Is your email HIPAA compliant?

I recently attended the annual Dentrix Train the Trainer conference and, during the banquet, I sat next to the HIPAA compliance manager for Henry Schein, John Mertz. My commitment to you, my readers, is to try and give you new and relevant content, so while I was chatting with John I asked him, “Can I interview you for my blog?” and he accepted. 

Q:  John, being the compliance officer for Henry Schein, what are the top two HIPAA issues offices are asking you about?

Great question Dayna, and thank you for this opportunity.

The top two questions I get are: 1) What kind of paperwork do I need between Henry Schein and our practice to be HIPAA-compliant? 2) Is the email I submit from my office HIPAA-compliant when sending directly from Dentrix?

Q:  How do you respond to their concerns? Do you refer them back to their own legal team or do you have resources you can pass along?

It depends on what the concern is. To maintain HIPAA compliancy, it is very important to have a Business Associate Agreement between the practice and Henry Schein on hand. To make the process much easier for our customers (and Henry Schein), we have a BAA available that can be downloaded, from our website, where it can be printed out (for their records) and submitted online. One aspect of utilizing this BAA is that it will cover our customers for anything they utilize from Henry Schein (practice management software, eServices, eClaims, TechCentral, training, support, etc.), avoiding the need to have multiple agreements on file. Last year, Congress passed what is called the Final Omnibus Rule of 2013. Anytime there are significant changes made to HIPAA regulations, it is necessary to update the Business Associate Agreement. Our BAA has been updated to reflect the changes made to HIPAA and we strongly encourage our customers to contact Henry Schein if they have not yet renewed that agreement since the Omnibus Rule had gone into effect. If anyone is unsure whether or not their BAA is current, they are encouraged to contact Henry Schein Customer Support.

In regards to email, if you are transmitting any PHI (Protected Health Information) data, the short answer to that is “No, your email is not HIPAA compliant.” Our practice management software does not encrypt email. There are a several methods that can be utilized to protect email and patient data. We encourage our customers to consult with their IT staff, or whoever setup their network regarding email encryption. If there is no one available, Henry Schein has a department dedicated to hardware and network configuration (Tech Central) that would be able to assist with that as well.

Dayna, the only times I would refer a customer back to their legal counsel is if there are questions regarding what they should do internally to comply with HIPAA. Henry Schein is unable to consult customers on HIPAA compliancy. Every customer would have different needs and each situation will vary. We strongly encourage our customers to have a well-documented HIPAA security and privacy policy on hand and their staff trained on HIPAA at least annually. There are several great resources available that can be utilized to help answer specific HIPAA questions. I will list a few of them below:

Disclaimer: the following websites are listed as information only. I intend no endorsement of their content and imply no affiliation with the organizations that provide their content, nor do I make any representation or warranties about the information on those sites, which I do not control in any way.

• U.S. Department for Health and Human Services: http://www.hhs.gov
• U.S. Department for health and Human Services; Centers for Medicare and Medical Services: http://www.cms.hhs.gov/
• U.S. Department for health and Human Services; Office for Civil Rights: http://www.hhs.gov/ocr\
• U.S. Department for Health and Human Services; Office of Assistant Secretary for Planning and Evaluation: http://www.aspe.hhs.gov
• Council of Inspectors General on Integrity and Efficiency: http://www.ignet.gov
• Electronic Code of Federal Regulations: http://www.ecfr.gov
• U.S. Department for Health and Human Services; Health Information Technology for the Future of Health Care: http://healthit.hhs.org
• Health Information Technology Standards Panel: www.hitsp.org
• National Institute for Standards and Technology; Information Technology Library: http://www.csrc.nist.gov

Q:  What is your answer for email?  How can the office be HIPAA compliant with email?

This is certainly a common question. I would refer to the answer I have given above to address this inquiry.

Note from Dayna:  Corresponding with your patients via email is one of the most common questions I receive from offices. As John stated above, sending email the common way is not HIPAA-compliant. For some HIPAA compliant options for your practice, CLICK HERE to be directed to the resources page on my website.  CLICK HERE if your office needs HIPAA training or Risk Analysis.

Opting out of virtual credit card insurance payments

The issue of using a virtual credit card for insurance payments has not only become a frustrating situation for the dental practice, but also costs the office money they don’t need to be spending. My friend and colleague, Jennifer Schultz, who is owner of The Virtual Dental Office Manager, is also having the same issues with her offices. She recently wrote an article on the same topic, CLICK HERE to read it.

When I received one of these virtual credit cards for an insurance payment, I was like, “What the h*%# is this and how am I suppose to post it?” Since I needed my deposit slip to balance with payments and credit cards, I ended up posting a $0 payment to the claim and adding a note in the claim status notes that it was a credit card payment and how much it paid on the claim. Then I posted it as a credit card payment and also made a note in the payment that this was an insurance payment. If it is not critical for your office to balance the credit card total on the Dentrix deposit slip with your credit card batch, then you could post the virtual credit card as an electronic payment and then make a note on the claim that it was a credit card. What a pain!

I would highly recommend you try and opt out of this method of insurance payments because it is costing your office a merchant fee of 2-4% of the total payment that you don’t need to be spending. This could add up to hundreds of dollars per month of unnecessary fees for the practice.

You can opt out of this payment method by calling the insurance company and asking to be removed from this method of payment. See if you can opt for a direct deposit instead. After you have opted out with the insurance company, make sure you follow up with the merchant that issued the credit card payment to see that it was done. Hopefully by making these two phone calls, you can avoid these virtual credit card payments in the future.

 

 

 

Success with your dental software implementation and training

 

Dental Software Advisor’s podcast series focuses on software technology topics relevant to dental users. In this interview with Dayna Johnson of Rae Dental Management, a longtime industry implementation and training expert, we have a frank discussion of software implementation ands how to build acceptance and increase rewards for using appropriate technology.

 

 CLICK HERE TO LISTEN TO PODCAST

One of the key topics during software implementation is to identify fears around software implementation and work to figure out what can be shifted to improve efficiency and reduce frustration. Solutions come from incorporating many different strategies.

 

For any dental practice implementing new technology, this discussion will cover common issues, frequent mistakes, and how to make the process easier and more complete. Efficiency, consistency and protection are the mantra Dayna Johnson uses for successful software implementations.

It's only an estimate, so make it as accurate as possible

Are you looking for a more accurate way to accommodate the difference that the insurance company calculates for posterior composites? What about the fact that perio maintenance is in the perio category but is usually paid at 100%? Would you like to be able to give your patients a more accurate out-of-pocket estimate? If so, then using the Payment Table will make you very happy. 

The Payment Table overrides the Coverage Table so it is perfect for those procedure codes that fall outside of the default coverage table. Here are some examples:

• Posterior Composite Downgrades – most insurance companies do not pay for composite fillings placed in molars, but they will pay for the equivalent of an amalgam filling. For example, you would take the fee for the D2140 (1 surface posterior amalgam code) and multiply this fee by the coverage %. Then in the Payment Table you would enter the D2391 (1 surface posterior composite code) and enter the fee you just calculated. This amount will override the coverage % and give your patient a more accurate estimate. I have seen some offices create a little “cheat sheet” in Microsoft Word for all the downgrade coverage and save it to the desktop for easy access.
• Nightguards (D9940) – they are located in the Adjunctive category, which is typically covered at 80%. However, in my experience with nightguards, they are usually paid at 50% or 0%. 
• Perio Maintenance (D4910) – this code is in the periodontal category which is typically covered at 80%. However, the D4910 Perio Maintenance is usually covered at 100% like a prophy.
• Crown Lengthening (D4249) – this code is also in the periodontal category. However, in my experience, it is covered at the same percentage as a crown (50%).
• Onlays – In the Dentrix default categories in the Coverage Table, they have onlays grouped in with the Basic Restorative at 80%. However, onlays are covered just like a crown at 50%. Instead of moving around your coverage table groupings, you can just add onlays to the Payment Table.

The Payment Table can be updated manually by going to the patient’s family file or the Office Manager > Maintenance > Reference > Insurance Maintenance and clicking on the Payment Table, or you can update the Payment Table while entering in insurance payments. If you are using the Fee Schedule Method and attaching fee schedules to the insurance plans, do not use the update payment table during insurance payment entry for your contracted plans unless it is one of the exceptions listed above. Only update the payment table during insurance payments for insurance companies with which you are not contracted. 

If you are unsure if you are using the Fee Schedule Method or you want more information on fee schedules, click below to read more on fee schedules.

Fee Schedules, the method of choice for PPO plans

Fee Schedules - your questions answered

Get the info out of your head and into the computer

When you have worked in the same dental practice for many years, you have a tendency to store a lot of information in your head, right? I find that is especially true when it comes to your accounts receivable. Being a financial coordinator in the practice, it is your responsibility to know the status of the accounts … but so often when I am teaching on collections, I hear, “Oh, I just know this family is making payments” or “The doctor said it was OK for him to make payments”. What if this information was in your practice management software so you could easily manage it? What if this information was in your practice management software so you, the financial coordinator, could take a vacation and not worry about someone else managing the accounts receivable while you were gone? What if your patient’s billing statement reflected his or her agreed payment arrangement? This can all be a reality.

Using the Dentrix Payment Agreement feature allows you to get the information out of your head and into your practice management system where it belongs. If your office accepts payments (even if your office does not accept payments, patients often slip into a payment plan out of necessity), this information will streamline your collections.

Entering in the payment agreements into Dentrix will help you manage your accounts in three huge ways.

1. If you have read my articles about patient collections, you know that I use the Collection Manager Report for managing accounts receivable. This report allows you to enter columns of information that will show you Payment Agreement Balance, Payment Agreement Amount Due, and # of missed payments. Having this information at your fingertips can be extremely helpful on this report because you don’t have to do any research about the account balance. You can see that the patient is on a payment plan and if he or she is current with payments. Read More . . . on the Collection Manager Report.
2. When you create a Payment Agreement, it will light up the Payment Agreement Summary section on the Ledger so anyone who opens the ledger will see that the account is on a payment plan and the status of the payments. If there are missed payments, this will show up in red in the Past Due section. This will be extremely helpful if the financial coordinator is on vacation and relying on other team members to collect money at the time of service or field phone calls.
3. When you send billing statements, if you have entered in the Payment Agreement, it will accurately reflect the amount due from the family. The billing statement will show the total account balance and, in the PLEASE PAY THIS AMOUNT box, it will show the agreed payment amount. Also, if the patient has missed a payment, the billing statement will show a past due amount at the top of the statement to draw attention to this missed payment. If you are not using this feature, you might be writing on the statement, which takes more time out of your schedule.

 

Use the features that Dentrix has to offer. Get the information out of your head and into the computer. Let the computer do the work for you and free yourself from being the keeper of information. I realize that being the keeper of the information might sound like job security, but it holds you back from pursuing other adventures like going on vacation, taking on new roles in the practice, or training new employees.

Top 5 reports every doctor should look at

I received an e-mail from a doctor the other day who had a situation that needed attention. Her clinical team had started posting procedures in the patient chart and had accidently posted a root canal as “complete” rather than “existing.” The root canal was not only posted to the patient’s ledger, but it was also sent electronically to the insurance company and paid. The patient called concerned about the EOB that he received and wondering why the office had billed his insurance company for a root canal he never had. When the doctor asked me what kind of safeguards she could put into place for her clinical team, my response was that this issue was an administrative boo-boo, not a clinical mistake.

As the doctor in the practice, I understand that you went to dental school to create beautiful smiles and improve the health of your patients. However, you are still a business owner and knowing what is going on in your business is certainly worth your time.

With that in mind, here are my five most critical reports every doctor should look at . . .

1. The Daysheet - If the doctor in the above story had looked at the daysheet, she would have noticed that the root canal was incorrectly billed out and it never would have been sent to the insurance company. Also, the clinical team can see if something was missed, such as X-rays, pulp caps, and buildups. The daysheet can be run from the Office Manager > Reports > Management > Day Sheet.
2. Audit Trail Report - This report is for your eyes only. You should have user IDs and passwords enabled in your practice. In the security rights, make sure you are the only person on your team who can access this report. My recommendation would be to look at this report on a monthly basis for any red flags such as <Deleted items> or <Initial Entry, Date Changed>. These entries would then require you to do a little more research or ask the team member who made the entries.
3. Adjustment Report – If your cash flow is not as it should be, this would be one of the first places I would look. See where the adjustments are being made. There are two adjustment reports you can run … one is by category and one is with patient names. The report by category can be run from the Office Manager > Management > Practice Analysis Reports > select your date range, Adjustment Summary and click OK. To run an adjustment report with patient names, go to the Office Manager > Reports > Management > Day Sheet, then select your date range, Adjustment Only Day sheet and click OK.
4. Provider A/R Totals Report – This report will show you your gross production, adjustments to production, net production, gross collection, adjustments to collection, net collection, and accounts receivable. If I was a business owner (oh right, I am J), I would want to know what is owed to me and what my net numbers are. You can find this report on the Office Manager > Reports > Management > Provider A/R totals report.
5. Collection Manager Report – I received an e-mail from a doctor last week in a state of panic because her front office team member had left abruptly and the office was receiving calls from patients about their balances and also receiving complaints that they had not received a statement. The Collection Manager Report is my favorite report in Dentrix and also a great, quick spreadsheet for the doctor to see what is going on with his or her accounts receivable. Go to the Office Manager > Analysis > Collection Manager, then select your parameters. Also, click on the Show Columns button and make sure you add in the Last Statement Date column so you can see if your patients are receiving billing statements in a timely manner. For more information on this report, CLICK HERE.

It is so very important that you stay informed about what is going on in your business. After all, it’s your livelihood.

Top 5 Reasons to bring your team to the Business of Dentristry Conference

It’s that time of year. It’s time to get your doctor and your team registered for the Business of Dentistry Conference. As you have heard me talk about before, I have never missed a conference and I am going to give you 5 reasons you and your team should not miss it either.

1. You will be repeating the words “I didn’t know Dentrix could do that! I can’t believe how we are under-utilizing our practice management software.” Even if you have been using Dentrix for over 10 years, I can guarantee you will learn things that you didn’t know existed. Last year, I taught the advanced Scheduling for Production class and my class was filled with doctors excited to learn how the software could help their practices meet production goals. It was eye-opening.
2. There is something to learn for every member of your team. The Dentrix courses have a skill level from entry level to advanced so the attendees can choose the level that best fits their knowledge of the software. This conference attracts some of the most sought-after consultants and they tailor their presentations to fit into the Dentrix agenda so you not only get amazing practice management educational material but you also get tips on how to implement it into your practice management software. Also, every year they are adding more and more clinical courses to meet the requests of the doctors, dental assistants, and hygienists. Check out the course listing by CLICKING HERE.
3. Don’t miss the Learning Lab. This is my favorite part of the Business of Dentistry Conference. This is where you get to bring your questions and sit down with a knowledgeable support tech and get one-on-one help. If you are having issues with Dentrix, eServices, Easy Dental, or Enterprise, bring it to the Learning Lab. Here’s a tip: Take screen shots and print them out so you can show the team your issue (make sure you black out any patient information).
4. Learn about third-party software that integrates with your Dentrix software. The vendors pour out into the hallways just waiting to tell you how their product, along with your Dentrix software, can help your practice more profitable, secure, or productive. Since Dentrix G5 opened up the Marketplace, there are many third-party companies that enhance your software in so many ways. To check out the Dentrix Marketplace, CLICK HERE.
5. Finally . . . have some fun and enjoy spending time with your team! This year’s conference is being held at the amazing Cosmopolitan hotel in Las Vegas. Henry Schein always brings the fun to this conference. I can remember bowling parties and dance parties that were off the charts. I can’t wait to see what this year has to offer.