Receiving patient data is crucial for the patient’s experience and the performance of the healthcare industry in the current digital era. Patients will properly assist you in providing pertinent information to ensure the right care and treatment required if they are confident in the Security of their medical data being entered into the healthcare departments. However, there is a risk to patient data security when moving medical data digitally to several sources.
In the 1996 Health Insurance Probability and Accountability Act, HIPAA (PHI), was created. The Data Control Laws, Safety Rules, and Warning Rules on Violations are all contained in the HIPAA (1996). In addition, the privacy rule permits organizations dealing with personal health information, such as healthcare providers and medical billing corporations, to be subject to regulation.
The privacy rule also limits how this PHI may be used (HIPAA, 1996). With the development of technology and electronic PHI storage methods, Security Regulations were developed, establishing mandatory standards for the Security of electronic PHI. The Minister of Health and Human Services must legally disclose any violations.
Thus, Health Insurance Portability and Accountability HIPAA Act was introduced as the pillar of the healthcare industries to ensure the privacy of sensitive patient information. It has its set standards of Security and privacy of the patient data in healthcare. Moreover, below we will highlight some of the detailed impacts of HIPAA Compliance in medical coding services and billing, its impact on electronic health records, technology, and the quality it provides to general healthcare practice.
Important Factors Affecting HIPAA Patient Data Security
Organizations in the healthcare industry and those that are related to it must gain a thorough grasp and practical application of:
- The HIPAA Rules and the restrictions they impose Common obstacles to the Security of HIPAA patient data
- Recommended methods for enhancing HIPAA patient data security
- To maximize HIPAA controls and completely secure patient data security and privacy, your organization may still require the assistance of a HIPAA compliance partner. This is true even if your organization knows HIPAA patient data protection requirements, obstacles, and best practices.
HIPAA Compliance in Medical Billing:
Patient data security is paramount because medical billing necessitates transferring patient-sensitive information to various healthcare providers, billing entities, and insurance companies. Additionally, engaging in non-compliance behavior will result in many fines. On the other hand, HIPAA Compliance established PHI protection requirements for every person involved with the healthcare sector to lower the risk. Therefore, the enactment of physical, technical, and administrative Security for every PHI system is required by these compliance laws and regulations to protect the data. Additionally, the rule ensures that the person receives training on security measures, carries out risk analyses, and applies the policies surrounding breach notifications.
The Advantages of Compliance with HIPAA?
One advantage of following HIPAA compliance is that it ensures doctors use virtual media without being feared that their patient data lacks confidentiality. Or else they tend to be charged if patient data are not confidential.
Prevent Fraud in Healthcare
Since there are already certain rules in HIPAA Compliance, healthcare providers within the organizations cannot commit fraud. One example rule it sets is that it forbids charging for the treatments that the healthcare providers have not carried out, nor can they falsify the diagnostic procedures that are not of medical use. Moreover, it allows bans on the charges for services not included in insurance.
Establish Patient Trust and Credibility
HIPAA Compliance rules also allow you to establish patient trust because you proactively record and secure patient medical data and personal information as it provides effective data management procedures to follow.
Shields from Expensive Penalties
In case of a non-compliance practice, your organization would use funds to improve the practice. However, a HIPAA Compliance implementation of practice will save you from penalties and punishments even when the violation occurs.
Enable One-stop Shops for Medical Needs
The app or portal allows for direct communication between doctors and patients to dispense care, access and enter medical data, and update HIPAA-compliant prescription services. As a result, healthcare providers may coordinate, bill for, and store patient data using compliant technologies without worrying about HIPAA violations.
All the papers we send, keep, and produce for our clients are kept at Right Medical Billing on a safe, off-site storage server. Our office staff members try to maintain compliance by receiving ongoing HIPAA training and information. To guarantee better adherence to the HIPAA, we inform our providers of any potential safety lapses and suggest fixes.
Consequences of HIPAA Violations
Since the HIPAA Compliance Act sets specific rules for healthcare organizations, compliance violations seriously negatively affect those organizations’ reputations. They can result in both financial penalties and legal repercussions. Intentional disclosure or misuse of patient information could result in serious criminal charges and financial penalties for the organization. As a result, observing compliance is a legal obligation and a moral and ethical duty for providers to safeguard patient privacy.
Describing the HIPAA Rules
To ensure patient data Security and privacy, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) was passed to raise the bar for healthcare delivery. HIPAA mandates compliance with the four core Rules—securing healthcare transactions and preserving the integrity of sensitive patient data—to assist organizations within and related to healthcare in achieving patient data security and privacy.
HIPAA: Protecting Patient Privacy Rule:
The Act HIPAA was enacted in 1996 specifically in support of patients that could have access to their medical information. However, the main objective for which it was designed was to ensure the integration of certain privacy rules to secure patient data from unauthorized sources.
Therefore, the act implied the patient’s rights to secure their sensitive data and make informed decisions about how this information is used. Also, they could have made amendments to their medical records.
“Covered entities,” which are businesses that are required to protect PHI, consist of the following:
Health plans – Institutions that pay for medical expenses, such as:
- Health, dental, vision, and prescription medication insurers
- Health plans provided by employers, the government, or churches
Healthcare providers — Businesses that send PHI during medical transactions, such as:
- Inquiries about benefits and claims
- petitions for referral authorization
- Paying for services
Healthcare clearinghouses: Businesses that standardize PHI for transactions involving a health plan or healthcare provider, such as:
- Charging for medical services
- Healthcare cost-recovery
- Information Systems for community health management
Business associates of covered entities: Business partners of covered entities are any company that carries out transactions for a HIPAA-covered entity that involve using or disclosing PHI. Examples include:
- Analysis of transactional data connected to healthcare
- Claims processing for insurance
- Medical billing services
The HIPAA Security Rule
The HIPAA Security Rule gives organizations the means to implement patient data security, in contrast to the HIPAA Privacy Rule, which recognizes PHI as a sensitive type of patient medical data. As a result, healthcare organizations are assisted in utilizing the most up-to-date technologies for data protection while minimizing the risks involved in healthcare-related transactions.
Three different types of precautions are included in the HIPAA Security regulation to safeguard electronic PHI:
Administrative protections: To achieve HIPAA compliance at an enterprise level, businesses can use administrative protections to help them put policies in place that address patient data security, such as:
- Management of security risks and vulnerabilities
- Delegating security professionals to carry out security policies and practices
- Access controls for environments containing PHI
- Control over employee security training
Physical Security: The following are some ways that physical security measures help healthcare organizations protect locations or buildings that store sensitive PHI:
- Control physical access to buildings housing PHI.
- Ensure that computers and other devices holding ePHI are used and accessed safely.
Technical security measures: In addition to administrative and physical safeguards, the Security Rule supports healthcare organizations in putting in place technological controls to secure ePHI, such as:
- Technical policies and procedures that limit access to ePHI settings or systems
- Employing audit measures to record access events in ePHI environments
- Integrity safeguards to prevent the manipulation of ePHI
- Security for ePHI transfer through electronic networks
Healthcare organizations can secure patient data comprising ePHI using the HIPAA Compliance security rule. Additionally, these guidelines support them in managing a high level of patient data protection. While non-digitized (legacy) records are also protected by the various types of protections in the rule.
The HIPAA Breach Notification and Enforcement Rules
Another aspect of HIPAA Compliance regulations is recording and notifying of any data breach during the procedure. Responsible management of the PHI data breach reporting procedure is done by the office of the Secretary of Health and Human Services (HHS). These are typically characterized as violating HIPAA Privacy or HIPAA Security standards.
The HIPAA Notification and Enforcement Rules promptly notify the incident for reporting if you notice a data breach in the data security procedure. If the breach, however, affects more than 500 people, they must:
- Following discovering a breach, you must alert HHS Security very away.
- Send the breach notification electronically.
- Each covered entity shall: if the data incident impacts less than 500 persons.
- Notify HHS Security within 60 days of the calendar year’s end following the breach’s discovery.
- For each incidence of a breach, send one notice.
The Office for Civil Rights (OCR) monitors the application of HIPAA Privacy and Security regulations. Investigations are typically carried out into reports of HIPAA non-compliance. Additionally, the Department of Justice (DOJ) participates in some investigations into HIPAA infractions.
HIPAA Patient Data Security Best Practices
Organizations must ensure that they are optimizing HIPAA Compliance to the best needs of patient data security and preserving PHI at every level of the process to achieve success. Reducing the dangers to data security and privacy if they are found is another practical approach. Otherwise, you might not be able to handle the fallout from the breach as it happens.
You will benefit more from certain best practices for the organization’s success as you optimize the HIPAA Compliance privacy and security guideline. Therefore, simplify company data security and privacy throughout the year and improve your cyber security posture.
A dental billing company makes sure that the billing process is managed pro-actively to speed up reimbursement. The overall revenue is increased by precise dental billing and coding, whereas claim processing errors result in denials and failure.
You must be aware of your company’s data security threats if you truly wish to improve patient data security and privacy practices. Although organizations in or near the healthcare industry likely experience some risks, a thorough risk-management strategy can be effectively used to match the process requirements and securely store the PHI.
By analyzing the dangerous threats to PHI’s likelihood and using the HIPAA Privacy and Security Rules as a reference, you may develop a risk management strategy to safeguard the confidentiality of patient data, explain possible consequences of a vulnerability to patient data security, assess the dangers posed by threats to PHI.
Even if the digital age offers many advantages, it also has drawbacks. Data security issues are one such instance among healthcare organizations. However, putting in place a few strong data security technologies will enable you to effectively identify the dangers and minimize any potential patient data security and privacy breaches.
The three most popular data security tools are described.
Penetration testing, often referred to as “ethical hacking,” is a method for identifying holes in the PHI processing system, like:
- Networks that transfer PHI between organizations
- Utilizing applications to conduct healthcare transactions
- Workstations are examples of hardware support and connecting systems.
Identity and access management: Identity management and access management for circumstances involving PHI, controlled access is crucial in preventing intrusion and unauthorized access.
- Utilizing an identity and access management (IAM) system, you may keep track of login attempts to databases or systems that contain PHI.
- Anomalous access events, such as privilege escalation outside of work hours, should be monitored.
- Grant role-based privileges to users inside the company.
Security awareness education HIPAA medical data security ultimately comes down to training your team on cyber alertness skills that will enable them to:
- Alert a dedicated IT security team to phishing efforts by recognizing them.
- Establish secure password usage practices across all devices, such as selecting long, challenging passwords.
- Follow security guidelines
Implementing a Security Policy
The ideal strategy to standardize patient data security and privacy best practice is establishing a security policy outlining all the processes and procedures involving all the transactions and PHI.
- Frequently updated (at least once a year) to reflect current data security requirements
- Embracing data security across your IT infrastructure is a prerequisite for a compliant patient data security policy.
- Updates and adjustments to the HIPAA Rules and related guidelines
Additionally, working with a HIPAA Compliance partner like RSI Security will be very beneficial to you in starting the adoption of HIPAA policy into your medical billing and data security practices and ensuring your company’s success.
Achieve and Maintain HIPAA Patient Data Security
No matter how many obstacles healthcare organizations must overcome to secure PHI, successfully adopting HIPAA Compliance into the procedure will considerably increase your chances of success. In addition to addressing urgent security flaws and vulnerabilities, it also strengthens and protects the procedure for protecting patient data.
Additionally, organizations can benefit from the deployment of HIPAA Compliance regarding the reputational effects and monetary and legal repercussions of patient data breaches. In terms of optimizing HIPAA Compliance and creating the best practices to support an ongoing process to the security system, as an experienced HIPAA Compliance partner, RSI will effectively provide you with the best.