Top Healthcare Compliance Issues for 2022
The healthcare industry is one that can be reiterated with all the departments that it consists of. The healthcare industry has last been estimated to reach $193.83 billion by 2020 and somewhere around $372 billion by 2022 by IBEF.
This industry is currently one of the oldest and the largest of the surviving industries that we have currently across the globe. We now have a healthcare center in the form of medical practices all around us. Gone are the days when we had to hunt for medical aid nearby because medical aid is not far now, especially if we look at the medical and dental practices, the number of which are growing each day.
The medical facilities that now go by the name of practices, have everything integrated into them, right from the booking of patients to patient intake and check-ins, patient diagnosis, tests, followups, and more, packed under a single roof. Besides, these practices, whether it is for medical or dental aid, are equipped with all the modern facilities that make up for excellent patient experiences along with abiding by the healthcare compliance laws. Yes, healthcare compliance is a really important thing that no medical clinics, hospitals, and practices can miss out on.
What is healthcare compliance?
We all know what compliance means. The word means to obey, observe, comply or respect a particular set of rules, standards, or guidelines. The term compliance means much the same when it comes to the medical industry too. The healthcare industry deals with patients, who are central to the industry, and their problems.
The healthcare problems of the patients are both physical and mental and may concern the mass or the persons associated with the same. Therefore, these ailments/diseases are not to be taken lightly and when it is not, the patients hit the medical and dental practices to get a cure for the same. Therefore, it is clear that the industry of healthcare deals with a lot of data, which are mostly related to the patients and their health, and the medical clinics and practices that provide medical aid is strictly advised against parting from the sensitive medical data of the patients or what we often term as (PHI) Protected Health Information.
Therefore, healthcare compliance is a formal term given to all the practices that are followed in healthcare units throughout the healthcare industry to meet and exceed the legal, ethical, and professional standards set for a particular healthcare provider or for the industry of a particular country/state all across the world.
Health compliance is strictly followed ever since the healthcare laws were framed, including the laying down of the HIPAA guidelines for healthcare professionals. The Healthcare Insurance Portability and Accountability Act (HIPAA) is a federal law that was framed in 1996 in order to build national standards to shield sensitive patient-centric information, also known as protected health information (PHI) from being revealed against the consent or knowledge of the patients.
HIPAA guidelines for healthcare professionals
The HIPAA privacy guidelines are formed with the sole aim of keeping the personal health information of the patients or what we often term as PHI, secure. Any 'individually identifiable health information' that can reveal a patient's identity whether individually or as a whole, is commonly grouped in as PHI.
This patient-personal information or PHI not only consist of information like the name, address, ZIP code, or telephone number of the patients but also includes any other information that is associated with:
Furthermore, the HIPAA guidelines also consider the car registration numbers, health plan coverage, and even examples of the handwriting of a patient as PHI. This information can be in image, video or may also be recorded in the written format.
For example, if a medical professional had to snap a photo of the eczema of a patient to help him/her discuss the patient's condition with his/her colleagues in order to better diagnose the condition, then that information can also be revealing the identity of the patient with the help of a distinguishing feature. This photograph would thus, be considered as a PHI, according to the HIPAA privacy guidelines.
Over 58% of the compliance officers have identified the HIPAA Security and Privacy as a top high priority to reduce the risk of compliance issues for the providers of now and this is possible with the help of GrowPractice. It is one of the leading providers of medical office and practice management solutions that are HIPAA-compliant, which will help the private medical offices/practices and urgent care providers stay secure and compliant.
What are healthcare compliance laws and how is compliance in the medical industry implemented?
It is the combined efforts of the Department of Health and the Human Services (HHS) Office of the Inspector General (OIG), which have contributed to defining healthcare compliance through their compliance guidance documents.
The documents that are brought out by them, assert the healthcare bodies to establish a culture of health compliance within the healthcare organizations. This culture of compliance would significantly help in preventing, detecting, and resolving the instances of conduct that do not conform to government laws, health care program requirements, and ethical and business policies.
This compliance in the medical industry is overseen in a number of different areas including patient care, billing, reimbursement, managed care contracting, research standards, HIPAA privacy, and security, OSHA, The Joint Commission standards, etc.
Healthcare compliance is a crucial necessity that every other healthcare service provider needs to be concerned about and promote. Health compliance can be summed up as the meeting of all the rules and requirements that are applicable to a healthcare provider, across a wide array of criteria, which considerably varies as per the kind of organization and the services it provides. However, in many such organizations, healthcare compliance is either not quite focused or happens to be practically non-existent. This is why it is the duty of the healthcare practices and their compliance officers to monitor all the requirements and regulations regarding the patients' data or the PHI and how it is handled.
Implementing healthcare compliance in the healthcare practices and other medical care units around the globe is necessary but it is equally challenging to do so. However, health compliance is mandatory as per the governing bodies of the industry. Here's where the improved medical office software and systems from GrowPractice can come to your help. This market leader that brings in world-class solutions to your medical and dental offices, also makes sure that you remain compliant with the healthcare laws. Security is primary for GrowPractice, which is why the medical office, patient, and practice management solutions provider, is reinforced with HIPAA-compliant software and tools for the healthcare providers.
A List of the Prominent Healthcare Compliance Issues that the Practices Face in 2022!
Issues are everywhere, in every industry, they find their own place and the healthcare industry is not an exception. Along with numerous other issues that the healthcare industry is challenged with, keeping it compliant is one of the biggest challenges that the medical sector is still trying to cope with. Though a major portion of the industry is digital now and the maintenance of healthcare compliance is easier than ever today, some compliance issues truly creep up to give a bad time to providers from around the world.
Cybersecurity issues
One of the most prominent issues that can easily be termed as the aftermath of the digitalization process that is in ripe is the increase of cybersecurity breaches. The digital procedures should always be secure and updated. Moreover, they also need to be monitored for any viruses, or security breaches. Malware, viruses, and ransomware attacks are growing to be infamously common now. In some the attacks like the ransomware attacks, the providers need to give out a sum of money or a 'ransom' to iron out things. Many healthcare providers have also been prey to ransomware attacks of late.
According to the 2021 survey reports, the FBI issued many cybersecurity warnings in 2021 and confirmed the rising cases of cybersecurity issues, which witnessed more than a 70% rise from what was seen in the previous year. These cybersecurity issues were documented to cost the healthcare providers losses that exceeded $4 billion. Here the healthcare providers were largely targeted due to the rush hours that they witness because of the rising cases of COVID-19.
Issues in processing claims
The billing department is what can be identified as one of the most complex areas of the healthcare industry, where numerous issues creep up every now and then and disrupt the workflow of the industry, as a whole. Survey says that around 80% of the medical bills contain errors in them. Furthermore, it has also been discovered lately that nearly 50% of medical claims have errors. All of these errors in the billing processes are usually due to the manual approach in the processing of the bills and claims.
Besides, all these billing and claims errors cost the healthcare providers nearly $68 billion annually. These primary errors in the processing can certainly be improved with the leading-edge software solutions that GrowPractice brings in integrated with their medical office systems. Furthermore, GrowPractice also enables the providers of today to significantly cut down the time wasted in the billing and claims processing, thereby boosting the patient experience.
Processing the patient claims and insurance is also identified as one of the high-risk areas for healthcare compliances as well and should be properly addressed by the providers in order to stay compliant. Therefore, if HIPAA in medical billing is a concern for your medical/dental care provider, then GrowPractice will help you achieve the same effortlessly with its secure and compliant software and office systems.
Troubles brewing between the healthcare employees and the providers
The employees and the providers should always stay in harmony with each other because if they are not compatible and at peace with each other, then troubles can start brewing adn heavily disrupt the workflow. Healthcare employees are growing scarce and more and more employees have already started resigning from a mix of job roles in the healthcare industry. This has been more distinguishable than ever after the outbreak of the Covid-19 pandemic, which saw over 18% of the total healthcare workforce resign. The medical workers have always been on the heat list of the employees that are burned out, where more than 55% of the employees have been diagnosed as victims of the mid-high level of burnouts.
Now, if the employees are continuously conflicting with their employers or the healthcare providers, then that can also risk the security of the entire system and stand as a major compliance issue. This is why the troubles brewing between the medical employees and the healthcare providers is always a red flag for health compliance in general.
With the increasing levels of healthcare employees quitting their jobs since the Covid-19 onslaught was noted, the pressure on the employees is always mounting. This can, however, be strategically reduced by implementing employee-centric healthcare solutions that GrowPractice offers the practices. The medical office solutions provider helps the practices get all the benefits of its fast and easy, digital patient appointment scheduling practices, smooth patient check-ins, and intakes. Furthermore, GrowPractice also assures the practices secure patient-centric two-way texting methods, accurate billing software, and the best-in-class patient follow-up processes to improve their security, compliance, and boost their revenues.
Security of the medical data
Patient sensitive data or PHI is always at a risk to be exposed to the persons or tools that can cause more harm than good. Furthermore, it is important to note that any data, which is associated with a particular healthcare practice, also need to be secured, which is not always possible. The security of medical data needs to be assured at any cost by the healthcare provider. Now, if you are worried about assuring the same, then never forget that GrowPractice is by your side. GrowPractice extends multi-level security, HIPAA-compliant software and tools, and powerful data encryption that will keep your medical data secure.
Lack of regular compliance monitoring
Monitoring and assessment of healthcare compliances or rather the lack of it is also a big concern for the healthcare providers. Even if there is a working compliant workflow at a medical/dental office, then that can also be disrupted without much notice in case it doesn't consider monitoring it. Therefore, it is always important for the practices and healthcare clinics to evaluate their performance along with the health compliance measures that they are undertaking.
Poor telehealth providers
As today is the era of digitalization, more and more medical care units are choosing telehealth providers to onboard their patients and address all of their needs and ailments. However, there are some cases where the healthcare providers are falling victims to insecure/fraudulent telehealth providers that are leading to security breaches and disrupting the compliance that the healthcare providers need.
Poor EHR/PM software
In this digital age, along with telehealth providers, the EHR/PM software is among some other mentionable tools that are revolutionizing the healthcare industry. These software act as portals for the patients that help them check all of their information. However, the security of the same often stands questionable. Here, with GrowPractice's secure medical office software and tools, the medical practices now can stay assured of extending secure EHR/PM software that is fast, secure, and easily accessible for the patients. Furthermore, GrowPractice offers the providers to integrate their systems with over 65 EHR/PM software, thereby reducing the risk of compatibility issues.
Lack of secure medical office software solutions
Medical offices need to be agile at rush hours but that doesn't mean that they would be overburdening the healthcare employees or provide lengthy and unpleasant experiences for the patients. This is why the practices need to rely on reliable medical office software providers like GrowPractice. The medical office, patient, and practice management software solution is trusted by a wide range of healthcare providers, and even by numerous US Federal Agencies for the security it provides.
GrowPractice as your Healthcare Compliance Solutions
GrowPractice is one of the biggest names when it comes to providing medical office software, patient management, and practice management software and systems that help the medical and dental practices get the best of their business. Along with the cutting-edge technology that powers GrowPractice to extend the best patient appointment scheduling software, paperless intakes and check-ins, patient billing software, and more, GrowPractice also brings an innovative way for patients to communicate with their providers via a two-way texting process. What's more important to note is that this excellent process is HIPAA-compliant too. This means that you, as a provider, would never have to worry about missing out on health compliance. In fact, GrowPractice will emerge as your healthcare compliance solution too along with providing medical office solutions.
GrowPractice is bringing what we can easily term as a revolution in the healthcare industry, improving the patient ratings as much as 97% for the providers and making them compliant along with equipping them with the latest digital software and systems. The GrowPractice systems have also proven to reduce the negative patient ratings by 85%. So, stop worrying about healthcare compliance issues and take your leap of faith with Growpractice!
