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Must-Have Privacy Protection and Compliance Policies for Revenue Cycle Management

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Must-Have Privacy Protection and Compliance Policies for Revenue Cycle Management

Throughout the industry, healthcare providers, hospitals and healthcare organizations are coming to terms with how best to ensure compliance and patient privacy protection in an increasingly interconnected world. In a digital age where PHI and confidential medical data are accessible online or via internet-connected devices, organizations must find innovative ways to safeguard their networks and create a culture of continuous compliance.

Since 2010 alone, criminal cyber attacks have increased by an incredible 125% according to the Ponemon Institute. What’s more, the report revealed that many healthcare organizations remain largely unprepared to adequately ward off hackers and other bad actors. Black Book Market Research confirms this in a recent survey of 733 provider organizations and 2,900 security professionals, which found that 93% of healthcare organizations have experienced some kind of data breach since 2016. Even worse,  57% also reported more than five data breaches in that same time frame.

However, few healthcare organizations have the manpower, equipment or even knowledge to contend with such sophisticated and frequent attacks. Yet, the need to ensure compliance is essential to prevent hefty violation penalties and damage to the organization’s image, as well as to inspire patient trust and loyalty. According to the same Black Book Market Research, only 21% of hospitals have a dedicated security executive. Regardless, it’s the responsibility of providers to ensure that they are up to date on the latest compliance requirements and regulations.

Equally complex is the fact that security compliance and privacy protection laws continue to evolve at a rapid pace. State and federal governments regularly establish new regulations in attempts to protect citizens, and complying with those changes often creates even more data that must be protected, along with another layer of added complication. Specific examples include keeping track of guidelines from HIPAA, the Payment Card Industry Data Security Standard (PCI DSS), the Centers for Medicare and Medicaid Services (CMS) and more.

Although no organization will ever be completely immune to a cyberattack or data breach, proactive steps can be taken to ensure strenuous compliance standards are met. Whether your organization is issuing an RFP for a new vendor or questioning the effectiveness of your current in-house policies, here are some actionable ways to create and sustain a culture of continuous compliance within your healthcare enterprise:

 

  • Create a PHI security improvement plan. Assessing the current state of your security compliance and data protection should be your first step. Though this could be time-consuming, it’s a crucial part of identifying strengths, weaknesses and general areas in need of improvement. Once complete, create a step-by-step plan, timeline, oversight committee and budget for how to address the problem areas identified in the risk assessment process.
     
  • Implement mandatory employee privacy training and continuous education programs. Data security training cannot be a one-time event during employee onboarding; instead, it must be regular and ongoing. Research consistently reveals that most data breaches or ransomware attacks are the result of phishing emails, hence why regular training and risk assessment are imperative to keep employees informed and prevent careless decisions.
     
  • Perform regular security risk assessments. Constantly auditing your risk and preparedness levels can help refine your processes, checks and controls. This consistent measure of effectiveness isn’t just about compliance; it’s also about sustaining higher levels of enterprise-wide vigilance. Also new threats will continue to emerge, so building in flexible controls and checkpoints to account for the long-term is essential.
     
  • Designate champions to stay current on the latest state and national regulatory requirements. Healthcare providers must be aware of evolving requirements and various industry certifications. This necessitates having in-depth processes in place to ensure compliance, which can be made easier by assigning certain employees to champion or monitor various state, local and federal regulations. Assigning specific areas of oversight can also help increase organization-wide accountability, build in more checks and balances, and establish policies for reviewing sanctions or reporting incidents.
     
  • Consider outsourcing your data security responsibilities. If your organization doesn’t have the time or resources to devote to meeting compliance and privacy standards, then consult outside vendors. Selecting the right partner is critical, so the vetting process should mirror that level of seriousness. After all, patient safety, privacy protection and the reputation of your organization could be on the line.

 

Want to learn more about how to nurture a culture of continuous compliance? Reach out to one of our experts.