HIPAA and Medical Billing Services

HIPAA, the medical records privacy act, introduced vast changes in medical billing. To keep up with the new regulations, many healthcare practitioners have turned to third-party billing services. By partnering with an outsourced billing service, clinics can take advantage of an established electronic billing system. Electronic claims not only guarantee HIPAA compliance, but also net substantial savings in administrative costs and bill collections.

Billing Services Offer a Direct Route to HIPAA Compliance
The federal Health Insurance Portability and Accountability Act (HIPAA) compelled the industry to adopt more efficient administrative processes. In an effort to comply with the complex web of regulations, many clinics turn to external billing services. These services bring to the table the expertise to implement the new standard. As one analyst puts it, Outsourcing infuses an organization with best practices, enabling far more efficiency and benefits than incremental changes over time. In other words, health practitioners avoid the growing pains of learning a new system and reap the benefits of efficient records management instantly.

Electronic Billing
One of the biggest leaps forward in medical billing was HIPAAs advocacy of electronic claims submission. Bringing medical records management online reduces error and increases returns dramatically. Billing services realize the following benefits for their clients through electronic billing:

• Electronic claims are paid in less than twenty-one days, compared to an average of ninety days using paper submission.
• Switching to electronic submission reduces outstanding receivables by an average of sixty percent.
• Electronic claims cost an average of eighty-five cents per claim, less than half of the $1.85 it takes to file a paper claim and the $2.05 cost of pending claims requiring manual review.

Given these benefits, its no wonder more than three-quarters of health insurance claims are submitted electronically, up from twenty-four percent in 1995.

Finding a HIPAA-Savvy Billing Service
To ensure that your business takes advantage of these benefits, look for a third-party medical billing service adept in HIPAA compliance. Medical billing experts recommend asking the following questions of your billing partner:

• Can you point to specific steps youve taken in response to HIPAA?
• Are your agents trained in HIPAA compliance? Do they understand the impact of the regulations on the delivery of medical billing services?
• How do you ensure the security of patient information?
• What medical billing software do you use? Is it compatible with my in-house records management applications?
• Do you offer comprehensive patient records management services?

The complex regulatory environment of healthcare records management demands an efficient and accurate billing system. A medical billing services partner can help streamline the billing process. Electronic claims submissions have accounted for huge gains across the healthcare industry. Some analysts estimate that practitioners have saved well over two billion dollars by implementing the standardized transactions required by HIPAA. Administrative efficiency is just the beginning. Third-party billing services are helping healthcare practitioners optimize the collections process, producing a higher rate of return than ever before.

Sources
Outsourcing Center
AMBA (American Medical Billing Association)