Medical Malpractice

With the increase in the use of technology and the extended reach of the internet and computers, the medical insurance sector also had to advance. While the information technology makes it easy for the insurance houses and the healthcare providers to do their jobs, risks like data theft, identity theft and misuse of information have also increased. This prompted the United States government to frame the Health Insurance Portability and Accountability Act (HIPAA) in 1996, to give the patient greater control over his insurance cover and medical information. Additionally it also regulates the working of the insurance houses and the healthcare centers, making them more accountable.

As the patients get more control now, the organizations providing the insurance covers and the organizations providing HIPAA training or the "covered entities" have to do a balancing act. The insurance cover can be pulled up for various listed violations under HIPAA and can face serious charges. The covered entities should take the right measures and respect the law. Listed below are a few things you can do as representative of the covered entity to stay clear of trouble and keep your organization out of trouble.

• Review policies and procedures related to patient privacy

As per HIPAA, the privacy rule clearly states that the patient can control who accesses his or her records. The covered entity should appoint a privacy officer who can scrutinize the policies and procedures related to the patient privacy and policies. The organization should time and again communicate with the patient and explain the privacy policy of the organization.

• Review policies and procedures related to patient health insurance security

The insurance cover is required to review all the policies listed by HIPAA that deal with all the aspects of the patient health insurance security (PHI). A security officer is appointed by the covered-entity who heads the security systems of the organization, making sure there are no glitches in the system that can lead to leakage of PHI. An occasional report compiled by the Security Officer should be sent to all the patients. The PHI should be password protected and the system should be foolproof.

• Educate the staff about HPAA in detail

The staff of the covered entity should undergo a training process periodically. The latest HIPAA policies should be studied in detail and the law should be understood in detail. Once it is understood by the trainers, it can be passed on effectively. If the covered insurance skips this step, the patient can take them to the court for non clarity of policies.

• Agreements with business associates

All professional organizations and individuals in business relations with the covered insurance must enter into a business agreement to reduce the risk of any malpractices.

• Respond to patient requests and queries

Patients will have queries, doubts and questions. Always address their concerns timely, the time frame being within 30 days of receiving the request.

HIPAA is a very beneficial act which can benefit the patients. However, the covered entity should not get into trouble for policy and procedural issues. Constantly reviewing, analysis, in house training, up to date security measures and communicating with the patients can reduce the risk of violations.