HIPAA and the Health Care Administrator

Healthcare

#1 I believe in evidence-based policy, and on that front there is evidence that the glass ceiling exists. I have no personal anecdotes to tell on the subject, and an individual anecdote is meaningless when discussing broad sociological phenomena. After all, this is a well-studied issue for which there is a lot of data. A lot of the studies on the subject are European, but there are a few that specifically discuss the United States. Cotter et al. (2001) found evidence that a glass ceiling exists in the United States in their study of the gender inequalities of earnings in the 25th, 50th and 75th quartiles of earnings. Their findings show that gender inequality with respect to wages, and opportunity, increases the higher up the corporate ladder you go. There is evidence that females have lower rates of holding positions of authority than do men (Baxter & Wright, 2000).

Moreover, women also perceive the glass ceiling, sensing that there are unofficial, unspoken constraints on their career success that have nothing to do with merit (Jackson, 2001). Not only the glass ceiling something that is perceived by those at the middle management level, but it also persists at the level of corporate boards, where such a phenomenon is highly-visible and therefore theoretically more subject to public scrutiny (Arken, Bellar & Helms, 2004). What all of this evidence shows is that the glass ceiling both exists, and is perceived.

#2 One of the most important pieces of legislation for the medical clinic receptionist to know about is the Health Insurance Portability and Accountability Act (HIPAA), which has been in place since the Clinton Administration. This law was passed because of concerns about fraud, but has a number of other implications for health care practice. Some of the objectives of HIPAA are to "improve the portability and continuity of health insurance coverage in the group and individual markets," to "combat waste and fraud," to "promote the use of health savings accounts," to "improve access to long-term care," to "simplify the administration of health insurance," "create standards for electronic health information transactions" and "create privacy standards for health information" (Green & Rowell, 2013, Chapter 5).

There are five main parts to HIPAA, Titles I- V. These are health care access, portability and renewability; preventing fraud; tax-related health provisions; application of group health plan requirements and revenue offsets. The first two titles relate substantially to the receptionist's position. Title I governs health insurance and Title II prevents fraud and abuse. Under Title II, physician practices have to take on a number of steps with respect to their billing and health information. These include periodic audits, developing written standards and procedures, designating a compliance officer, conduct appropriate training, and responding appropriately to detected violations (Green & Rowell, 2013, Chapter 5). Physicians are also guided to provide proper coding and billing, to ensure that services are reasonable and necessary, to have proper documentation for everything, and the keep employees updated regularly on compliance activities.

From an administrative perspective there are several critical elements that should be remembered. The first is that the privacy rule is critical. Patient privacy is sacrosanct and must be protected at all times. This is not just the protection of medical records, but not talking about patients out of the work context, using unique identifiers for patients to that their names are not always on every record, being careful when transferring medical records, informed consent and gaining the individual's permission prior to accessing medical records. There will be extensive training on all of these things.