Richards Laboratories, Inc. - HIPAA Contact Person:

Marcy Zabriskie (801)785-2500 extension 128

According to the Standards for Privacy of Individually Identifiable Health Information Richards Laboratories, Inc. is required by law to maintain the privacy of protected health information. As a laboratory we are committed to protecting the privacy of individually identifiable health information generated, utilized, and maintained at all of our laboratory locations.

Richards Laboratories is involved in an ongoing pursuit to comply with any and all government regulations regarding clinical laboratories.

DEFINITION OF HEALTH INFORMATION

 

Health information is any information, oral or recorded, in any form or medium that is created or received by a covered entity. Health information would include anything that relates to past, present or future physical or mental health or conditions of an individual.

DEFINITION OF INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION

 

Individually identifiable health information is information that either identifies a person, or offers a reasonable basis to believe it could be used to identify an individual.

            Examples: name, address, birth date, social security number, insurance number, etc.

DEFINITION OF PROTECTED HEALTH INFORMATION (PHI)

 

Protected health information (PHI) is individually identifiable health information that is transmitted by electronic media, maintained in electronic media, or transmitted or maintained in any other form or media.

 

            Examples:      report forms, log sheets, reimbursement forms, etc.

As outlined in the Federal Register / Vol. 63, No. 163 the Office of the Inspector General (OIG) of the Department of Health and Human Services (HHS) and other Federal agencies charged with responsibility for enforcement of Federal law have emphasized the importance of voluntarily developing and implementing a Clinical Laboratory Compliance Plan.

In response to this request, Richards Laboratories has developed and implemented a Compliance Plan relating to the billing of Medicare / Medicaid and private insurance companies based on claims submitted by the physician offices to which we provide microbiological services.

As a clinical laboratory, we embrace the opportunity to participate in a nationwide effort to reduce fraud and abuse in national health care programs. With that resolve in mind, we have endeavored to create a compliance plan fulfilling all federal guidelines. This plan specifically establishes guidelines and protocol followed by Richards Laboratories in regard to billing procedures, documentation of records, record-keeping, and other procedures based on reimbursement rules and federal anti-fraud laws.

We are relying on the following when we submit reimbursement requests to Medicare / Medicaid and private insurance companies for tests that our laboratory has performed for your patients:

 

            ∙          Accuracy of information for patient tests to be submitted for reimbursement from Medicare / Medicaid and private insurance companies on the Richards Laboratories Medicare / Medicaid / Insurance Billing Form (Please See the accompanying copy).

 

            ∙          That the physician or other authorized individual has determined that the tests requested and performed are covered, reasonable, and necessary for the beneficiary, given his or her clinical condition. Tests submitted for Medicare reimbursement must meet federal guidelines of necessity.

As a matter of federal compliance it is our obligation, as a laboratory providing service to your office, to inform you that Medicare generally does not cover routine screening tests.