21 Apr How Do Medical Record Retrieval Companies Handle Compliance?
Book a Demo TodayPrivacy has always been a cornerstone of the medical field. Conversations between patients and healthcare professionals have always been confidential—at least until a lawsuit or insurance claim requires them to be made available.
In the days of handwritten notes and filing cabinets, keeping medical records secure was fairly straightforward. As long as the documents were kept under lock and key, patient data remained safe.
Today, with electronic health records (EHRs), data security isn’t so simple. Systems can be hacked, files can be intercepted en route, and information can be shared with the press of a button.
This is where modern compliance regulations come in. Under government acts like HIPAA and HITECH, healthcare providers and medical record retrieval services have an obligation to protect patient privacy.
How do medical record retrieval companies handle compliance? From following data security protocols to carefully filling out authorization forms, retrieval organizations do everything in their power to keep patients safe.
What Compliance Means in Medical Record Retrieval
In the context of medical record retrieval, compliance refers to following the rules created by government agencies to protect patient data. Compliance is one of the pillars of the record retrieval industry; without compliance, there is no trust.
To be compliant—which is a legal requirement—both the organization requesting the medical data and the healthcare facility handling the request must comply with all applicable regulations.
In general, protecting patient data is critical. People deserve to have private conversations with their doctors and therapists.
However, privacy and protection are particularly important in legal and insurance workflows. Both industries process and store a lot of sensitive data (including Personal Identifiable Information, or PII) throughout the course of cases and claims. Even a single misstep could cause a breach of privacy and jeopardize the validity of a case.
This explains why, over the past few decades, several landmark patient privacy acts have been introduced.
HIPAA Compliance
In 1996, the Health Insurance Portability and Accountability Act (HIPAA) was signed into law. The act included a number of health-related measures meant to protect patients in an ever-changing world.
In particular, HIPAA responded to the increase in electronic health insurance transactions. With more providers sending documents digitally, new standards were necessary.
Per the U.S. Department of Health and Human Services (HHS), the main goal of the HIPAA Privacy Rule is to protect individuals’ health data without impeding the flow of information. HIPAA compliance covers a lot of ground, but the most important parts for medical record retrieval companies are:
- “Minimum necessary” use and disclosure – Organizations must only use the health information necessary for the request.
- Data safeguards – Medical records must be physically and technically secured with passwords, and access should be limited to those who need it.
- Legal and financial penalties – Failure to comply with HIPAA regulations can lead to serious penalties.
HITECH Compliance
In 2009, the Health Information Technology for Economic and Clinical Health Act (HITECH) was developed to strengthen HIPAA. Digitization had picked up steam since 1996, and new regulations were required to protect patient privacy and security.
To comply with HITECH, organizations must (among other things):
- Perform regular risk assessments to identify vulnerabilities
- Encrypt data when in transit and at rest
- Destroy information when it’s no longer needed
- Notify patients if there’s been a breach of their personal health information (PHI)
- Pay higher fines for the mishandling of PHI
State-Specific Compliance
In addition to the federal requirements listed above, some states have their own regulations. For example, California has the Confidentiality of Medical Information Act (CMIA), while Texas passed the Texas Medical Privacy Act (HB300). Other states have additional protections surrounding sensitive information.
In many cases, state regulations go above and beyond HIPAA compliance. Record retrieval companies must adjust their procedures on a state-by-state basis to ensure nationwide compliance.
The Risks of Non-Compliant Retrieval Processes
When medical record retrieval companies fail to comply with federal and state regulations, they put patients at risk. Medical records often contain sensitive information that can be damaging if made public.
Non-compliance also puts the company itself at risk. Record retrieval services have a vested interest in keeping PHI secure, as non-compliant retrievals can lead to:
- Data breaches – If medical records are not stored properly, breaches can occur. Whether a breach is caused by a malicious actor (a hacker) or an internal human mistake, the result is the same: sensitive PHI leaks to the world. Large-scale data breaches can affect millions of patients.
- Legal penalties – Companies that violate compliance guidelines can face financial and criminal penalties. HIPAA fines can reach upward of $2.19 million for the most serious offenses, and individuals who knowingly violate HIPAA can go to jail.
- Reputational damage – Because organizations are required to alert patients, the HHS, and potentially even the media about data breaches, non-compliance never stays a secret for long. And once a company has publicly admitted to non-compliance, clients are much less likely to trust them with their retrieval requests. The HHS’s Office for Civil Rights even has a “Wall of Shame” for companies that have violated HIPAA.
Non-compliance also impacts the clients who trust retrieval services to obtain records on their behalf. Compliance issues can lead to delayed cases and increased liabilities for the firm.
The Key Components of a Compliant Retrieval Process
Record retrieval services must meet various stringent requirements to ensure regulatory adherence and accountability. While compliance is multifaceted, the core components of a compliant retrieval process are as follows.
Authorization Management
Authorization plays two different roles in HIPAA compliance.
First, a patient must authorize the disclosure of their PHI. A request must be signed and dated by the patient themselves or their legal representative.
Second, the organizations that handle the data must carefully manage who can access the files. Using unique user IDs and passwords, record retrieval companies ensure that only authorized individuals can view and modify data.
Secure Data Transfer and Storage
All PHI needs to be encrypted in transit and at rest.
Encrypted data is essentially “scrambled,” and can only be understood with the right decryption key. Authorized users are the only ones with the key.
Encryption ensures that even if PHI is stolen, it’s unreadable and unusable.
Audit Trails
It’s equally important to know who accessed data, when they handled it, and why. An audit trail makes this possible.
Audit trails log the details of every request, including when and where data was sent. This in-depth monitoring enables accountability, making it easier to determine how a breach occurred.
Additionally, bad-faith employees may be less likely to commit intentional violations if they know their actions are being recorded.
Leveraging Technology for Compliance Management
So, how do retrieval companies stay compliant? Modern medical record retrieval services leverage technology that helps protect patients, even as client lists grow and regulations change. Industry-standard solutions include:
- Secure platforms – A HIPAA-compliant platform allows for role-based access and monitoring capabilities. That way, only approved users can handle PHI. Multi-factor authentication (MFA) is a common measure for additional security.
- Encryption – As mentioned, data is encrypted at all times. Encrypted data can only be read by authorized users.
Avoiding Common Compliance Pitfalls
For record retrieval companies to adhere to HIPAA, HITECH, and other regulations, they must avoid the following missteps:
- Incomplete authorizations – When retrieval services ask for access to data, they file a formal request. If this request is missing information, incorrect, or expired, the authorization may not be considered “compliant,” especially if information is released based on the incomplete form.
- Insufficient training – Uninformed employees can accidentally violate regulations, so all staff must be trained on the latest HIPAA and HITECH guidelines. Staff also need to learn the signs of phishing, which is a common scammer tactic that aims to extract PHI.
- Improper data handling – Employees should never use personal email accounts or SMS to transmit PHI, and they must keep their work computers and phones secure at all times. Data must also be disposed of properly: Devices should be thoroughly wiped, and paper records should be shredded.
The easiest way to stay compliant is to create and follow a standard operating procedure. If all employees follow the same strict internal policies, they can minimize the risks of non-compliance.
Prioritize Compliance to Protect Your Operations
Overall, standardized compliance is the foundation of trust in the medical industry. Clients, providers, and other stakeholders all rely on compliance guidelines to reduce risk and uncertainty.
Without proper compliance, everyone involved is at risk of reputational damage, fines, and legal repercussions. That’s why compliant medical record retrieval for lawyers and insurance companies is so important.
At American Retrieval, we understand the nuances of compliance better than anyone. After more than 30 years in the industry, we’ve developed a system that provides secure, compliant medical record access through trackable record sharing. Our medical records retrieval solutions can help protect your business, your clients, and the patients, so you can focus on what you do best.
Learn more about our commitment to compliance, then book your demo today.
Sources:
The HIPAA Journal. HIPAA History. https://www.hipaajournal.com/hipaa-history/
U.S. Department of Health and Human Services. Summary of the HIPAA Privacy Rule. https://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html
The HIPAA Journal. What is the HITECH Act? https://www.hipaajournal.com/what-is-the-hitech-act/
Consumer Federation of California. The Confidentiality Of Medical Information Act (CMIA). https://consumercal.org/about-cfc/cfc-education-foundation/cfceducation-foundationyour-medical-privacy-rights/confidentiality-of-medical-information-act/
The HIPAA Journal. What is Texas HB300? https://www.hipaajournal.com/what-is-texas-hb-300/
The HIPAA Journal. What are the penalties for HIPAA Violations? https://www.hipaajournal.com/what-are-the-penalties-for-hipaa-violations-7096/
U.S. Department of Health and Human Services. Breach Portal: Notice to the Secretary of HHS Breach of Unsecured Protected Health Information. https://ocrportal.hhs.gov/ocr/breach/breach_report_hip.jsf
