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medical billing service, revenue cycle management process, medical billing company, medical billing outsourcing, RCM process, HIPAA medical billing

The ERAs and EFTs in Payment Posting for Medical Billing

As a medical billing service, it is our primary duty to look after the revenue cycle management process of physicians on board. We are on a mission to narrate billing obligations in a fashion that is fast and in the direct interest of clinicians. Some of our clients have recorded their detailed feedback on Clutch.co for any of you interested in reading client reviews. https://clutch.co/profile/p3-healthcare-solutions#reviews

The claimed and paid amount has to concur in an ideal state. It is the job of a medical billing company to comply in such matters that involve the speedy transfer of payments. Any hiccups in the billing process directly affect the practice besides tainting the reputation of the third-party billing vendor.

Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERAs) are documents that discuss the amount billed and the payment received. They also contain information about any discrepancies in both the amounts. The third term EFT refers to Electronic Funds Transfer which is the modern way to address the payment process.

Medical Billing Company Supports ERAs in an Age of Automation

Physician practices can save much time and money if their EOBs turn into ERAs that are electronic documents. Think of the time it takes for a medical practice to deal with payment details manually. It involves a lot of fields to be manually addressed, dropping checks at the bank, and reconciling payments.

If payers can create digital documents like ERAs regularly, physicians won’t have to re-enter payments manually. The process of payment posting is crucial, and to make it easier, we’ll have to digitize EOBs right away.

Medical billing outsourcing requires accurate coding of claims in which there are no over coding and under coding errors. If EOBs reimburse amounts lesser than what is claimed in the bill, our company investigates so that the RCM process keeps on running smoothly.

Benefits of ERA

  • Once the system of automation is in place, posting payments doesn’t involve manual intervention at all
  • It enables faster payments because time is saved in the very instance
  • Makes way for improved and classic denial management

Electronic Funds Transfer (EFTs)

HIPAA medical billing says a lot about the medical billing service in line with the law and its provisions. Under HIPAA, EFT via the Automated Clearing House (ACH) is the only standardized way to move funds electronically. Hence, we have to take a note of that in every transaction we make on behalf of the physicians and specialty-specific doctors.

Just like the way employee checks are deposited, ACH EFT makes sure funds smoothly move between insurance companies and physicians.

Benefits of EFT

  • It is a payment mode that directly coordinates with ERAs
  • The staff members don’t have to be occupied, and there is less paper usage
  • The claims payments are deposited in a safe and secure manner
  • Saves time

21st Century After Effects of Electronic Cashflow

The healthcare industry brought into effect a new standard in the form of ANSI 835 for electronic insurance payments and reconciliation a few years ago. Both ERA and EFT are part of this act. Their role for each other is vital. When an ERA carries the details of the payment, EFT is the actual process through which the payment is made to their rightful owners upon adjudication of claims.

ERA merely forms a report by which benefits are explained. Both the technologies devise simplification of the payments to physicians while expediting the process in the spirit of better healthcare outcomes.

Learn more: 5 Medical Billing Tips to Help Orthopedics Earn More

HIPAA medical billing, HIPAA medical billing and coding, healthcare services, healthcare system, outsource HIPAA medical compliance, Protected Health Information, PHI, billing companies, Medical Billing and Coding Companies, HIPAA violation, HIPAA compliance, HIPAA rules and regulations, HIPAA compliant medical billing, medical billing services, medical billing companies

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 in the USA.

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 go 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 violation.

  • 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.

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.