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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 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.

PHI, Protected Health Information, EHRs, Electronic Healthcare Records, Healthcare, Healthcare Solutions, HIPAA, Medical Billing and Coding, medical billing company, Medical Billing Services

What every physician needs to know about PHI?

Protected Health Information (PHI) refers to data that is collected and managed during the diagnosis or treatment process and identifies each patient.

In simple words, PHI is all the information in medical records including the conversations during the treatment, medical billing and coding, and the health insurance data. Generally, medical billing services have to deal with all such information. Therefore, they must conform to the HIPAA rules.

HIPAA – Compliant Medical Billing Services

Any information related to patients and their healthcare plan is sensitive and can be misused. Thus, medical billing companies should compile medical claims in a protected environment to prevent confidential data from being leaked under the rules of HIPAA.

HIPAA – Health Insurance Portability and Accountability Act focuses on:

  • Making identification information private
  • Using patients’ information only during the course of healthcare
  • Disclosing private information only to relevant and trustworthy parties

PHI Includes

  • Billing information from medical billing services or clinicians
  • Contact information
  • Medication and prescription statements

Information like blood pressure reading and burned calories are not considered in the PHI category.

Securing healthcare information is one of the major responsibilities of medical billing services. Any medical billing company failed to take measures in this regard unconsciously exposes their clients to a serious financial threat.

It is to remember patients have the right to access medical records anytime. However, HIPAA restricts access only in specific circumstances.

Healthcare organizations or medical billing companies on their behalf need to educate patients about their rights; otherwise, the idea of the progressive healthcare industry won’t work.

What Can We Do to Protect Data from Hackers?

As technology is evolving and offering reliable storage solutions, managing data on papers is not feasible. Electronic healthcare records (EHRs) propose a better solution, provided strict actions are taken to secure data in all formats.

Healthcare organizations and other stakeholders of the healthcare industry need to design and implement a strategy that safeguards the integrity of data on all levels be it technical, physical, and administration.

Such small steps lead us towards a reliable and seamless data transmission, making an empowered healthcare system.