Optometric Management Tip # 69   -   Wednesday, May 14, 2003
HIPAA Efficiency

The federal law referred to as the Health Insurance Portability and Accountability Act of 1996 (HIPAA) is far reaching for all health care providers. As we all try to understand and implement the patient rights and privacy portion of this program, we are realizing that compliance brings a very real cost that our practices must bear. The cost comes in many forms, including the paper and printing of the Notice of Privacy Practices that each patient must receive, but also in the time we must spend educating patients and documenting our compliance.

Now that the deadline for implementing the privacy notices is well past us, it is smart to review our office procedures for HIPAA with an eye toward improving efficiency. It's also good to review the regulations now that receptionists have dealt with HIPAA in the real world... knowledge and confidence can reduce awkward moments when patients ask tough questions.

One of the requirements of the law is to document that each patient received the Notice of Privacy Practices (NPP) by obtaining the person's signature. Here are a few points to note:

• Your office must offer the NPP at the first patient visit.
• The NPP need only be provided once and the signature only has to be obtained once (unless the document is changed).
• The patient does not have to take a copy of the NPP form if they don't want it (they only must be offered it). Many patients have already received similar forms from many different doctors, they know about it and they don't want the paperwork.
• You may want to place a stack of forms at the front desk and allow patients to take one if wanted.
• If a patient refuses to sign the HIPAA NPP receipt acknowledgment, you may still treat him or her. You are only required to attempt to obtain a signature - just make a note that the patient declined to sign.

One thing we did that has worked well in our office is to make up some special rubber stamps. The stamp is self-inking with red ink and reads:

HIPAA info received

Initials______ Date______

As my staff prepares the records for patients who are coming in the next day, they pre-stamp the outside of each file folder on the front. When the patient checks in, the receptionist explains and offers the HIPAA notice, and asks the patient to initial the blank on the file folder. This reduces the paper that must be filed, and it allows us to see at a glance on future visits that this patient has already received the NPP, and we need not offer it again.

SIDE NOTE: I forgot to state in last week's tip that I have no financial interest in Viking Office Products, when I recommended it as a source for printed folders. I receive no discount or other perks by mentioning the company. If I ever do have a financial relationship with a company that is mentioned in a tip, I will always disclose it.


Best wishes for continued success,

Neil B. Gailmard, OD, MBA, FAAO
Chief Optometric Editor, Optometric Management