Being at the front desk of a medical practice can sometimes feel like you’re running interference at an air traffic control station. From working with insurers to calming frustrated patients, the job can be all-encompassing. One area that some medical front desk staffers may not have time to focus on is unfortunately one of the most important: complying with regulatory requirements.
To boost your medical front desk staff’s regulatory compliance, check out five key areas that every team member must understand.
1. HIPAA
Although HIPAA has been around for years now, it’s still hard to maintain compliance with every facet of the rules, but your practice’s future depends on ensuring that the front desk team stays on top of all three pieces involved in the rule:
Privacy is what the front desk team mainly deals with. It involves making sure you protect and keep patient’s protected health information (PHI) confidential. It’s important that the front desk team understands the importance of using or disclosing someone’s PHI as minimally as needed for the job. For instance, you can’t look up someone’s medical records because they’re your neighbor and you’re curious, and you can’t tell patient A which doctor patient B is seeing.
The transaction and code sets involve what your revenue cycle and billing department deals with. It’s a good idea for front desks to have a basic understanding of this because patients may ask financial questions.
Security is how you’re protecting patients’ health information with your technology and the use of tools like electronic medical records, as well as how you exchange information and whether it’s secure. If a patient asks you to fax a record to their primary care provider, are you using a secure method of doing it, or are you just trusting that the fax number they hand you is accurate? Once you’re dealing with patient information, it’s your responsibility to keep it private and secure, no matter what.
2. Confidentiality
Confidentiality is important because it spans beyond complying with the HIPAA requirements and into other areas. Patients sometimes confide in front desk team members for a variety of reasons. Maybe they haven’t had someone to chat with in a while, or they come in frustrated and just need to vent to the first person they see.
No matter the reason, what they tell you should remain confidential, whether it involves a fight with their partner, the fact that their car was repossessed or that they just got a new job. Your practice should not reveal patients’ confidential information even if it isn’t considered PHI.
3. Corporate Compliance
Your practice should have its own compliance regulations, aside from what you’ve developed to stay in line with state and federal laws. For instance, your office may have ethical regulations that are different from other practices’ and that’s why you get more patients than the competition does. It’s your job to know every detail in your organization’s regulatory handbook and follow them without exception.
4. Regulations on treating minors
If your practice sees minors, it’s essential that the front desk knows the rules around this topic. This can be particularly challenging because each state has completely different rules regarding minors and parental consent. For instance, in one state, only a biological parent may consent to treatment for a child, while in another, a stepparent can consent to a child’s treatment. Your state may require written permission, while another jurisdiction might need the parent to be there.
In addition, some exceptions may apply even to these rules, such as an exemption if the child is seeking an exam for a venereal disease or treatment for addiction. The front desk should have the rules for patients in their state (and surrounding states) at hand to stay on top of them at all times.
5. Payer Requirements
Because the front desk team often requests copays, informs patients of deductibles, and works with insurers on preapprovals, it’s essential that your staffers understand payer regulatory requirements, which also differ in every state. If the front desk team needs a primer on how, for instance, one state’s Medicaid program requires you to collect coinsurance vs. another state’s, set up a quick session between the billers and the front desk staff where the billing team can share high-level, must-know details. Sometimes, just having the basic knowledge as a baseline is all your front desk staff needs.
Hungry for more front desk best practices? Expert Tracy Bird, FACMPE, CPC, CMPA, CEMC, CPC-I can show you the way during her one-hour online training, Front Desk Fundamentals That Guarantee Success. Check it out to ensure that your front desk continues to run smoothly and optimize compliance to keep patients coming back.
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