More Secure Backups required:
Backing up HIPAA data takes on a little more significance than backing up a lot of basic data. HIPAA, Financial data, and personal information always requires a little more security than backing up your pictures and music and other data that is not so sensitive. And how that is done is important. The beginning of this article is intended to remind us all of the basics of a good backup plan. Executives and owners need to be sure the basics are in place and then further ensure the HIPAA requirements are met, which are addressed in the final section of this blog.
Any Good Backup follows these basics:
You should always start with examining your backup program to insure the basics are covered, and that includes two main elements. Where is the data backed up to and how often is it backed up.
Where is it backed up?
I am always amazed at how often when I ask someone if they backup their systems the answer is either no, or I think someone here does. But even more amazing is where they have what they consider a good backup plan, only to find it is located in the same facility and often the same room. If the backup is onsite at the same location as the main data storage, it is really only backing up in case of disk failure or hardware failure. I have met a number of folks who have experienced a fire, flooding or theft only to realize their backup went the same route as the main data storage.
A typical sad example was when an older house behind the office complex caught fire and the Backup drives were destroyed along with the server. Both were housed in the same computer area. It was painfully obvious to this company after the fact that this plan had failed. And even those folks who take their backups off site at night, for example to the IT person or owners home, will leave a lot of room for a bad scenario. Major unexpected disasters are all over the news and that backup a few miles from the office has been and will continue to be destroyed in the same major disaster.
So any backup plan should include an off-site facility that is not in the same area. Fortunately these types of backup locations and services are all over the internet. This is one of the truly great uses of the high speed internet and ability to move data quickly. Most of these services can take advantage of zipping (reducing the size of these files), only sending the data that has changed since last backup, and encryption (securing the data). Some software vendors will even offer a service to assist you with backing up the data from their applications to a remote site including the software to do all the above. But never assume anyone else is responsible for making sure you have a good backup plan.
How often should my data be backed up:
Every basic plan needs a minimum backup frequency and that should be the level to which you are comfortable redoing your work. For major disaster recovery or smaller companies, backing up each night might be sufficient. Just remember with a nightly backup, a failure at the end of the day means you might have lost that entire day’s work.
While that might be acceptable for a staff of 4 to reenter a day’s work and get caught up, and the cost to do more than that is not worth it for a rare need to recover that work, that might not be the case in a large organization.
If you have hundreds of people working all day, a failure at the end of the day could be costly. And if a lot of that data is not from another source, such as recording notes from phone conversations all day in your ambulance billing and collections department or your EMS dispatching center, then you might lose all those notes and conversations for the day.
For larger staffs a more expansive program might be needed. This is where modern software and modern backup techniques can really be useful. For example you can now set up your database to be “mirrored” or “replicated” instantly all day long. And these two copies of the data can be in two different locations. A lot of software can also be set to auto fail over, meaning that with two servers having an exact copy of the data, one can fail or lose its connections and the software will continue to run on the remaining database server until the other is restored. This means you not only have your data intact, but your staff continues to be productive all day.
What is different about HIPAA data?
So all this previous information applies to and is part of the basics of a good backup system. How does that differ with Ambulance Billing Software data, Ambulance Dispatching software data, and EMS Dispatching and EMS Billing data? Simply put this data includes HIPAA information and therefore we are responsible for ensuring an additional level of security. This kind of data needs to be encrypted before it ever leaves the security of your location and your firewall protection. The site you are sending it to must also be secure and have the proper security certificates in order to insure when you send the data to someone, you are 100% sure it is going to them. The nature of sending secure data is to make sure it is encrypted and password protected and it lands where you think it is going, and when it lands it is secure and protected.
Furthermore you want to ensure that site follows the basics of backing up their data in multiple secure locations and they have the proper physical and electronic security in place. The industry has the tools and the ability to do all that safely and securely. But you have the responsibility to make sure you do this, or you hire a professional who knows how to do this. If you are not 100% sure this is the case with your backup and your backup data then now is the time to find out.
Thank goodness, gone are the days when all the ambulance billing paperwork had to be done by hand! At one time, every step of the process had to entered, and filed, resulting in endless amounts of paperwork. Needless to say, this was a tedious process, with much double-checking and manual verification required.
More and more, billing for EMS services is done electronically, and this has resulted in cost and labor savings. Getting to the next level in electronic billing means finding software or tweaking your billing system so that data entry is not duplicated, and information is entered once, or as needed.
From the initial 911 dispatch call, to the EPCR, to the billing and maybe even to the hospital, why not utilize systems that can transfer and store important client records, medical information and signatures, allowing users to import information from system to system, and to enter only the new data, as required.
As we all know, for those working in the emergency medical field, documentation is key. When working with ambulance billing, the room for error is large. From the time a patient calls 911 or requests a basic transport, until the time a bill is sent, there are many opportunities for information to be missed, or entered incorrectly. By eliminating duplication of entry, the room for error is minimized, ensuring that all parties involved have access to complete and accurate records, and are only required to enter the new information that pertains to their task.
All aspects of the ambulance service can be handled electronically with the latest in ambulance billing technology. This system allows for data to be entered into the system one time, and then it is accessed by all parties electronically, saving on time and labor costs. Instead of clerks re-entering data from forms filled out by E.M.T.'s, they simply add any new information to an existing file. This will save on paper and clutter by eliminating paper forms and unneeded filing cabinets.
The latest software in ambulance billing also features a very handy pop-up window so that all relevant data can be viewed during entry. In this way, the biller entering data can view the narrative from the E.M.T. personnel and find the pertinent information needed to complete the ticket for billing purposes.
Another great feature that will save on paper storage clutter is the ability to store paper documents that you receive by scanning them into the system, thus allowing them to be sent along to the appropriate parties. Even checks received by patients, or insurances companies check and their Explanation of Benefits can now be stored with each transport or Bill and retrieved at the press of a key. The best systems will take you from the transport entered, to the page of the EOB in one mouse click or enter key. All stored electronically along with the ticket and patient data for safe record keeping.
The ability to connect related documents is also important during the ambulance billing cycle. An example of this is to attach a copy of the E.O.B. (explanation of benefits) to the bill that comes in from the insurance company. In this way, with one simple click, users can view the explanation that goes with each ticket.
Another way to improve your system is ensure that patient information, such as medical history, medical conditions and any other pertinent data, does not have to be re-entered for multiple ambulance uses by the same client. A good system will ensure that all relevant data for the patient is stored is handy and accessible every time the patient is picked up. In this way, care decisions at the E.P.C.R. level are based on the most current and thorough information.
Storing your records electronically can save you precious time by making all aspects of documentation easier and more accurate. A seamless system that goes from the initial dispatch call to the patient billing will help everyone involved work together and be informed.
Speed and efficiency are two universal factors that contribute to the success of any ambulance dispatch run. Regardless of the emergency, an ambulance dispatch aims to accomplish its mission in the quickest, most proficient way possible.
Being said, it’s no surprise that today’s CAD systems must be able to effectively communicate between crew and dispatcher while simultaneously minimizing the time spent on the radio. CAD systems need to get the data and Information from the CAD center to the crew (and vice-versa) without all the excess Radio Chatter.
To those unfamiliar with the term, “Radio Chatter” is essentially the noise that literally and figuratively pervades the dispatch airwaves. Its existence can detract from the progress of the dispatcher and crew, altogether reducing the speed and efficiency of the dispatch run.
Because of its potential hazards, reducing and altogether eliminating Radio Chatter is an essential component to be considered when structuring an ambulance dispatching system. In order to achieve this, it is essential that it all start with effective software and hardware to manage it all and keep everything flowing smoothly.
What are the basics functions to search for in software and hardware to cut down the critical time and effort spent on radio chatter? Let’s investigate:
- Call Data Transfer: Being able to send call data to the crews – such as location, situation, patient name (if known), caller (if known), and for non 911 calls as much of the basic transport information such as location and room number, appointment time and free form text.
- Pickup Location Synchronization: Being able to send the location of the scene or pickup so that a local device Garmin or MDT (Laptop) in the vehicle can route that call with the push of one button and not have to rekey the address/location or worse—write it down and use maps.
- Streamlined Status Updates: Improve communication back to the CAD Center by providing a tool for the crew to update the dispatcher as to their status, with the simple press of a button. That button should send information to the dispatcher or dispatching system that used to require radio time. Such as when they are enroute, at scene, departing scene, arriving at the destination and when they are available for the next call
- Streamlined Location Updates: Location data also need not take up radio time. Through the use of GPS devices, which can constantly track vehicles and crews at all time, the location of a crew can be quickly ascertained without radio communication (especially when they are on their route to the scene and from the scene.) That information can be displayed on a desktop monitor and also be displayed on a map in the dispatch center. Systems can now store, relay and allow replaying of the times of events, routes taken, along with providing data about speed and other events such as rough braking, or lights and sirens turned on. For more advanced users the GPS device can tell when you are within a certain distance of a location or scene and be set to automatically update the dispatchers, without the crew pressing a key.
- Coordinated Analytics: The ability to quickly see an individual vehicle on a map, a location of a scene or destination, or expand the map and see other vehicles and determine who is closest to the scene.
This and many more new and exciting features can cut down Radio Chatter to improve communications, allow single dispatchers to handle more work, and allow the crews to focus the actual task at hand. The information is necessary, but getting it there can be much more efficient.
Gone are the days when a lengthy conversation with extensive dialogue needed to take place in order for the dispatcher to relay specifics of the destination to the crews en route. Instead, the right technology needs to be in place that allows for an immediate and real time transfer of this information electronically with the radio never even being picked up on either end.
Given the prevalence of GPS mapping systems in a large majority of motor vehicles these days, and in virtually every emergency response vehicle, it is also essential that ambulance and EMS dispatching software have the ability to fully integrate itself with the GPS systems that are already being used by these crews. This integration of software also provides benefits to the dispatchers in that at a simple glance, the ambulance or EMS dispatcher will be able to instantaneously see where crews are without having to hail them on the radio for this information.
Software and Hardware today are tools to be used to accomplish all this and more.
Fortunately or not, ambulances are always in demand, which means ambulance billing software is always being used and depended on by ambulance companies and ambulance billing companies. If you're an ambulance company, you may be using your own ambulance billing software or you may be using an ambulance billing service. As with any business decision, there are benefits to each side that you can examine and make the best decision for your business.
- Pros of using ambulance billing companies
- Lower Personnel Costs - When you outsource your billing, they have the personnel and expertise to manage ambulance billing software so your business won't have to increase its staff.
- Policies and Procedures - Billing companies already have policies and procedures in place to insure you get paid. They can also follow up on claims for your company
- Less Hassle - You don't have to worry about interviewing, hiring and training new personnel. Billing companies have well-trained people with great experience and customer service skills
- Pros of using your own ambulance billing software in house
- Control - There's no doubt that when you use in-house ambulance billing software, you'll have complete control over all billing.
- Claims Collection - Collections are how your business makes money and when you keep collections in house, you can monitor the effort that is put into collecting claims.
- Cost Effective - If you have a higher number of annual claims and have the resources available, using ambulance billing software in house may make more sense for your company.
The Cons of using ambulance billing companies versus keeping it in house are also worth considering:
- Cons of using ambulance billing companies
- Cost - Like any other service you contract out, there is a cost to using a billing company. The cost of using a billing company needs to be compared to what your ambulance billing software costs and personnel costs would be.
- Lack of Control - The billing company will handle billing and collections with their policies and procedures, but may not focus the way your employees would.
- Cons of using your own ambulance billing software in house
- Cost - Ambulance billing software, billing costs, personnel, benefits and others costs need to be considered while you make the decision about a billing service.
- Increase in Resources - When you handle billing, you'll be increasing resources - printing, personnel, postage, computers, IT support and more.
Billing is necessary for all ambulance companies. What you'll need to decide is whether it's best for you to invest in outsourcing your billing or in ambulance billing software. Only you can decide what the best fit for your business will be.
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