Privacy
In today’s health care environment, PMG and its staff members understand the need for patient privacy and complying with payor and HIPAA regulations. Each staff member signs an agreement containing company policies regarding Protected Health Information ( PHI) and receives training on all policies related to patient confidentiality upon starting at PMG. This initial training is supplemented at regularly scheduled intervals during compliance and staff meetings. From a technology standpoint, PMG’s network is secure with state of the art firewall and intrusion detection equipment, policies requiring the consistent changing of user passwords, electronic encryption options and other policies designed to meet and exceed all applicable HIPAA and payor regulations.

Compliance
In today’s vexing health care environment, compliance plays a significant role. Although numerous definitions exist, compliance is defined as acting in accordance with certain accepted standards, rules and/or policies. In our world, compliance means to adhere to all Federal and Private payer regulations governing reimbursement related activities. This is an extremely important aspect of our business and we comply to the regulations with unwavering viligence. PMG’s Compliance Officer meets regularly with billing, managerial and executive staff to ensure that our written compliance plan is effective, that we are up to date on industry trends and happenings and that we continually “detect and correct” any billing or reimbursement related inaccuracies.

Prior to working with PMG, one of our clients billed a common lab test using the incorrect CPT code to all of its major payors. This appearance of this code triggered an electronic edit at Medicare and a visit with members of the Office of the Inspector General (OIG) which is Medicare’s investigative arm soon was arranged. After an in-depth investigation, the client agreed to reimburse all payments related to the code and other corrective action was needed in addition. Although no active PMG clients have been through this type of process, our compliance plan coupled with medical coding training and medical record review offered to all providers is a strong first line of defense.