HIPAA Compliant Ophthalmology Medical Billing Services

Basics of HIPAA

Medical Billers and Coders (MBC) being a leading medical billing company manages all revenue cycle management activities in HIPAA compliant way. In this article, we shared the basics of HIPAA compliance, and how selecting HIPAA-compliant ophthalmology medical billing services can help to receive accurate insurance reimbursements while reducing the chances of payer audits. HIPAA is the acronym for the Health Insurance Accountability and Portability Act. Although HIPAA covers many things, physicians including ophthalmologists are most concerned with HIPAA’s administrative simplification provisions, particularly the privacy, security, and breach notification requirements.

At its core, HIPAA simply implements longstanding physician commitments to protect the confidentiality of their patient’s medical information and maintain open physician-patient communications. However, the specificity of the requirements goes well beyond traditional, self-evident obligations, and violations can result in serious penalties. Physicians should also note that HIPAA is considered a ‘floor,’ meaning, states may have requirements that go above and beyond what the federal government requires.

The most important thing ophthalmologists must be aware of is that there’s no such thing as ‘HIPAA-compliant certification’. In other words, ophthalmology practices can’t earn an ‘approval’ that makes them compliant once and always. While credentialed staff at independent firms can give their professional opinion on your practice’s HIPAA compliance status, any HIPAA assessment is just a ‘snapshot in time.’ HIPAA compliance is a continual effort of your practice.

To protect your practice against a security breach and ensure you’re in compliance with HIPAA, follow some steps like educating staff about the importance of complying with HIPAA requirements; performing a privacy and security risk assessment for all health care information technology, and not just your electronic health records; also maintain a paper trail to ensure all electronic patient information is encrypted when in transit and at rest.

HIPAA Compliant Ophthalmology Medical Billing Services

Being a leading ophthalmology medical billing services provider, Medical Billers and Coders (MBC) has an efficient audit system to ensure proper documentation as well as timely entries of all superbills so as to avoid missed charges. Our coders are divided as per medical specialty, so our AAPC-certified coders are well versed in the latest CPT, ICD-10, and HCPCS codes. Our coders clearly understand the reimbursement rules of all major insurances including Medicare, Medicaid, Workers’ Compensation, and personal injury. Being leading ophthalmology medical billing services provider, we observed a lot of HIPAA violations done by practices almost every day, some of them are as follows:

  • Uninformed or unaware employees are the most common reasons for HIPAA violations. HIPAA requires all employees who come into contact with PHI to receive training. The inability to educate employees on HIPAA policies is a violation of the law.
  • Employees accidentally disclosing patient information is the most common HIPAA violation. Your front desk and billers having patient information may disclose this PHI (protected health information) while having a casual discussion with friends or co-workers.
  • Some ophthalmology practices still use paper charts or records. The provider might be violating HIPAA rules by accidentally leaving a patient’s chart in an exam room for other patients to see it. Forgetting a patient’s lab test results near the public area printer is also a HIPAA violation.
  • Due to lack of training, staff may disclose PHI to a patient’s family member or to a medical facility for further treatment. But sharing patients’ PHI without their written permission is a HIPAA violation. May may post patient photos or textual information on social networks. It’s also a HIPAA violation. Even if your employees do not mention names and other details, someone may recognize the patient, which is a breach of privacy.
  • An unauthorized employee accessing a celebrity patient’s PHI out of curiosity is a widespread HIPAA violation. This violation could cost your practice a hefty fine or your employee his or her job and even jail time.
  • Providers might use their home computers after work hours to access PHI to record notes. This could result in a HIPAA violation if a family member uses the computer and sees the patient information.

If you are not sure if your ophthalmology practice is following HIPAA compliance, you can always think about outsourcing your ophthalmology medical billing services. Being a HIPAA-compliant ophthalmology medical billing services provider, Medical Billers and Coders (MBC) can keep PHI protected all the time, even while processing the claims. To discuss more our ophthalmology medical billing services, email us at info@medicalbillersandcoders.com or call us: 888-357-3226.