HIPAA compliance in medical billing services acts as a privacy law for securing, managing, and transferring protected health information (PHI).
Where Protected Health Information (PHI) is the main goal of HIPAA, it also filters the audience reaching this data. Therefore, it has covered a variety of components in it such as data control laws, various safety rules, and warnings on violations. As we know healthcare IT has made significant uplift in this era especially. Today we have more automation in our healthcare related daily tasks and back-office work. So, the practices must be HIPAA compliant completely to make their RCM seamless. The medical billing services must comply with HIPAA to reduce the claim denials as well.
Let’s overview the role of HIPAA compliment in the betterment of medical billing services. And how it makes medical billing outsourcing companies more reliable for practices more than ever?
There are several entities within your provider network or outside your network who deal with PHI. Similarly, the medical billing service companies need PHI to generate the medical claims. On the other side, the payers want to access patient profiles to recheck that they got the right bill.
Here making your medical billing services HIPAA compliant saves you from several cyber security issues. By implementing this rule, the practice sets its limitations for the PHI use and accessibility. It filters the audience reaching patient profiles. Moreover, the entities can only get access to patient’s information by their consent.
Thus, HIPAA is a patient information privacy rule by the federal government in the USA. The government mandates HIPAA compliance for all healthcare medical billing services. They have to obey the electronic personal health information security and protection requirements. Otherwise, the medical billing services have to bear the strict action for any violation. The Minister of Health and Human Services is closely working on assurance of HIPAA compliance in healthcare.
It is not only the outsource medical billing services that needs to be HIPAA compliant. Everybody connected to healthcare organisations in any way and dealing with PHI must obey HIPAA. The compliance rule resolves the data security related issues in almost every healthcare process. However, when it comes to medical billing services, providers are seriously concerned. They are the real gamers who help providers in their revenue collection. Therefore, they need access to patient’s medical information.
These are some benefits that medical billing service companies get by complying with HIPAA.
HIPAA has put up a powerful fraud detection system and related protocols for it.
- It prohibits the medical billing services from overcoding.
- Also, the providers can get revenue for rendered services only. Their medical billing and coding team will only include the list of rendered services in the medical claims.
- In addition to this, it is fabricating diagnoses to support the use of procedures that are not medically necessary.
- Alongside this, it forbids utilising the wrong ways to pay for non-insured services.
Physicians can use virtual media without worrying about breaching patient confidentiality. Also, they have less fear of facing legal action if their patients’ medical information was not kept private. As long as their practice and medical billing services are HIPAA compliant, they will not face such issues.
Today, healthcare practices have effective data management techniques. Moreover, RCM automation solutions in medical billing services are making the best combination. In such a scenario, HIPAA compliance will motivate to proactively protect patients’ medical records and personal data.
The money used to pay fines for non-compliance would be used to promote the practice. In contrast, obeying ensures that the process won’t be harsh if and when a breach happens.
The app or portal allows for direct communication between physicians and patients. They collectively serve for different purposes like:
- Dispensing care;
- Accessing and entering medical data;
- And updating HIPAA-compliant prescription services, etc.
Healthcare providers may far more easily coordinate, charge for, and store patient data. Therefore, they use compliant technologies without worrying about HIPAA violations.
Several EHR solutions help practises better comply with HIPAA’s billing regulations. Finding an EHR that complies with HIPAA and can meet your specific demands is something that QPP MIPS highly advises. You should collaborate as a provider with a medical billing services company that recognises the significance of HIPAA.
Several categories of organisations are required to conform to the regulations. Companies affected by this legislation include:
- Provider Personal Setups (Clinics)
- Healthcare supplies
- Insurance, payment, and healthcare organisations
- Companies of the covered organisations (Who offer technologies that collect, transmit, or retain PHI data such as medical billing services)
- Cloud-based SaaS for healthcare professionals
- Healthcare analytics processing services
- Application programmes for doctor-patient dialogue
- Medico-legal transcription services
Medical billing services must have strong agreement with HIPAA to manage the RCM effectively. All medical billing outsourcing companies are very serious about HIPAA. The government can fine up to $1.5 million for HIPAA violations. So, patient health information is not a joke. Therefore, your medical billing services have enough potential to avoid any cyber security issues.