The PCS Compliance Risk Assessment "*" indicates required fields Step 1 of 6 16% Welcome to PCS Compliance Risk Assessment! The questions below are designed to help us gain an in-depth understanding of your practice's unique compliance status in the areas of HIPAA, Fraud & Abuse, OSHA, and more. Your answers will provide the PCS team with valuable insights to tailor a compliance solution specifically to your needs. After completing the assessment, a member of our sales team will reach out to discuss how we can support your practice in meeting its healthcare compliance requirements. HIPAA QUESTIONS1.Do you have signed business associate agreements with all business associates?1. Do you have signed business associate agreements with all business associates?* Yes No a.Have they been updated after 2016?a. Have the been updated after 2016?* Yes No 2.Do you have a secured and encrypted text and email system in place and if not, do you have authorizations from all patients to contact them by standard email?2. Do you have a secured, encrypted text and email system in place and if not do you have authorizations from all patients to contact them by standard email?* Yes No 3.Have you completed a security risk assessment and management plan in the past year?3. Have you completed a security risk assessment and management plan in the past year?* Yes No 4.Do you store paper medical records in your office?4. Do you store paper medical records in your office?* Yes No a.Have you documented your risk management plan?a. Have you documented your risk management plan?* Yes No 5.Is your Notice of Privacy Practice prominently displayed in your office?5. Is your Notice of Privacy Practice prominently displayed in your office?* Yes No HAZARD QUESTIONS1.Do you have a current listing of all chemicals stored in your office?1. Do you have a current listing of all chemicals stored in your office?* Yes No a.Do you have safety data sheets on file for each?a. Do you have safety data sheets on file for each?* Yes No b.Are they accessible to your staff?b. Are they accessible to your staff?* Yes No 2.Have you done Hazard training for your staff?2. Have you done Hazard training for your staff?* Yes No a.Have they taken a test?a. Have they taken a test?* Yes No b.Do you have copies of the test?b. Do you have copies of the test?* Yes No 3.Do you have an OSHA approved first aid kit?3. Do you have an OSHA approved first aid kit?* Yes No 4.Do you have items that come in contact with bodily fluids (including tears / blood / mucus)?4. Do you have items that come in contact with bodily fluids (including tears / blood / mucus)?* Yes No a.Have you documented risk management plan?a. Do you have sterilization / disposal protocols?* Yes No b. Are your protocols written?b. Are your protocols written?* Yes No 5.Are all your exits properly marked with lighted signs?5. Are all your exits properly marked with lighted signs?* Yes No FRAUD, ABUSE & OPERATIONAL QUESTIONS 1.Have you completed a medical records audit in the last year?1. Have you completed a medical records audit in the last year?* Yes No 2.Do you know the 5 Fraud and Abuse laws that you must comply with?2. Do you know the 5 Fraud and Abuse laws that you must comply with?* Yes No a.Can you name them?a. Can you name them?* Yes No 3.Are you displaying the required patient anti-discrimination language at check in?3. Are you displaying the required patient anti-discrimination language at check in?* Yes No 4.Are your referral protocols and co-management fees up to date with the 2020 changes?4. Are your referral protocols and co-management fees up to date with the 2020 changes?* Yes No 5.Do you have a grievance officer?5. Do you have a grievance officer?* Yes No HR QUESTIONS1.Do you have an updated employee policy manual that is compliant with current state law?1. Do you have an updated employee policy manual that is compliant with current state law?* Yes No a.Is it compliant with federal law?a. Is it compliant with federal law?* Yes No b.Do your employees have access to your employment manual?b. Do your employees have access to your employment manual?* Yes No 2.Do you have any employees you pay on a salaried basis?2. Do you have any employees you pay on a salaried basis?* Yes No 3.Do you have employees that you pay as independent contractors?3. Do you have employees that you pay as independent contractors?* Yes No 4.Do you have current state and federal employee information posters?4. Do you have current state and federal employee information posters?* Yes No a.Are they posted in a visible space?a. Are they posted in a visible space?* Yes No 5.Are your employee files kept in a secure location and backed up?5. Are your employee files kept in a secure location and backed up?* Yes No Name* First Last Phone*Email* All personal information you provide is completely confidential, used solely for contacting you regarding your compliance needs, and will not be shared with any parties outside of PCS. 19483