What Does HIPAA Compliance Mean in Medical Billing Industry?

What is HIPAA compliance and when did it come into existence?

HIPAA means the “health insurance portability and accountability act. This is an official guideline and a part of rules and regulations issued in the U.S. in 1996. To maintain the privacy of the data obtained from the citizens and to protect their interests, HIPAA was passed in 1996. 

The importance of following rules and regulations in the medical industry to secure the privacy of the patient can never be ignored. This is the reason why most of the healthcare providers need to adhere to these guidelines.

Presently, the healthcare system is facing a critical situation that demands to shift paradigms. The present model is moving from the volume-based model to the very beneficial value-based reimbursement system. These changes are taking place to minimize the costs associated with the healthcare systems, as well as, raise the high-quality care of the patients.

Electronic Claims Submission and Maintaining Privacy of Patient Data

HIPAA strongly supports the electronic submission of the patient’s claims. Electronic submission will ensure limited errors and great returns. This versatile act also stipulates security guidelines for maintaining the privacy of the patient’s data. This is why HIPAA is highly significant for the medical billing information system. Companies adhering to HIPAA guidelines reap the following benefits- 

  • The office will be guarded 24/7
  • Password-protected computers will be there with full security
  • Staffs get well-versed in preserving and protecting the privacy of the patient data. Any non-disclosure and confidentiality require authenticated signatures.
  • Installation of firewall and anti-virus systems in every computer
  • Prompt health information available which can assist in identifying a person, such as, his/her name, email ID, telephone number, photographs, medical record number, health plan number, license number, and social security number.

Why HIPAA compliance is mandatory in the medical industry billing service systems?

 If you are a healthcare provider that handles multiple patient queries, then you need to comply with HIPAA to maintain the patient records. This is mandatory to secure the privacy of the patients.

Ineffective medical billing services have become a major hurdle for doctors. Delivering and maintaining a high-quality medical billing system is an inevitable part of professionalism. 

If a physician is not following proper guidelines issued by the governing bodies, to preserve and protect the patient, he/she will invite many problems. If any patient sensitive information leaks out, it will pose an emotional and a financial threat to the people associated with it. For instance, an intruder might hack all your bank accounts with the assistance of the social security number. In this modern digital era, it is possible for an intruder to use digital numbers.

So, non-adherence to HIPAA can prove to be risky, both for the patient, as well as, the physician. You will end up creating problems for yourself and the provider. The legal consequences of this breach will be beyond imagination.

HIPAA Compliance- Why it is an integral part of the medical industry and why is there a need to secure patients’ information?

People who have no value for the ethical boundaries and have no respect for the law of the country are in a position to manipulate the things. They can misuse the numbers for their personal benefit and gains.

Recently, the medical industry has witnessed many incidents where the patient’s data was available outside without any authentication and proof. But the government instantly took action and resolved the issue on time. To avoid such kind of situations, the government has imposed mandatory guidelines and regulations.

HIPAA ensures that the healthcare provider follows all the rules and takes necessary measures to protect the information. From your computer networks to communication networks, everything should be secured so that nothing leaves out. 

Achieve the status of an “ideal” medical biller with the help of HIPAA compliance

The key to becoming the best medical practitioner is the protection of the “medical information of the patient” in all the circumstances. It is the duty of all the covered entities- the payers and the providers- to secure and protect all the information verbally, virtually, and physically. 

Like a good medical biller, you should never share any relevant or sensitive information with someone else, especially those who have nothing to do with that information. You might call this as ethical practice- which if breached will hold you to be accountable. 

This is like recalling the significance in your head and training your subconscious of the implications of PHI leakage.

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