Compliance

Compliance

Affinity is committed to a culture of compliance, and expects its providers, first and foremost, to always comply with the law. Nothing on this website is intended to supersede or waive any provider or patient rights under the law. It is ultimately the responsibility of the provider to know and understand the laws that govern their interactions with and obligations to patients in specific circumstances, and providers should not rely on this website as a substitute for competent legal advice on what is the proper action to take in a specific circumstance.

• Provider Demographic Data Update
  Affinity has made it easier for providers to update their demographic data by simply clicking here or the link above to be directed to our online submission portal. Submissions must be made within 30 days of a change. Providers may also printout and fax their submission by clicking here.
• Cultural Competency and Language Assistance
  Affinity strives to ensure that all clinical and non-clinical services provided to our members are delivered in a culturally competent manner. Affected members may include those with limited English proficiency or reading skills, the hearing impaired, and those with diverse cultural and ethnic backgrounds. Affinity providers must ensure that members in need of language translation services be given access to professionally trained interpreters in their preferred language. Affinity provides access to training materials and language resources to promote cultural competency. Providers and their office staff are encouraged to complete cultural competency training annually. If your practice requires assistance in facilitating cultural competency training for your staff, contact Affinity Provider Services.
• Medicare Fraud, Waste, and Abuse
  Affinity requires its providers and vendors to comply with Medicare requirements with respect to fraud waste and abuse and general compliance. Please ensure your staff review these requirements annually.
• Required Managed Care Access Standards
  Managed Care After-Hours Suggested Messaging
  Affinity Medical Group strives to provide timely access to healthcare for its members. Affinity, therefore, requires its providers to comply with regulatory appointment access standards and after-hours availability requirements. Affinity monitors provider performance against these standards. For more information on these standards contact Affinity’s Customer Service Department.
• Privacy and Security of Protected Health Information
  Providers may view this slideshow to learn more about the following federal and state laws for protecting patient’s personal health information (PHI).- HIPAA: Health Insurance Portable and Accountability Act
  – HITECH: Health Information Technology for Economic and Clinical Health Act
  – California Confidentiality of Medical Information Act
• Policies & Procedures
• Notice to Members
  Affinity Medical Group complies with the CMS requirement that physicians in California inform their patients that they are licensed by the Medical Board of California, and include the board’s contact information.

Providers may prominently post the notice above in 48 point Arial font in their offices where patients will see it. The notice may be included in a written statement that is signed and dated by the patient and kept in the patient record, or on letterhead, with discharge instructions, or other documents given to the member. (The notice should be placed immediately above the member signature line in 14 point type.)