eFerral FAQ

What is Eferral?

EFerral is one of the few online services that allows doctors to communicate and share sensitive patient records including charts, x-rays, photos and other private information in a secure, HIPAA and HITECH compliant, efficient manner, as well as being an online patient referral delivery service.

Does Eferral meet HIPAA and Electronic Medical Records (EMR) requirements?

EFerral meets and exceeds HIPAA and EMR Requirements.

**Note: EMR for dentistry takes effect in 2015. Thus all inter-office correspondence need to be EMR and HIPAA compliant.

What is HIPAA?

HIPAA is the federal Health Insurance Portability and Accountability Act of 1996. The primary goal of the law is to make it easier for people to keep health insurance, protect the confidentiality and security of healthcare information and help the healthcare industry control administrative costs.

What is HITECH?

The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009, was signed into law on February 17, 2009, to promote the adoption and meaningful use of health information technology. Subtitle D of the HITECH Act addresses the privacy and security concerns associated with the electronic transmission of health information, in part, through several provisions that strengthen the civil and criminal enforcement of the HIPAA rules.

What is EMR?

An electronic medical record (EMR) is a digital version of the traditional paper-based medical record for an individual. The EMR represents a medical record within a single facility, such as a doctor's office or a clinic.

What is Massachusetts 201 CMR 17.00?

The Massachusetts General Law Chapter 93H and its new regulations 201 CMR 17.00 require that any companies or persons who store or use personal information (PI) about a Massachusetts resident develop a written, regularly audited plan to protect personal information. Both electronic and paper records will need to comply with the new law. The regulations went into effect on March 1, 2010. Identity theft and fraud are the major concerns at the core of the implementation of the 201 CMR 17.00.

What are the fines for a HIPAA violation?

HIPAA Violation	Minimum Penalty	Maximum Penalty
Individual did not know (and by exercising reasonable diligence would not have known) that he/she violated HIPAA	$100 per violation, with an annual maximum of $25,000 for repeat violations (Note: maximum that can be imposed by State Attorneys General regardless of the type of violation)	$50,000 per violation, with an annual maximum of $1.5 million
HIPAA violation due to reasonable cause and not due to willful neglect	$1,000 per violation, with an annual maximum of $100,000 for repeat violations	$50,000 per violation, with an annual maximum of $1.5 million
HIPAA violation due to willful neglect but violation is corrected within the required time period	$10,000 per violation, with an annual maximum of $250,000 for repeat violations	$50,000 per violation, with an annual maximum of $1.5 million
HIPAA violation is due to willful neglect and is not corrected	$50,000 per violation, with an annual maximum of $1.5 million	$50,000 per violation, with an annual maximum of $1.5 million

What are the fines for Massachusetts 201 CMR 17 violation?

The implication for businesses is clear: regardless of where your business is physically or operationally, if you handle or store the personal information of any Massachusetts resident, you are legally obligated to protect that information. Failure to comply with MA 201 CMR 17 could result in fines of up to $5,000 per violation, although "per violation" has yet to be clearly defined.

Will Eferral integrate with my office software?

Eferral is independent of the office software that you are running in your office and will be compliant with any office software because it is an online application.

What is data encryption?

Data encryption is the act of changing electronic information into an unreadable state by using algorithms or ciphers. The translation of data into a secret code. Encryption is the most effective way to achieve data security. To read an encrypted file, you must have access to a secret key or password that enables you to decrypt it. Unencrypted data is called plain text; encrypted data is referred to as cipher text.

What is SSL and https?

Secure Sockets Layer is a standard security technology for establishing an encrypted link between a server and a client—typically a web server (website) and a browser; or a mail server and a mail client (e.g., Outlook).SSL allows sensitive information such as credit card numbers, social security numbers, and login credentials to be transmitted securely. HTTPS, which stands for Hypertext Transfer Protocol Secure, makes it more difficult for hackers, the NSA, and others to track users. The protocol makes sure the data isn't being transmitted in plain-text format, which is much easier to eavesdrop on.

Does Eferral use https?

Web browsers such as Internet Explorer, Google Chrome and Firefox display a padlock icon to indicate that the website is secure, as they also displayhttps:// in the address bar. When you visit www.eferralonline.com from any web browser you will see that it has both the https:// and the padlock icon displayed. This means that the website encrypts the session with a Digital Certificate and allows for secure communications.

Is my patient information encrypted with Eferral?

Eferral has an unrivaled security protocol to ensure your patient’s privacy and data security. Your patient data is protected by a proprietary level 3, 128 bit encrypted data base and stored on secure HIPAA compliant servers.

What kind of information can be sent over Eferral?

You can send documents, correspondence letters, x-rays, emails, photos, patient charts, referrals, and even instant messages all quickly, efficiently, and securely.

What is the difference between Eferral and other secure email sites?

Eferral allows for two way encrypted communication (sending and receiving of information), back and forth between physicians, while most secure email sites allow only for one way transmission of patient information. A doctor can only receive information from another physician but cannot send information back if need be. Also, other sites often only encrypt certain parts of the information being sent, like any attachments, but the body of the message may not be encrypted. This is still a violation of HIPAA and HITECH.

Why can’t I send patient information by Gmail or Hotmail?

Both Google and Microsoft go through private email to target ads at users based on keywords and sometimes to block spam. Regardless of the reason, patient information can be viewed and this is a violation of HIPAA and HITECH.

I received an invite to Eferral from another doctor how do I retrieve the information?

If you have received an invitation from another doctor to join Eferral there will be a link included in the email that you must click on. The link will direct you to Eferralonline.com and will ask you to create an account. Once an account has been created, the original link will no longer function and will become invalid. An email will be sent to your email account with your username and a temporary password. Type or copy and paste the temporary password in the first time you log into Eferralonline.com and you will then be able to change the temp password to the password of your choice.

What is Eferral X Software?

Eferral X Software is a proprietary software that will allow you to immediately upload scanned documents, screenshots and files including patient charts, x-rays, photos, patient registrations, doctor’s notes, and any other important patient information.

Why doesn’t Eferral X Software work on Google Chrome?

Eferral X Software does work on Google Chrome, however one simple extra step is needed for you to override Google Chrome's new security measure. When you click on “Start Eferral X” a small shield appears in the far upper right of the web browser bar. Click on this shield and click on “Load unsafe script” and then restart Eferral X and it will function normally. A video of this is included on our Eferral Support page.

How do I install Eferral X Software from Internet Explorer?

Before you can use Eferral X Software to attach information to your messages or cases, you must download it and install it. Click the “Download Eferral X Free” button and click “Run” at the bottom of your screen. Windows will attempt to protect your PC and prevent the software from installing. Do not click “OK” at this point, but instead click “More Info”. Once you have clicked on “More Info”, you will see an option to “Run anyway”. Click on “Run anyway” and Eferral X Software will install successfully on your computer.

What is the difference between Eferral Full Version and Eferral Lite Plus Version?

Eferral Full Version is recommended more for specialists who want to send and receive correspondences back and forth with their referring general practitioners. The Full Version allows the specialist to have a digital referral pad online as well as corresponding digital office templates and letters that would usually have to be mailed back to the referring doctors during the progression of a case. It allows for all correspondence in regards to patient treatment to be transmitted back and forth digitally during the entire duration of treatment. Eferral Lite Plus Version is recommended more for general practitioners who want to correspond with other colleagues in regards to patient care and who want to be able to send private patient information (including documents, x-rays, photos, etc.) in an encrypted manner to comply with HIPAA and HITECH.

How much does Eferral cost?

The Full Version of Eferral costs $200/month, while Eferral Lite Plus costs $50/month

Will my Eferral account be cancelled if I do not pay the monthly fee?

Your Eferral account will never be cancelled, however, the functionality of your account will be limited if you fail to pay the monthly fee and your account will be downgraded to the Eferral Lite Version. In particular, you will not be able to include any attachments to your Eferrals or messages using Eferral X Software or the Eferral Printer until your account license status is renewed and restored.

What is the Eferral Printer?

The Eferral Printer is found under the Support Tab on the Eferralonline website. It will download and install a virtual Eferral printer on your computer that becomes part of your computer’s startup. It also has Eferral Checker which will sit on your desktop and will give you real time updates to any new messages or cases that have been sent to your Eferral account. The Eferral Printer gives you 3 options: (1) upload attachments to the Eferral System and leave for later use; (2) upload attachments and attach to a specific case; and (3) attach something directly to a message.

Do I have to convert documents and images to a specific format before attaching them with Eferral X Software or the Eferral Printer?

No. Eferral will automatically convert all word documents to PDFs, and will convert all image files to JPEGs online before sending them.

Do I have to leave the Eferral Checker open on my desktop for it to work?

No. You can minimize the Eferral Checker by clicking the “X” in the upper right hand corner and it will remain running in the “hidden icons” section of your toolbar.

What is the Patient Transfer function on Eferral?

The Patient Transfer function on Eferral is very similar to sending a case to a specialist, but may be sent to another general dentist or to the patient themselves. It is a way to transfer all of the patient’s records to another doctor, or to the patient, in a digital format. It allows you to use Eferral X to upload patient charts, x-rays, photographs, treatment plans, transactions, and any other pertinent information in the patient’s record. If the information is being sent to the patient, the patient will need to answer a few specific questions to verify that it is truly them before being able to access the information.

Eferral FAQs.