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Is my cash practice a HIPAA Covered Entity?This episode is an interview of Nancy Beckley of Nancy Beckley and Associates, a rehab compliance consulting firm. We get into the nitty-gritty of HIPAA (and also Medicare) as it relates to a cash-based practice. She fields my questions for over an hour and absolutely fills us with the info we need to protect ourselves and our practices.

More specifically, we discuss these cash-based practice topics:

  • What exactly is HIPAA and why does it exist
  • How to determine if your practice is a “Covered Entity” and must comply with all the laws and regulations of HIPAA
  • If you are a covered entity, and want to use an eFax, some important considerations for finding the right HIPAA-compliant system.
  • HIPAA-compliant texting software, and when something like this is necessary if you are texting/emailing about patients with other providers.
  • The HIPAA Omnibus changes and how they may have opened the door (in some scenarios) to provide covered services to a Medicare Beneficiary on a cash-pay basis.
  • The Jimmo vs Sebelius case on “Medical Necessity” and how it affects our ability to see Medicare Beneficiaries on a cash-pay basis for certain types of services.

Resources and Links mentioned in this episode:

Interested in the cash-based private practice model?

Click Here to learn how to start your own Cash-Based Practice

Let us know if you enjoyed the show:

[Click to Tweet] Thank you @NancyBeckley for being an awesome guest on the Cash-Based Practice Podcast w/ @DrJarodCarter

Some parting notes:

Definitely have a look at the HHS Info Sheet. As I re-listened to this podcast and reviewed that info sheet, I came across a few things that I wanted to point out or re-highlight:

  • Determining if your practice is a HIPAA Covered Entity comes down to whether or not you transmit any “covered transactions” “in electronic form”
  • “covered transactions” are defined in detail on pages 7 – 9 at the above info sheet. Take a very careful look at all the different things that could be considered covered transactions. It does NOT ONLY include transactions/transmissions of payment/billing-related information. Although I don’t directly bill any third-party payers for my services, there are still “covered transactions” that I do occasionally transmit. I therefore have to make sure that I only transmit such things in non-electric format.
  • “In Electric Form” is defined on page 9 of the above info sheet. Essentially, Fax is NOT considered “electronic format” so I, and practices like mine that want to avoid being a “covered entity,” need to make sure that the sending of any information is only done by fax.

I’m guessing many of you may have questions for Nancy. Please type them in the comments below, and make sure to give as much detail as possible on all factors and components surrounding your question so she has the best possibility to give a clear answer.

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