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Bringing over HIPAA question

Posted By: from new MT board - sm on 2006-01-17
In Reply to:

Can anyone answer the question: Do you HAVE to remove PHI from reports legally?

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bringing to the top
Coding certification

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Posted By: diddles on 2005-12-22
In Reply to: medical coding - looking for work

First I would encourage you that if you are serious about coding, do NOT go to a course that does not allow to test for NATIONAL certification.  There are only 2 organizations in the US that do national certification.  AAPC (the first) and AHIMA.  With AAPC there are numerous companies that offer their course.  The cost runs between $1200 and $1600 for a three month course of 8 hour classes plus your proctored exam and membership to AAPC, or you can do the self-study course for the same money (I chose to be in a classroom setting so I could have questions answered on the spot).  You can opt to take the course for hospital coding CPC-H (which few hospitals will recognize as official) or the doctor/outpatient based course - CPC, which is widely recognized.

I don't know the cost of AHIMA's testing but it is as intense as AAPC's but it is mostly taken by people who either already have AAPC certification or are already working in a medical coding setting.  Both organizations offer apprecentice programs if you are not already in a coding setting until you can clock some coding hours.  I think you need references to enter either program as to your character - remember, if you make a mistake the penalty could be monetory and/or a jail term.

Now, can you get a job and is the money worth it.  Most hospitals want AHIMA's inpatient certification and 1-2 years OTJ experience, unless they are hiring for their outpatient clinics and/or ER (which they will then accept the AAPC's CPC).  Most of these positions pay between $15 and $24/hr plus bennies.

It is very hard to get into the coding industry.  It's just like trying to get into MT without any experience, only harder.  I would network, join both organizations as a member and go religiously to the monthly meetings to network and learn.  Both certifications require a high number of CEU's to be earned each year.  It is easier to get into a physician's office setting as a CPC.  Most of these jobs pay $9 to $18/hr depending on geography, but again you'd have to be very, very good and have good references from certified mentors to help you get a job with no experience.

Most jobs are obtained by word of mouth.  If you are very good, you could skip working in a hospital or doctor's office and become a consultant and/or instructor without any working experience (more $$ for the instructor's certification).  It would be like working as an IC.  You would have to hustle to get clients and build a reputation.  I was lucky and got a job with a hospital in their outpatient clinic side at $19/hr with hospital bennies and had an offer with the people whose course I took to become an instructor and consultant for them even before I got the results from my test score (but I had prior coding experience).  My job was basically consulting, doing audits and giving feedback and education to doctors on how to maximize their reimbursement, how to document charts properly and be available for their coding questions.  I loved the respect I got from the doctors.  It was totally unlike what I get directly from doctors as an MT.  They are eager to learn, listen to what is being taught, are interactive, friendly and recognize that you are there to help them succeed.

If your MTSO is also adding a coding department to their company, that would be an easier way to get into coding as it could be done from home with access to electronic medical records.  There are a number of tools available to coders that help to electronically code and flag potential errors, hopefully your company would pay for all that because it can be quite expensive.

I tried to portray a clear and realistic picture with discouraging you.  It's a lot like going into MT without someone being realistic with you, so the fact that you asked is a good sign.

Thanks for bringing that up.
I cringe when I read this bord. The cruel and crude remarks meant to make another feel small actually sting my eyes when I read them.

Where did this come from? We were oncde librarians who loved medicine. Now, we have management, the noisy and miserable librarians who insist on an opinion on everything and refuse to budge, our immediate supervisor. I would give a million bucks to be able to be a good conversationalist. It appears that gets one farther than anything in this industry.

Younger MTs? The loud MTs are the ones who are MTholics and think just because they have dissected and analyzed every aspect of the typed medical sentence, the fact is more deaths take place in hospitals now than at any other time, due to medical record errors.

This is about patient health, not the QA, editor, whateverrrrrrrrrrrrrrrr, so I say to this industry:

Lighten the fk up. We are human beings and your colleagues. WHY are you being to rude?

Monitors would help but they love it. The rude remarks to a question leave one with a feeling of disappointment and dread, monitors, so uh, do your job.
Bringing up my DQS problem from down below, how many of the MQ MTs that use this..sm

are running it under XP AND have updated to the service pack 2? Tech Support says that's the only thing he can think of as everything else looks fine on my system. And on the converse, how many of you use DQS and DON'T have XP with or w/o service pack 2, or are just using the original XP w/o any upgrades. I don't want to be doing something to my machine that's going to screw it up even more. Thanks for your help. nm

Chickadee,..bringing this to the top

A better alternative to Lap band is the Medifast 5 and 1 plan. You eat 5 of their meals a day and then what they call a Lean and Green that you prepare yourself. I've only just started, but have lost 9 pounds in 4 days. Check out the website... Medifast1.com

Read the info and check out the message boards. I think you'll be pleasantly surprised.

You can spend 17+ thousand dollars for a band and eat 6 small meals a day or spend a couple of hundred dollars a month and eat 6 small meals a day.

Bringing up old documents....
Hi-I have only worked on Extext for a few days and it seems pretty good. I agree with the problem with inserting doctors names though. I am especially interested in finding out how to pull up old documents as I wasn't told about this feature. Can you let me know? Thanks....
I've often wondered about this one myself - thanks for bringing it up! nm

Bringing up hurricane discussion

Just for some other information.  When Hurricane Rita hit in Texas, i.e. Jasper, Beaumont area, these people were not prepared.  They were not prepared because hurricanes do not come in that far inland.  The Jasper area is one of the areas where most hurricane victims evacuate too.  There are people in that area that are still without power including elderly people and children.  Most of the surrounding areas (Pineland, Rosevine, Hemphill) are retirement areas.  These are also low income areas as well.  These people definitely would not have expected the hurricane to effect them in the way that it did, but it did.


Also, people in Lufkin and Nacogdoches, Texas were effected from it as well.  Again, a hurricane never has come close to these areas and these areas are also where evacuees come.  During the time we had evacuees from Galveston, Beaumont, Houston, and still the ones we had from Louisiana drained the resources that we did have here (not saying anything negative by this – just a statement).  None of the businesses could get trucks in to deliver gas, food, ice, water, etc.  When we did get gas delivered, the lines were so long that people were waiting 9-10 hours to get gas and of course by the time most got up there, it was gone again.  This went on for several days.  Even the Wal-Mart here and in Nacogdoches was only able to be open a few hours a day and for the first few days after the hurricane because of the amount of extra people in these areas, they finally had to limit the number of people they were allowing in the store at a time.


Some of you say, people should be prepared.  I do agree and especially more so if you live in a coastal area.  However, these people affected in the areas I mentioned above do not live on the coast; however, were heavily impacted by this natural disaster.  You are saying these people don't deserver help?!  Well let me tell you this.  When we had a lot of LA evacuees here, FEMA stepped in and for a lot (not all of course) they received $2000.00 for help with housing, another $600.00 for food, and there $400.00 for something else (honestly do not remember what it was).


However, my mother and father-in-law who are elderly went 14 days without power, lost everything in the freezer and refrigerator, and they are also raising 2 of their grandchildren (both young teenagers).  They were unable to get FEMA to help with anything. 


I guess the point is this.  Before spouting off about who needs to do what or who the government does or does not need to help (or where you tax monies go), you might want to think about the fact that this was a natural disaster and therefore, no one can ever really be prepared for one.  I hope none of you ever have to deal with anything like this.  It is not a pretty site in this area right now.  Clean up is still going on.  There are still trees down on houses and cars.  How would you feel if this were you? 


By the way, yes I do feel that my family was very lucky to come through it unscathed; however, some were not so lucky.


Just my 2 cents.

Bringing up from below the subject of low carbs, SM
Food Network used to  have a chef named George Stella who lost several hundred pounds by doing the Atkins diet. I'm not sure if  his show is still on, but he does have a cookbook.
Bringing topic over from 2nd page. Someone
higher rate because he/she has the CMT. I say the reality is that 90% or better don't give a toot about the CMT and are going to pay what they want anyway. And, all the RMT is going to do is cause major grief to a lot of hard working MTs, MTs who are barely making it financially. The RMT will cost MONEY along with their requirements. AAMT has caved to offshoring and is doing American MTs no favors. Frankly, I think the only worth an AAMT membership holds is the money you would be paying to put in their pocket. And, for what? To lobby on the Hill in favor of a bill that would ensure that patients’ individually identifiable health information is secure and protected; improving health care quality and reducing medical errors, and developing best practices to support and accelerate efforts to adopt, implement, and effectively use interoperable health information technology when all the while AAMT is openly embracing offshoring?

In a nutshell, your money is fodder for a worthless organization.

Oh, and Jay and anyone else from AAMT, in case you're reading here, here's a couple of suggestions for AAMTs potential name change...

Foundation for the United Council of Kooks (Formerly Modesto Mavens)
Organization Of Offshore Suckups (OOS)

I agree - can't have any convo w/o bringing..sm

the ones that can not have a discussion about current events without mentioning their fanaticism.....

Most folks have some religion/spirituality.

Most folks don't interject it into every conversation 24/7/365.......just the fanatics!

Great tips! Thanks for bringing up the

In my experience when bringing this issue to

my supervisor's attention (when I worked outside the home).  They are afraid to talk to the physicians about dictation - they don't want to bother them.  Makes no sense NOT to bother them!  Now that I work from home, I find that if I leave blanks ---- QA puts in what they THINK is right!  LMAO?  Makes no sense


bringing back the work!
In addition to doing MT, I also work as a coder at a very large teaching hospital and academic facility with 160'some clinics. Our transcription is outsourced and recently started going overseas. Guess what - our hospital is bringing it back to the States AND will not accept voice recognition! Too many errors that affect coding, AR days and, thus, reimbursement. Our dictation will continue to be outsourced but will not be allowed to go outside the US and can only be done by a real MT. Too bad it had to be the reimbursement that was the only issue that will bring the work back and not simply the fact that the quality is just not there but..at least there is something that will keep the work here in the US and keep it from being doing by VR. I just thought someone might like to know this is happening. I am hoping other hospitals get the hint.
Bringing up Bo Bice - he is back in hospital. nm
Hey Patti and MQA and other MTSOs..bringing thread to top

Hi again,

Just to let you gals know, I got up the nerve at the last minute, partially because of the posters to my thread about starting my own business, to quickly print up a resume and cover letter along with a sample ortho report and take them to my physical therapy appointment. (They may need an at-home transcriptionist.)  The office manager was not in yesterday, but my PT gave me a little info about how the process works.  Unfortunately, we were interrupted when she was about to tell me what they dictate IN TO, but she mentioned that she thought that was going to change.  On my way out, however, when she was flipping through my chart to see when I should come in next, I asked her if they received the transcription via floppy disk or CD, and she told me, *No, paper.*  Yes, they still use *sticky paper*!  Too bad we got interrupted earlier.  I have a feeling they transmit the dictation via the internet or phone lines, then the Transcriptionist delivers the finished work to the office. 

Anyway, my PT says it is slow right now.  (Indeed, there were only 2 patients in the office at the time with 4 PTs.)  But she thought if things picked up and the sole remaining MT got overwhelmed, there might be a chance of picking up the overflow, which would be just peachy for me. 

More questions...(now, why did I, at first, capitalize the Q in question????)  I may as well start preparing as much as I can now in case I DO snag a job....

1.  Can anyone or everyone recommend a good medical spell checker that interfaces with Word?

2.  What about an Expander to work with Word? I know some use Instant Text, but at least one says she uses the Word Autocorrect feature. (I think.)  Does the Word autocorrect hold a bunch....can you put whole reports into it...large capacity?

3.  You all mentioned that the docs usually supply their letterhead and to use plain copy paper for subsequent pages.  Does the MTSO usually supply the paper or the docs?  Same question with sticky paper...that sounds expensive! 

4.  Any other inexpensive tips you gals can think of that can be gotten ready now besides the main transcriber? (Would want to wait on that to see which type the office uses.) 

Now that I have the ball rolling, I am also going to contact the two MTSOs that I know locally and ask if they have any overflow.  Might also send a sample psych report to my shrink and see if he can spread the word.  Scary stuff, but you gals really helped!  Thanks so much for all the encouragement!!  

When bringing up old documents in Extext, Ctrl S,
I think I missed a step.  I hit ctrl S, put in patient's name (in this case) and then click find, or quick find.  Then, it brings up a list of the patient's admission.  Then, what do I hit to bring up the document?  The options on the right side are statistics and close?  I tried to highlight and double click the admission but nothing.  Need some help here....Thanks
Ooop - meant the RMT- sorry. Txs for bringing to my attn.
OK. Now if your husband is bringing you down by his mental illness and not paying rent
(is husband able to work? how deep is this mental illness? did he have money to pay rent and spent it elsewhere?) then maybe you should think about leaving him rather than placing your kids in any kind of foster care. That has to be traumatic but then so does living on the street. Speaking of placing your children in foster care while you get yourself OK in the head, what is your problem at this point. You see, if there is a lot of arguing and a dysfunctional family living on the streets, then foster care to permanent placement may be better for them. I just don't quite understand how you got into this mess and if these are mental health issues on both your part and your husband's I would look into placing the children. BTW, how old are they?

So all things considered if you don't have any issues other than depression because of a lack of a place to live and your husband's mental health, I would go to a family member or church and BEG for help sorting your life out. If there is more than that going on, including maybe substance abuse along with permanent mental health issues that will keep you from caring for your children, yes I would seek placement for them. And I would seek PERMANENT placement rather than foster care which I would think would be more traumatic for your children.
Bringing the head lice post back up. This has been going around at my daughter's school.
Saturday, after having been checking her head all week, found lice on her head. Did the treatment on her, on me, DH and other daughter, just in case. Only youngest and myself apparently had them. Got rid of the lice, now need to deal with the eggs. No problem with daughter's head because I am meticulous and have been checking daily and removing anything I find. My problem is my own head. Oldest daughter tried to look through, but she had hard time, though she tried. Husband "I don't see anything", so not much help. I can't look at my own head, so my dilema is how do I get the eggs off my own head and keep them from rehatching? Any help/advice would be appreciated. Never gone throught his before.
I was told that Healthscribe outsourced and when acquired, that Spheris would be bringing work
And this is information came to me from the inside, given to me when I was hired and in training.
Bringing up ExpressScribe pedal question again. Does anyone have 9-pin Infinity pedal on a USB?


That is against HIPAA
What about HIPAA?
   Our hospital is adamant about no accounts going offshore.  Not only because of quality, but also privacy, lawsuits, etc.  ESPECIALLY after what happened a couple years ago between UCSF Hospital and sub-sub-contractor in India.  (MT there who got gypped in pay held accounts for "ransom".)

Some in the office I work in said there are HIPAA rules that apply to transcription, such as font size, etc.  Does anyone know about this and where I can get more information.


HIPAA and cc - what to do? sm
If doctor wants carbon copy sent, I'm told it's a violation of HIPAA rules. Please tell me where I can find this on the Internet. Thanks.
Why would that be against HIPAA?
I have to save my files at least through the invoice period anyway.  Why would it be against HIPAA to run them through IT? 
I'm not the OP, but yes, there is a HIPAA (sm)
violation if you keep copies of patient reports on your hard disks in a form where the patient is identifiable.

What I do to make my normals and IT glossaries is cut/paste a copy of the body of each report, with no info to identify the patient, into wordpad and save under the dictator's name (such as jones hysterectomy, smith HP, etc).
There is nothing in HIPAA that says this information cannot be in the record. What it says is that IF you need to de-identify the information for any reason, all of those things must be removed. Probably not the best policy to have but not a HIPAA violation.
I was recently hired as an employee at a doctors office and we have been discussing taking my MT work home. It is all on hard copy except for occasional e-mails I need to send to the office to download. What do I need to be doing to comply with HIPAA?
HIPAA req.
I use encrypted e-mail through CryptoHeaven, cryptoheaven.com.  They have a bunch of different packages and well priced.  All work must be kept confidential and protected as much as possible (lock box for saved work on CDs).  I keep all patient lists only to type and then they are shredded.  Make sure if you are faxing pt lists back and forth, you are using a front fax cover sheet with a statement on it regarding confidentiality, etc. (your doctor's office probably uses this when sending stuff from their office).  I also have the ability to lock my office when there are parties, etc. at the house just to be on the safe side. 
It's HIPAA............nm
I don't know about HIPAA.... sm

But I wonder why they were asking you all those questions? The only thing I remember when enrolling my son was making sure his shots were up to date. Of course, we are talking a long time ago!

I don't understand why a kindergarten would need such a thorough medical history on their students. HIPAA or not, it sounds like invasion of privacy to me.

It's HIPAA, not HIPPA, and the provisions are only enforceable within the US.

There are free HIPAA courses online; you don't have to become certified, just become familiar with it so your work area, computer, etc. are compliant. Should be mandatory learning for all MTs.
it's HIPAA, not HIPPA. nm
HIPAA Compliance ?
Does anyone have any knowledge about a US MT typing from home and any HIPAA compliance violations if this MT also types from a 2nd residence in a different state for part of the year?
HIPAA response
HIPAA has more to do with the confidentiality of a patient's information. It has nothing to do with what residence you transcribe from, as long as you maintain the confidentiality of the patient's information. The company you work for may have some sort of requirement that you notify them if you'll be working from a location other than the location that they have on record for you.
Is it HIPAA compliant?
That certainly does sound like a great solution! You are right, I would probably want them to zip their files anyway since I have only dial-up available to me at home and would need it at a CG if I ever get to that point in my life.

Thank you for your feedback. It is sincerely appreciated.
HIPAA rules
A lot of the national transcription services have many accounts where the hospitals/docs still want the name of the patient in the body of the report and do not want "the patient" in the body of the report. So the facilities still respect what the doctors want.
It's HIPAA and you pronounce it hip-uh.
By the waq, it should be brEAch of HIPAA. nm
HIPAA at the Hosptial

Was at the hospital yesterday for some radiology testing. To summon me from the waiting area (full of other patients), the person who does the registrations used my first and LAST NAME! Bleah!

Then, after I was registered and back in the waiting area, another patient entered, sat beside me, and said "So, you're here for the same thing I am--I heard you mention it when you were being registered. I was in the next cubicle."

Shortly after this a different hospital employee summoned another patient from the waiting area using first AND LAST NAME! EEEK!

What on Earth ever happened to the HIPAA regulations? HIPAA applies to the hospital setting, right?

Any suggestions?

HIPAA is a joke
as long as these private records continue to travel overseas beyond the reach of the long arm of U.S. courts and law enforcement.
It's not a HIPAA violation for sure. Can you
have the account use digital recorders that are uploaded to your FTP site? Bypass the TASP entirely. Or if you are the only transcriptionist, you can use Bytescribe's E-shuttle. Check it out at bytescribe.com
Ack, misspelled HIPAA!
I really do know how to spell HIPAA correctly, except when I'm being an airhead, sheesh!
HIPAA and Outsourcing

How can outsourcing to an offshore company, where a patient's sensitive personal and medical information is concerned, be HIPAA complient?  Shouldn't we as patients have the right to know if our medical info and personal data are being sent via the Internet to a foreign country?  Shouldn't we as patients be asked to sign a release/agreement to such a practice, notifiying us of this?  I have never asked my doctor/hospital if they outsourced to offshore companies...but I will now.  Wonder if I'll get a truthful answer. 

According to HIPAA, SS# are not to be on reports.
SSN is not a HIPAA issue here
HIPAA, health information, SSN is not health information, no way relates. SSN would be a schools way to verify date of birth and U.S. citizenship.
The joys of HIPAA
Or you could just activate a password-protected screen saver on the machine any time you needed to take a BR break and there was anyone with a 5-county radius of wherever your machine was.  Even the hospitals do that.  I have to laugh at HIPAA sometimes.  They're so worried someone might find out someone else has hemorrhoids, when most of the violations actually prosecuted that I've seen have involved hospital employees who had a legitimate right to see the patient demographics but used their position to perpetrate identity theft.  Hey, if somebody is dying of cancer, they might be dead before anyone notices the unauthorized spending spree.
HIPAA is a joke
Sorry, but I edit reports for a large department in a major medical center that are all transcribed, you guessed it, overseas. Names, medical record numbers, Social Security numbers, etc., etc., are ALL included. Nobody truly follows HIPAA where I work. I even had to bring a shredder in from home to shred patient info sheets sent to me from the doctors' offices. Not only that, but patient letters WITH identifying information are e-mailed back and forth all the time without encryption. Until HIPAA is actually enforced by anybody, I'm afraid nothing will ever change.
HIPAA compliance
I am thinking about trying to get my own accounts and am trying to plan for all types of scenarios.  For various reasons, I am not able to pick up and drop off tapes.  Obviously, digital would be the best way to go.  However, if a doctor absolutely wanted to use tapes, would it be a HIPAA violation to ship the tapes certified (requiring signature) via USPS or UPS?  What about the completed reports?  I had two physicians in the past who refused to go digital and I ended up having to stop working for them because it was becoming increasingly difficult to pick up and drop off tapes.  What are your thoughts?  TIA.
A DB does not violate HIPAA

Contrary to what you may have heard, the HIPAA regulations of 2003 address the medical transcription field only in passing. There is no extended discussion of the transcription field. On reading the entire thing, the (few) mentions of medical transcription appear almost as after-thoughts.

What those regulations state concerning medical transcription is that the Transcriptionist (or the MTSO) must take reasonable care (their terminology) in safeguarding the confidentiality of the records.

This has been interpreted by the leaders in the medical transcription field to mean:

1) The MT's computer is safeguarded so that unauthorized persons don't have access to her files.
2) Any electronic communication of those records is done in a secure fashion.

Now, I am fully aware that some MTSOs do not allow the completed report to remain on the MTs computer. That is their right. But to hear them state that such is a requirement of HIPAA is wrong. It is not. It is a requirement of THEIR implementation of HIPAA, not a requirement of HIPAA.

For an MT to have a database of the patients she transcribes is completely within HIPAA. However, she must ensure that others do not have access to her computer / files. That is HIPAA.

Merrry Christmas,

Vann Joe