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HIPAA Medical Billing Is More Important Than You Think

If you belong to the healthcare industry in any capacity be it as a physician, nurse, surgeon, pharmacist, or health IT specialist, you would know the importance of privacy protection and confidentiality obligations.

HIPAA medical billing needs no introduction. The practice of HIPAA medical billing and coding has proved only to be fruitful for a progressive healthcare system.

Therefore, taking casual measures to ensure data protection and using ordinary software to store data is now just not enough.

Private Data is at Risk!

We say that healthcare services have progressed and we have gone automated, but so have data hackers.

Medical Billing and Coding Companies need to upgrade their systems and take standardized measures.

Lots of sensitive data is transferred from physicians to insurance companies to patients.

As billing companies are directly responsible for data handling, they are held accountable for any mishap.

Why HIPAA Compliance Is Important?

Because the expense for data breaches goes far beyond fines and penalties.

No matter what the reason may be for healthcare organizations to outsource HIPAA medical compliance. We should keep in mind the following perspectives.

HIPAA Medical Billing Is Compulsory for Healthcare Organizations

According to the HIPAA Omnibus Final Rule, medical billing companies would be penalized for risking Protected Health Information (PHI). Any violations will not be entertained at any cost, and the company responsible for even minor negligence will have to bear heavy fines. Of course, it would also dent a company’s reputation leading to low revenue.

Data Security Threat Has Not Remained To Just Data Manipulation/Stealing

Not long ago, accidental exposure of sensitive data was considered a HIPAA violation. It means a situation in which you have to bear the financial loss.

However, the modern definition states that even unauthorized access to data is a threat to HIPAA compliance.

The following factors build the base for the damage of HIPAA violations.

  • The scope and type of healthcare data compromised
  • Characteristics of the party or person that accessed the data or violated the HIPAA rules
  • The measures, taken to avoid vulnerable areas to protect PHI

A medical billing company can only be successful by following the HIPAA rules and regulations. The best approach is to include clauses in the BAA – Business Associate Agreement.

Moreover, the Office of Civil Rights (OCR) also allows a bit of relaxation in HIPAA regulations to promote the trend of HIPAA compliance.

Things to Remember

To safeguard the interests of HIPAA-compliant medical billing, it is important to not over-commit responsibilities to clients. The things, which, medical billing services are unable to commit can be strictly stated to the physicians.

COVID-19 Impact on the HIPAA Medical Billing

The COVID-19 PHE (Public Health Emergency) has distraught healthcare delivery, and HIPAA-compliant medical billing is no exception.

Lots of flexibilities have been observed in this regard that meaningfully provide a way for healthcare providers to perform their operations without getting penalized. Some of these flexibilities are temporary, considering the hectic administrative and operational load on physicians, while some of them have led to a discussion for permanent implementation.

The Effects of HIPAA will Remain the Same!

While we are talking about the changes, we should not forget one thing that the implications or effects of HIPAA compliance remain undisturbed. There is no doubt about that! Similarly, we cannot see any change in the HIPAA Privacy Rule, Security Rule, and Breach Notification Rule.

However, the enforcement and execution of data privacy rules can be modified a bit. There are three notices for Enforcement Discretion in 2020 and one notice for 2021 that the OCR issued. Amidst the coronavirus emergency, many sanctions would not be penalized, but conscious carelessness would be marginalized in terms of Medicare payments.

Medical billing companies, no matter what state they are in, should look into the details to help physicians with their financial matters.

Here’s a List of Things Medical Billing Should Perform

  • Perform thorough risk assessment
  • Design and implement a full-proof security plan
  • Secure Privacy policy
  • Dedicate trained resources for operations

The accuracy of billing procedure is the second priority; the first remains the infrastructure that supports the cause of HIPAA compliance. Thus, meeting security parameters and confidentiality clause is the only way forward for medical billing companies.

3 replies
  1. Cambridge Hospital
    Cambridge Hospital says:

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