Frequently Asked Questions

Get Answers From Professional Medical Management Services

We hear a lot of questions at Professional Medical Management Services: What is HIPPA? ICD-10? What happens to practices that don't comply with federal standards, even by mistake? As a new practice, are we missing something?

With more than 35 years of collective healthcare compliance experience, the ProMed Services team is prepared to offer answers to these frequently asked questions, and any other questions a practice, medical office employee, doctor, or staffer might have.

Find several FAQs listed below, but feel free to reach out to Dr. Varsha Shah and her qualified associates to get help with anything not touched on here.

Ready to move beyond "What is HIPAA?" Call the Professional Medical Management Services team at (856) 840-5570 or send a message online.

What is HIPAA?

HIPAA stands for the Health Insurance Portability and Accountability Act, which the United States legislature passed in 1996 to set national standards for maintaining confidential patient information and allowing or restricting access to these records. The law applies to doctors' practices, medical offices, and anyone who works with these files and documents. ProMed Services helps its clients ensure compliance with the complex regulations put in place by the act.

What is ICD-10?

The World Health Organization publishes a list of medical classifications known as the International Statistical Classification of Diseases and Related Health Problems, used to report diagnoses and procedures. The current version of the list is the 10th revision. The U.S. Department of Health and Human Services set Oct. 1, 2015, as the deadline for U.S. practice compliance with this cataloging system. ProMed Services can audit a practice to assess its conformation to the latest codes.

What should new physicians consider when thinking of opening a practice?

  • Location
  • Health plan credentialing
  • Hospital privileges
  • Hiring, especially with an eye for revenue
  • Billing software and electronic medical records
  • HIPAA and compliance training

ProMed Services can assist with all of these tasks and more.

Compliance Reviews

Why does compliance auditing and monitoring matter?

Proactive auditing and monitoring as part of a successful compliance program identifies risks, optimizes business operations, and helps lower potential fines and penalties in a corporate integrity agreement, if necessary.

ProMed Services can develop an individualized program based on an organization's needs and available resources, with compliance solution services including:

  • Risk assessment
  • Helping to establish and implement standard policies, procedures, processes, and best practices across an organization to promote compliance with applicable laws and contractual obligations
  • Reviewing current policies and procedures
  • Reviewing the claim submission cycle
  • Reviewing bills and documentation for coding accuracy
  • Assisting with the development, implementation and maintenance of the auditing and monitoring program within an organization

What sort of training and education is necessary for compliance?

Since compliance training creates compliance awareness, which in turn prevents or mitigates risks, it is a vital component of any medical-related organization's efforts to maximize security, patient safety, and practice accountability. ProMed Services offers training and education in:

  • Compliance
  • HIPAA privacy
  • Security
  • Documentation
  • Coding guidelines

ProMed Services can also help to design a training and education program, as well as work with an existing program to ensure it meets all of an organization's needs.

Get more detailed answers to these frequently asked questions and others beyond "What is HIPAA?" from the team at Professional Medical Management Services. Call (856) 840-5570 or contact us online.

MANAGING
THE DETAILS

A thriving healthcare organization must successfully navigate the complexities of modern business and healthcare compliance requirements. Professional Medical Management Services specializes in consulting with practices to provide help with the physical office and staff, coding and billing training, software selection and setup, policy and procedure implementation, HIPAA and ICD-10 training, and more.

Additional Benefits
  • Billing software selection
  • Policy and procedure implementation
  • Office location scouting
  • Clinical documentation software setup
  • Moreā€¦