Are you planning to outsource a medical billing company? Is the company HIPAA compliant or not? Why is it important to check that either the medical billing company is HIPAA compliant or not?

Healthcare facilities have tons of personal and health information. So, they are vulnerable to threats of data breaches and cyber-attacks. It is important to check whether the medical billing company complies with HIPAA and Protective Health Information.

What is HIPAA?

HIPAA or The federal Health insurance portability and accountability act administrated by the office for Civil rights in the U.S department of Health and Human services. HIPAA was approved to regulate the procedure for handling Patient Health Information. This Law was passed in 1996. A HIPAA violation may lead to a penalty of $ 25,000 even on single record. It can prevent any fraud and abuse in healthcare. HIPAA can decree the standards for healthcare information.

What are HIPAA rules for medical industry?

With the arrival of automation, the threat for patient data raises. As the hackers may try to steal healthcare data and use it for fraud purposes. Both Healthcare entities and medical billing companies are responsible for healthcare data. The HIPAA rules and regulations mention the proper usage and disclosure of PHI. HIPAA rules cover the fraud in insurance companies as well.

HIPAA privacy and security rule for billing

Medical billing companies have access to PHI for example they have access to past and present treatment information, fees, location etc. HIPAA rules are applicable and have details of “How to safeguard the healthcare information”. It may include physical safeguards, technical safeguards and administrative safeguards. Medical billing companies must be careful for all these safeguards. They must train their staff for compliance and implement firewalls, and other technical safety measures like end-to-end encryption or data backups.  Office of inspector general is liable to ensure that medical billing companies are HIPAA compliant.

HIPAA-Compliant medical billing services providers

Medical billing companies offer multiple services, from consultation to data security. Medical billing companies offer electronic health records that contain sensitive health and personal information. This blog will highlight the importance of PHI and why you must select a HIPAA-compliant medical billing company.

What is PHI, and which information can be a part of PHI?

PHI is a personal health record, and the information included in it

• Date of Birth
• Contact information
• Information regarding residence or office
• Lab-Test reports
• Medical History
• Complete information regarding insurance
• Mental health problems
• Additional information that is required for Healthcare treatment.

The above mention details are sensitive and require security. If this data is not secure, anyone can use it for a fake claim.

Role of HIPAA in PHI security and Protection.

EHR systems contain the information of an individual even before his birth. When a mother conceives, and she approaches a healthcare provider, the EHR starts recording initial information regarding the individual. The initial information may contain information regarding the parent’s details, length, weight, body temperature, any complications, and expected date of birth. When he is born, EHR records the next information. Hence, the accumulated data regarding an individual increase as the person ages.

HIPAA limits the access to personal details of the individually authorized personnel. HIPAA prohibits anyone other than those who use it for

• Research and treatment
• Public health
• The merger of HIPAA-covered entities.

Why should you choose HIPAA compliant medical billing services provider?

A HIPAA-compliant medical billing company is a guarantee for protected PHI, as they are legally bound to secure your data. US Department of Health and Human Services conducts audits of medical billing companies for HIPAA compliance. If a medical billing company is not HIPAA compliant, they may have to pay penalties of thousands of millions of dollars.

How to know that medical billing company is HIPAA compliant?

It is significant to know that a medical billing company is HIPAA Compliant. A HIPAA-compliant medical billing company has a physical presence and puts on security measures on the ground as well. A HIPAA compliant Medical billing company takes technical and non-technical safeguards to ensure EHR protection.

HIPAA-compliant medical billing companies have

Trained staff.

• A medical billing and coding company that is concerned about Hippa compliance must consider training for their staff. Consistent training of medical billing and coding staff at regular intervals. This training is meant to promote the knowledge of Patient Privacy protection.

Software.

• The software, tools, forms, and systems have safety guards to secure them from attacks and threats of a data breach. These software or tools must be end-to-end encrypted. If a client has specific credentials, these credentials must be secret.

Protocols for Online data transfer.

• A HIPAA compliant Medical billing company follows the specific protocols for online data transfer. The HIPAA protocols limit the data transfer to the specified personnel only. The communication process must be end-end encrypted. So, the file transfer can be safe and secure.

Polices for use.

• Creates policies for the use, access, or transfer the medical information. They may impose restrictions on deleting, transferring, or even reusing of personal information of the patient. A professional and best medical billing company has protocol implementations,

Unique User Logins.

• Unique user login details, auto log-off, creating a mechanism for encryption and decryption.

Emergency access.

• Establishes Emergency access methods. These access methods must be safe and the company must take special safety measures.

Regular Audit.

• Provide regular audit reports. Audit reports depict their credibility and working. The better audit reports shows how much a medical billing company is following result oriented reports.

Privacy Notification System

• Establishes a privacy notification system for their office location.

HIPAA Security Risk Assessment.

• Conduct Annual HIPAA Security risk assessment. National coordination for health IT and HHS office for civil rights has developed a special tool for HIPAA security risk assessment named as SRA (Security Risk Assessment). This tool is downloadable for windows, mac book and other devices. This tool provide report in excel format.

HIPAA Certification

• You can ask for the HIPAA certification as an additional clarification.

Choose the best medical billing service provider that is HIPAA compliant. If you partner with a medical billing company that is not HIPAA compliant may cause the breach of data. If the data is leaked, you have to pay high fines.