
  • Contract reporting: They must perform a review of contact with vendors or other third-parties who have access to patient data.  The formal document is the Business Associate Agreement.

Is your medical practice prepared? If not, read on.

Solving Compliance Problems with a Consulting Firm

RandallTech is a specialist consulting, and full-service compliance firm. They are experts in medical compliance, providing a one-stop service for struggling medical practices in need of compliance support.