OCT 2017

MedEsthetics—business education for medical practitioners—provides the latest noninvasive cosmetic procedures, treatment trends, product and equipment reviews, legal issues and medical aesthetics industry news.

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Additionally, lack of supporting documentation for diag- noses or treatments administered can impact reimburse- ment, since the physician cannot corroborate the codes that are being billed to the insurance providers. Of particular importance to aesthetic practices, many physicians and mid-level practitioners fail to properly docu- ment their supervision and oversight of providers to whom they have delegated treatments. Documentation of super- vision and oversight demonstrates that the proper steps were taken for all procedures performed. Lack of it can be a red fl ag if something goes wrong with a treatment. FOR YOUR EYES ONLY In medical aesthetic practices, it is not uncommon for both licensed medical and non-medical personnel to work with patients. However, due to the privacy protection require- ments of the Health Insurance Portability and Accountabil- ity Act of 1996 (HIPA A), some of the information on patient charts must be withheld from non-medical personnel at the practice. "HIPA A generally allows workforce members who are employees of the entity [medical aesthetic practice] to have access to patient records, although the entity does have to have proper policies and procedures in place to limit the amount of information accessible by those individ- uals to what's known as the 'minimum necessary,'" Reyero says. "Essentially, employees should only have access to information that is necessary to do their jobs, or practices can be exposed to risk. Improper access by employees to information that they don't otherwise need can give rise to HIPA A breach issues. You see that a lot with the celebrity HIPA A breaches, where employees who have no relation to the treatment or care given to a celebrity access their information, and the hospital or facility didn't have the proper policies or procedures in place to prevent that from occurring." State laws regulating patient privacy may be even more stringent than HIPA A, so it is important to consult a health- care attorney familiar with your state guidelines to establish policies and procedures to prevent employees from access- ing information that they do not need. If a practice is using electronic medical records (EMR), the system typically can restrict access to certain informa- tion from users who do not have authorization to view it. If you do not know whether your system includes such features (or if you do not know how to use them), consult your EMR vendor to learn how to set them up. If your practice does not use EMR, it is critical to establish strong internal procedures and to properly train employ- ees. "Training can take the form of a lunch meeting where everyone reviews the policies and procedures, or online questionnaires where you print out a certifi cate at the end of the test, or one-on-one training where you sit down with the individual and walk through their daily routine to make sure that everything they're doing is in line with the policies and procedures in place," says Reyero. "You can customize it to each individual employee's relevant situation and circumstances, so that when you walk through their daily routine, you're sure that you're talking about—and educating them on—the policies that will impact them on a daily basis, rather than overwhelming them with 20 different policies when maybe only two are applicable." The practice must continually update and assess the risks of employees improperly accessing confi dential medical records, and implement appropriate safeguards in order to prevent that access. The practice also must hold employees who improperly access confi dential medical information accountable. HIPA A and state patient privacy violations can alter a medical aesthetic practice forever, so it is critical that they be prevented. Keep in mind that, while HIPA A violations are costly and damaging to a practice's reputation, they are not the No. 1 reason to take patient-charting procedures seriously. These records are created and maintained in order to protect the patient and help providers deliver the best care. Those who create and maintain medical records have a duty to make sure that the information on the chart is complete and accurate. It should tell the patient's entire medical story, so that any physician who opens up that document has all the information needed to make an informed deci- sion about the patient's health care. Alex R. Thiersch, JD, is a Chicago-based healthcare attorney with ByrdAdatto Law Firm, and founder and director of the American Med Spa Association (AmSpa), which was created to provide legal and business re- sources for medspas and medical aesthetic physicians in the U.S. Contact him at 24 OCTOBER 2017 | Med Esthetics LEGAL ISSUES "Essentially, employees should only have access to information that is necessary to do their jobs."

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