LST is working with some of the leading business in your area asking them to assist us in determining the market potential for a new service. This service is designed to help senior management make smart decision on data security and employee productivity. The questionnaire is based on the guide lines established by the National Business Institute.
| 1. | Does your organization engage in HIPAA standard electronic transactions / insurance filings? | ||||||||
| Yes No | |||||||||
| 2. | Does your Practice Managment Software have an electronic medical records module? | ||||||||
| Yes No | |||||||||
| 3. | Create, store, use or maintain ePHI (Electronic Protected Health Information)? | ||||||||
| Yes No | |||||||||
| 4. | Send ePHI to patients using the Internet? | ||||||||
| Yes No | |||||||||
| 5. | Receive ePHI from patients using the Internet? | ||||||||
| Yes No | |||||||||
| 6. | Send ePHI to third parties using the Internet? (e.g., billing and claims information to a billing company or health plan: exchanging ePHI among providers involved in patient treatment: sending prescriptions to pharmacies) | ||||||||
| Yes No | |||||||||
| 7. | Receive ePHI from third parties using the Internet? | ||||||||
| Yes No | |||||||||
| 8. | Send or receive ePHI through the Internet between multiple facilities maintained by your organization? | ||||||||
| Yes No | |||||||||
| 9. | Does your organization permit Doctors or other employees to have remote access to your systems and applications (e.g., through a telephone modem, DSL line, virtual private network, etc.)? | ||||||||
| Yes No | |||||||||
| 10. | Have you taken any recent actions to protect the confidentiality, integrity or availability of ePHI on your computers and network? | ||||||||
| Yes No | |||||||||
| 11. | Does your organization have a Privacy Official (Someone that is in charge of the HIPAA Security Rule)? If so, Please list his/her name and contact information so we can provide valuable security tools to assist in keeping your ePHI safe and secure. | ||||||||
| Yes No | |||||||||
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Thank you for completing our survey. Please provide your contact information so we can mail your lotto ticket. Good luck!
| Employer: | |
| Name: | |
| Telephone: | |
| E-mail: | |