Physicians Practice - March 2008 - (Page 53)

ASK THE EXPERTS YOUR TOP QUESTIONS ANSWERED SELLING YOUR PRACTICE; WHEN PHYSICIANS TAKE CHARTS HOME; PHYSICIAN RECRUITING TIPS SELLING TO A HOSPITAL Q Do you have any information about what to consider when a hospital is interested in buying your practice? A As you can imagine, the possible issues are numerous. Brieﬂy, though, pay attention to the details of the proposal offered by the hospital. Are the terms fair? Is it an outright purchase, or are there terms for what happens if the alliance dissolves? What does the covered entities to share information that is directly relevant to the involvement of a spouse, family members, friends, or other persons identified by a patient, in the patient’s care, or payment for health care. If the patient is present, or is otherwise available prior to the disclosure, and has the capacity to make health care decisions, the covered entity may discuss this information with the family and these other persons if the patient agrees or, when given the opportunity, does not object. The covered entity may Charts should never be left in the car. Not even while you run in to get a quart of milk at the store. BIG NO-NO hospital propose in terms of getting patients to you? Will it do your billing? How will that affect collections? Do your staffing decisions have to go through hospital bureaucrats? How are physicians compensated? If you run the numbers for the proposed compensation model based on production from last year, what would each physician make? What are the hospital’s expectations for productivity in the next few years? Has this hospital acquired other practices? Are the physicians at those practices happy? SHARING HEALTH INFORMATION So, for example, if a patient’s husband calls in asking about his wife’s diagnosis but you have no reason to think the patient couldn’t tell him herself if she wanted, you ask the husband to have his wife call you back to give permission. On the other hand, if you know the wife is completely drugged, unable to communicate, and the husband is asking a speciﬁc question about how to treat, say, a bed sore, by all means help the poor fellow out. You might do well to role-play some possible or real situations from the past with staff and physicians so you all share a sense of what’s right. Document this training! TAKING CHARTS HOME also share relevant information with the family and these other persons if it can reasonably infer, based on professional judgment that the patient does not object.” Do we need to ask each patient to write down all of the people to whom we can disclose healthcare information and then double-check this information each time a spouse or relative calls? Q I need some help writing a policy concerning physicians taking patients’ records home to work on. Suggestions? A I think you make this part of your privacy policy, as referred to in the HIPAA privacy rights statement that new patients sign. If that policy promises to keep charts safe, you should spell out how you’ll do it. If I were writing such a policy, I’d include: • Charts should never be left in the car. Not even while you run in to get a quart of milk at the store. • Charts should be transported in a locked case. • Charts should never be out of the ofﬁce for more than one night. • There should be some way to know where the chart that went home is — some placeholder in the record room. Really, if I had my druthers, I’d tell physicians that if they want to MARCH 2008 | PHYSICIANS PRACTICE | Q I’m unclear on when it’s OK to give out information to a spouse, relative, or friend. I found the following statement online: “The HIPAA Privacy Rule at 45 CFR 164.510(b) specifically permits WWW.PHYSICIANSPRACTICE.COM A No, you don’t need an individualized list from each person. It would likely be impossible to refer to it every time anyway. What you can do is make it clear in your privacy policy that you will be using your best professional judgment about whether to share some medical information with family members. Then, in each instance, you use professional judgment, making sure everyone in the ofﬁce understands that privacy is paramount. 53 http://WWW.PHYSICIANSPRACTICE.COM

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Physicians Practice - March 2008 Contents The Bigger Picture: Try a Little Tenderness Second Opinion Letters Physicians Practice Pearls: The Value of First Impressions Noteworthy Cover Story: Your Complete Guide to Patient Service Billings & Collections: Rules to Code By The Administrators Desk: Selecting an EMR Technology: Learn to Love Your Nerd Ask The Experts Coding The Guide The Tech Doctor: All About Blogs The Great Practice Makeover: When Bad Things Happen to Good Practices Start It Up - NEW! The Law: Audits 101 In Practice: Do As I Say... Pretty Please? Healthonomics: Handling the Changes Wrought by Medicare D Classifieds Advertiser Index

Physicians Practice - March 2008

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