How can you maintain patient confidentiality during revenue cycle management?

Revenue cycle management (RCM) is the process of managing the financial aspects of a patient's care, from scheduling and registration to billing and collections. It involves multiple steps, data exchanges, and interactions with patients, providers, and payers. As a corporate accountant, you need to ensure that RCM is efficient, accurate, and compliant with various regulations and standards. One of the most important aspects of compliance is maintaining patient confidentiality, which means protecting the privacy and security of their personal and health information. In this article, you will learn how to maintain patient confidentiality during RCM and what are the benefits and challenges of doing so.

1 What is patient confidentiality?

Patient confidentiality is the ethical and legal obligation of health care professionals and organizations to respect and protect the privacy and security of their patients' personal and health information. This information includes demographic data, medical history, diagnosis, treatment, payment, and insurance details. Patient confidentiality is governed by various laws and regulations, such as the Health Insurance Portability and Accountability Act (HIPAA), the Health Information Technology for Economic and Clinical Health (HITECH) Act, and the General Data Protection Regulation (GDPR). These laws and regulations set the standards and rules for how patient information can be collected, used, disclosed, stored, and disposed of.

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Tomi Akinwale ACCA, ACA, ACTI, B.TECH, FMVA, AAT.

Tax | Deloitte | Financial Reporting & Modelling |
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Patient Data Confidentiality is a relevant idea that Accountants must take into consideration when performing accounting tasks and procedures. It's simply keeping the confidentiality of Health data during accounting tasks

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Nico Rivera, PMP

Vice President, Controller at JPMorgan Chase & Co.
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In healthcare revenue cycle management, upholding patient confidentiality goes beyond legal compliance; it's key to patient trust and integrity. While HIPAA, HITECH, and GDPR set frameworks, the challenge is in daily operational implementation. This requires secure IT systems, ongoing staff training, and awareness of law nuances. As technology evolves, so do data risks, necessitating regular privacy protocol audits and updates to balance operational efficiency with stringent privacy protection.

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2 Why is patient confidentiality important for RCM?

Maintaining patient confidentiality during RCM is important for several reasons. First, it is a legal requirement that can result in penalties and lawsuits if violated. Second, it is a moral duty that can affect the trust and satisfaction of patients and their families. Third, it is a business strategy that can improve the quality and efficiency of RCM processes and outcomes. By protecting patient confidentiality, you can avoid errors, fraud, disputes, delays, and rework in RCM. You can also enhance your reputation, loyalty, and competitiveness in the health care market.

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Tomi Akinwale ACCA, ACA, ACTI, B.TECH, FMVA, AAT.

Tax | Deloitte | Financial Reporting & Modelling |
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Patient Confidentiality is relevant to Revenue recognition to prevent reputation damage and legal proceedings being instituted in cases of breach.

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3 How can you maintain patient confidentiality during RCM?

Maintaining patient confidentiality during RCM requires following certain steps and best practices. You should implement a privacy policy and a security policy that outlines the roles and responsibilities of your staff, contractors, and partners. Furthermore, you should train and educate them on the policies and the applicable laws and regulations. It's also important to use encryption, authentication, authorization, and backup systems to protect the data transmission, storage, and access in RCM. Additionally, you should limit the collection, use, and disclosure of patient information to the minimum necessary for RCM purposes. Obtaining consent from patients before sharing their information with third parties is also essential. Patients should also be informed about their rights and options regarding their information. Finally, when patient information is no longer needed for RCM purposes, it should be disposed of securely and timely using shredders, erasers, or destroyers to eliminate paper or electronic records. It's important to follow the retention and destruction schedules and guidelines of your organization and the relevant authorities.

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Tomi Akinwale ACCA, ACA, ACTI, B.TECH, FMVA, AAT.

Tax | Deloitte | Financial Reporting & Modelling |
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Privacy policies should be maintained while access to confidential information regarding patients should be limited wether electronically or physically

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4 What are the benefits of maintaining patient confidentiality during RCM?

Maintaining patient confidentiality during RCM can offer several advantages, such as reducing the risk of legal, financial, and reputational damages due to non-compliance or breaches. This can also increase the trust and satisfaction of patients and their families, leading to better retention and referrals. Additionally, it can improve the accuracy and efficiency of RCM processes and outcomes resulting in faster payments, lower costs, and higher revenues. Moreover, it can enhance your competitive advantage in the health care market, potentially attracting more customers and partners.

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5 What are the challenges of maintaining patient confidentiality during RCM?

Maintaining patient confidentiality during RCM can offer many benefits, yet there are also challenges to consider. Keeping up with changes and updates in laws and regulations affecting RCM and patient confidentiality is one such challenge. Additionally, balancing the needs and expectations of patients, providers, and payers regarding the access and use of patient information can be difficult. Furthermore, managing the complexity and diversity of RCM systems and workflows, which may involve multiple stakeholders, platforms, and formats, can be daunting. Finally, there are human and technical factors that can compromise patient confidentiality such as errors, negligence, or malice that must be managed.

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6 Here’s what else to consider

This is a space to share examples, stories, or insights that don’t fit into any of the previous sections. What else would you like to add?

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Tomi Akinwale ACCA, ACA, ACTI, B.TECH, FMVA, AAT.

Tax | Deloitte | Financial Reporting & Modelling |
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Confidentiality of information across board is one of the professional principles of Accountants and Auditors regardless of the circumstances.

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How can you maintain patient confidentiality during revenue cycle management?

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1 What is patient confidentiality?

2 Why is patient confidentiality important for RCM?

3 How can you maintain patient confidentiality during RCM?

4 What are the benefits of maintaining patient confidentiality during RCM?

5 What are the challenges of maintaining patient confidentiality during RCM?

6 Here’s what else to consider

Corporate Accounting

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