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Are Orthopedics Justified in Embracing HIPAA Compliant Orthopedic Billing to Boost Their Reimbursement

February 22, 2013

Reimbursements have generally been tight recently for orthopedics – Medicare cuts, shrinking fee schedules, increased technology intervention in medical billing, and a multi-payer environment that is more vigilant than ever have really made it tough for orthopedics to realize their reimbursements to the maximum. But amidst these monumental challenges, HIPAA compliant clinical and operational management may still offer avenues to keep reimbursements level above average. Thus, orthopedics across the U.S. are beginning to embrace technology-driven HIPAA compliant orthopedic billing to offset the impact of a series of restrictive impositions on medical billing.

The significant about HIPAA compliance is that it can not only endorse orthopedics as being responsive to patient privacy and security but also entitle them to incentives for showing up as responsible partners in effective and efficient health care delivery. Moreover, payors perceive HIPAA compliance to be yardstick for measuring orthopedics’ integrity for medical billing. Therefore, HIPAA compliant orthopedic medical billing may just be the factor that can create a sense of trust among your payors. But HIPAA compliance needs to planned and executed in a way that best suits individual practitioners or hospitals; HIPAA compliance cannot be generalized even though you happen to be in the same discipline as orthopedics. The factors that will need to be taken care of while migrating to HIPAA compliant orthopedic medical billing are:

  • Ensuring Protected Health Information (PHI): HIPAA compliance requires you to protect health information, which may include anything that can be used to identify an individual and any information shared with other health care providers or clearinghouses in any media (digital, verbal, recorded voice, faxed, printed, or written).
  • Adhering to Principles of HIPAA: While HIPAA may allow smooth flow of PHI for healthcare operations subject to patient’s consent, it is deemed violation of HIPAA compliance if you disseminate PHI for purposes other than treatment, payment, care quality assessment, competence review training, accreditation, insurance rating, auditing, and legal procedures
  • Following HIPAA Implementation Process: HIPAA implementation need necessarily include both pre-emptive and retroactive controls and have process, technology, and personnel aspects.
  • Sourcing right Technology for HIPAA Compliance: HIPAA compliance needs to be served with the right technology that can assure physical data center security, network security, and data security
  • Being enabled role based access control (RBAC): Because health care data under HIPAA compliance may accessed by multiple stakeholders across the clinical delivery system, it is important that data is made available based on Role Based Access Control (RBAC) to control the extent of data that may be shared with each of such stakeholders.

Because of interplay of these multiple factors in HIPAA compliant orthopedic clinical and medical billing operations, providers may have look beyond internal competence and outsource technology enabled HIPAA-compliant clinical and medical billing implementation. Medicalbillersandcoders.com offers to ease complexities during as critical an implementation as HIPAA compliant orthopedic medical billing. Our affiliation with experienced, competent, and credible orthopedic medical billing resources should provide the right choice of expertise to have your medical billing infused with HIPAA compliance standards.


Category : ACA / HIPAA / Reforms