Prioritize HIPAA in medical billing and save your healthcare practice from legal consequences and reputational damage.
The Health Insurance Portability and Accountability Act (HIPAA) is the golden word for healthcare providers and practices. There is nothing more important than safeguarding sensitive patient information from unauthorized use. HIPAA compliance maintains the confidentiality of patient records, personal healthcare information (PHI), and its electronic transmission.
As healthcare providers deal with sensitive data, understanding HIPAA and following all compliance rules becomes crucial. Also, it is essential to simplify medical billing and achieve adequate revenue. This blog is your guide to everything about medical billing HIPAA compliance. So, read on to discover the elements of HIPAA compliance for a better medical billing process.
Understanding HIPAA Compliance in Medical Billing
In simple terms, HIPAA compliance is a set of regulatory standards mandatory for healthcare providers and practices. The idea behind setting these rules is the protection of sensitive patient information from data breaches. This involves utilization of physical and technical techniques to protect patient data. The goal is to implement a framework of usage, disclosure, and storage of personal health information.
HIPAA focuses on factors such as confidentiality, integrity, and availability of data risks, along with strategies to mitigate data risks if any. Being proactive and dealing with uncertainties are both equally important for HIPAA in medical billing.
There are two major regulations under HIPAA, and they are:
- HIPAA Privacy Rule
- HIPAA Security Rule
While the privacy rule supervises access and mismanagement of patient data, security rules involve protecting electronic health records (EHR) from cyberattacks.
HIPAA Privacy Rule
The HIPAA privacy rule governs the handling and disclosure of patient health information. According to this rule, patients have the right to access and alter their medical information, but otherwise access is restricted. If healthcare providers want to share patient data, they must acquire written consent from respective patients. Only after that, healthcare providers can share patient data with third parties like insurance providers or any other medical professionals.
The HIPAA privacy rule protects the confidentiality of sensitive patient information. To reinforce the privacy rule, healthcare practices need to establish physical and technical policies to secure patient information.
The physical policies should involve safeguarding the area, such as cabinets, where the medical records are kept. Whereas the technical policies include the implementation of access controls and permissions.
However, the privacy rule of HIPAA in medical billing only focuses on the surface level of risk assessment. Yet, in the case of data breaches, healthcare providers are subject to penalties, legal consequences, and damage to reputation.
HIPAA Security Rule
The HIPAA security rule highlights three aspects, such as security, confidentiality, and integrity of patient information in both physical and electronic form. The main focus of HIPAA security rules is on securing the electronic PHI. This requires healthcare providers to implement strict access controls, including data encryption. Establishing a mandatory disaster recovery plan is vital under the security rule. Other than that, healthcare providers must include employee training to ensure a secure medical billing process.
This rule concentrates on safeguarding electronic systems and data from cyberattacks. Under this rule, risk assessment is mandatory, and healthcare providers must indulge in this regularly. They must also take responsibility for developing contingency plans, identifying vulnerabilities, and taking measures to correct them.
Just like the privacy rule, failure to maintain the security rule will result in legal consequences, penalties, and reputational damage.
Duration of HIPAA Compliance in Medical Billing
According to HIPAA in medical billing, healthcare providers are supposed to protect sensitive electronic patient data for at least six years. However, this is not a universal rule, and time limits are different in some states.
When it comes to the Centers for Medicare and Medicaid Services (CMS), securing patient data for six years is mandatory for healthcare providers and practices. However, if a healthcare practice comes under critical access hospitals, this duration is reduced to five years.
There is another rule for businesses and partners that mandates securing medical data for 30 years under the Occupational Safety and Health Administration (OSHA).
Tips for Effective HIPAA Compliance in Medical Billing
HIPAA in medical billing is significant for healthcare providers and practices as it is responsible for safeguarding patient information. Even so, handling HIPAA requirements can be challenging for healthcare providers.
So, here are some tips for healthcare providers:
- Understand the requirements specific to the needs of the practice.
- Make sure to establish physical, technical, and administrative measures for protection of data.
- Include employee training sessions consistently, preferably regularly.
- Educate your staff to recognize suspicious activities and secure devices and report unusual incidents.
- Implement robust access controls and dual encryption to secure patient data.
- Ensure unauthorized access to PHI at the time of transmission.
- Monitor and audit security policies and contingency plans for better adherence to compliance.
- Focus on internal and external threats to sensitive patient information.
- Don’t miss out on incident response and develop a dedicated plan for it. Stay up to date in terms of HIPAA in medical billing and understand everything about HIPAA compliance in medical billing.
Outsource Medical Billing Services to Improve HIPAA Compliance in Medical Billing
Managing HIPAA compliance can be a lot for healthcare practices and providers. To deal with this, healthcare providers can outsource their medical billing. Professional billers understand the nuances of HIPAA and help healthcare providers protect patient information.
A medical billing company assists healthcare providers and practices at every step and simplifies adherence to HIPAA compliance. As a result, healthcare practices are able to avoid legal actions and maintain their reputation among the patients. Moreover, medical billing companies provide specialized services to enhance the revenue cycle management and boost the bottom line.
All in all, medical billing services can maximize revenue, optimize the operational flow, and streamline HIPAA compliance in medical billing.
Why Choose Eminence RCM?
Eminence RCM is a hub of medical billing services in the USA with specialized services for a multitude of medical specialties. We have been helping healthcare providers and practices for a while now. Our experience in this industry allows us to navigate through complex billing and coding along with HIPAA compliance.
We ensure utmost protection of sensitive patient information from unauthorized use. Our team stays up to date with frequently changing regulatory standards and implements them in your billing process. We monitor, evaluate, and improve your physical and technical safeguards to ensure complete satisfaction.
We know that HIPAA compliance in medical billing is extremely crucial, and we make every effort to maintain the security, privacy, and confidentiality of your patients. With our services, you don’t have to worry about revenue cycle management and HIPAA compliance.
So, maximize your revenue, optimize operational flow, and streamline HIPAA compliance with Eminence RCM!
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