COMPLIANCE
HIPAA Compliant: PACE+ meets and complies with the guidelines established by the Health Insurance Portability and Accountability Act (HIPAA) to maintain privacy and security of Protected Health Information (PHI). PACE+ uses Electronic Data Interchange (EDI) with national standards to securely transmit and exchange among providers, payors, and covered entities that are involved in the care, treatment, and management of the patient. PACE+ EDI transmissions are HIPAA compliant and minimize the number of people involved in handling patient/client Protected PHI, thereby increasing the level of privacy for patients/clients
Clinician Credentialing: With PACE+ one can track clinicians’ credentials, dates of licensure/certification and continuing education units in the provider profile section of the EHR. Specific billing codes correspond with clinician credentials, ensuring accurate service reporting on progress notes. Thus, PACE+ prevents data validation errors by limiting clinicians to report only the services for which they are qualified to perform.
Audit History Trail: PACE+ incorporates an audit management tool for each form in the electronic file. Every iteration, no matter how small the change, is saved in the EHR archive. Each stage of recording progress notes prior to submission of encounters is date and time stamped. Supervisors can monitor activity logs and reports and use version control to view or print authors and times of use. This tool also allows claim tracking individually or by date to accurately address billing denials.
Data Validation: is the process regulators follow to determine the accuracy of data submitted by providers for payment. It involves a sample of records to determine whether the procedure codes submitted are appropriate for the diagnosis. They also determine whether the clinician who reported the service has appropriate credentials to perform the procedure. Regulators extrapolate their findings from the sample and sanction providers for errors. PACE+ employs edits that prevent such errors. The system ensures that procedure codes are appropriate for the services reported and that they were provided by authorized clinicians.
