Are there areas of patient privacy where state laws are stricter than the federal HIPAA privacy rule?

HIPAA

There are certain Wisconsin patient privacy laws that are stricter than sections of the federal privacy laws. Areas where Wisconsin privacy law is more stringent than HIPAA pertain to consent: Wisconsin allows disclosure of PHI without written consent of the patient for reasons that fall within the scope of treatment, payment or health care operations… Continue Reading Are there areas of patient privacy where state laws are stricter than the federal HIPAA privacy rule?

What is the security rule and what steps can dental offices take toward compliance?

HIPAA

The purpose of the HIPAA Security Rule is to protect the confidentiality, integrity and availability of electronically submitted protected health information whereas the HIPAA Privacy Rule applies to all patient information whether oral, written or electronic Covered entities (those who submit protected health information electronically) were to comply with Security Rule requirements by April 21,… Continue Reading What is the security rule and what steps can dental offices take toward compliance?

What needs to be done with regards to the HIPAA/HITECH Breach Notification Rule?

HIPAA

In 2009, the American Recovery and Reinvestment Act put forth rules pertaining to breaches in security to your patients’ protected health information. In 2013 HHS strengthened this act by clarifying when to report breaches and also increased monetary penalties based on negligence of the breach. If a patient’s PHI is acquired, accessed, used or disclosed… Continue Reading What needs to be done with regards to the HIPAA/HITECH Breach Notification Rule?

An unhappy patient has made threats to both the dentist and staff. The staff feel their safety is compromised and fear his/her return to the office. Is it a HIPAA violation to report this patient’s threatening behavior to law enforcement authorities?

HIPAA

In general, HIPAA Privacy does not prohibit a covered health care provider from sharing protected health information in order to report a crime which transpired on the provider’s own premises. The rule permits covered entities to disclose protected health information to law enforcement officials, without written authorization from the patient for specific circumstances. Disclosures should… Continue Reading An unhappy patient has made threats to both the dentist and staff. The staff feel their safety is compromised and fear his/her return to the office. Is it a HIPAA violation to report this patient’s threatening behavior to law enforcement authorities?

What is Medicaid and why is dentist participation low?

Medicaid and Discounts

Medicaid is a program with 40 percent funding of state and 60 percent funding of federal tax dollars. Its purpose is to serve individuals and families who cannot afford private medical/dental insurance and provide comprehensive care in order to prevent or treat illness. DHS works in conjunction with the state’s Legislature to establish the parameters… Continue Reading What is Medicaid and why is dentist participation low?

How can a practice care for Medicaid patients without becoming overwhelmed?

Medicaid and Discounts

Dentists are not required to become a provider under the state’s MA program, but many dentists who do wish to participate are often reluctant to do so from fear of becoming overwhelmed with MA patients. The Wisconsin MA All-Provider Handbook specifically notes, “All providers have the right to limit the number of Wisconsin MA patients… Continue Reading How can a practice care for Medicaid patients without becoming overwhelmed?

Can dentists who are not Medicaid-certified treat a patient on an emergency basis and, if so, what is the correct procedure?

Medicaid and Discounts

Yes, a non-certified dentist can treat a patient on an emergency basis. However, effective August 2013, all dentists who treat MA patients, even if just on an emergency basis, must be enrolled in as a MA Provider for that single day. Dentists who do not wish to take all MA patients into their practice will… Continue Reading Can dentists who are not Medicaid-certified treat a patient on an emergency basis and, if so, what is the correct procedure?

Where can Medicaid-certified dentists refer MA patients if they are unable to treat them?

Medicaid and Discounts

A MA-certified dentist can direct an individual to the ForwardHealth Member Services at 800-362-3002. ForwardHealth is the fiscal agent with whom the State of Wisconsin contracts for the administration and claims payment for the MA programs. Representatives are available Monday through Saturday, 7 a.m. to 9 p.m. and will assist patients who are currently covered… Continue Reading Where can Medicaid-certified dentists refer MA patients if they are unable to treat them?

Are dentists who are not Medicaid-certified providers allowed to still see MA patients providing they inform the patient ahead of time they are not MA-certified? Can the dentist require the patient to pay the dentist’s full fee?

Medicaid and Discounts

Yes, a dentist who is not MA-certified can treat any MA patient and charge the patient the dentist’s normal fee. To limit confusion or miscommunication, it is suggested a treatment plan, along with payment arrangements (which also should clearly state that MA will not be billed), be signed prior to any treatment being performed so… Continue Reading Are dentists who are not Medicaid-certified providers allowed to still see MA patients providing they inform the patient ahead of time they are not MA-certified? Can the dentist require the patient to pay the dentist’s full fee?