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Billing often becomes one of the biggest administrative burdens for solo and small behavioral health practices. Behavioral health providers managing both clinical care and business operations face unique challenges: complex prior authorization requirements, extensive documentation standards, and insurance coverage barriers.
Anesthesia billing is notoriously complex. Generic medical billing software simply doesn’t cut it. That’s why choosing the right anesthesia medical billing software is a critical decision. Key Takeaways: Learn why your anesthesia practice needs specialized billing software and the key features to look for.
Challenges of Healthcare Claims Processing A medical claim is a request made by a healthcare provider to insurance companies (payer) to receive reimbursement for services rendered. Not if you ask billing managers. Healthcare providers and organizations have the power to improve medical billing and collections. Easy, right?
Safeguarding patient information and ensuring data security is always the highest priority in medical billing. With the expansion of digital healthcare information systems, security and regulatory compliance—such as HIPAA (Health Insurance Portability and Accountability Act) —have become not only best practices but also legal requirements.
These are likely to continue to be reported by affected HIPAA-regulated entities over the next few weeks. CA Health Plan 12,224 Unauthorized Access/Disclosure Mailing incident involving mailing vendor (Billing Documents Specialists) Shipping labels contained Social Security numbers.
VAs can handle a wide range of tasks, including medical records management, billing and insurance processing, scribing and transcriptions services, and patient communications, allowing practices to provide timely, efficient, and patient-centered care. healthcare protocols. For more information, visit www.MEDVA.com.
The database also contained software billing and compliance reports belonging to a medical software company. The post Ascension Notifying Patients About Data Breach at Former Business Partner appeared first on The HIPAA Journal.
The file review has now been completed, and it has been confirmed that the data compromised in the incident included names, addresses, dates of birth, health insurance information, medical record numbers, patient account numbers, and certain health information.
After a long day of treating patients, the last thing you want to worry about is the mountain of paperwork and headaches involved in billinginsurance companies. Learn how a clearinghouse supports HIPAA-compliance. They’re like the postal service for your medical bills. What Is a Clearinghouse in Healthcare?
trillion in annual transactions, yet billing inefficiencies cost hospitals an estimated $262 billion each year. At the heart of this challenge lies the complex world of billing in hospital management systems, where accuracy, compliance, and efficiency determine the financial viability of healthcare organizations worldwide.
Healthcare practices are often plagued with medical billing compliance questions like: “Am I upcoding?” ” With all of these concerns, it’s vital that providers and billing departments understand and follow the key elements of proper medical billing compliance to run a successful practice.
The affected individuals included employees and dependents of clients who used its services, which include HR outsourcing, benefits enrollment, billing, and administrative services. The post Verisource Services Increases Data Breach Victim Count to 4 Million appeared first on The HIPAA Journal.
The affected individuals have been advised to monitor their accounts and explanation of benefits statements and report any suspicious activity to the appropriate healthcare provider or insurer. The post Compumedics Cyberattack Affects Almost a Dozen Healthcare Providers appeared first on The HIPAA Journal.
The compromised information included names, addresses, email addresses, phone numbers, health insurance information, and medical appointment information. The post Small Georgia Medical Practice Closes Due to Cyberattack appeared first on The HIPAA Journal. Suspicious network activity was identified on or around November 14, 2024.
Medical billing and coding may be the ideal choice if you’re interested in working in healthcare but prefer a comfortable office environment over a hospital setting. These codes inform insurance companies about the type of treatment a patient received and enable them to pay physicians for their services.
Understanding the Challenges in Claims Processing Errors in medical claims processing have traditionally posed significant challenges for hospitals, insurers, and patients alike. Manual methods are prone to: Human Error : Misfiled billing codes, missing data, and inaccuracies are common with manual input, according to one report.
The compromised data includes names, dates of birth, Social Security numbers, diagnoses, dates of service, provider names, medical information, and/or health insurance information. The post Medical Imaging Provider Confirms Data Breach Affecting More Than 348,000 Patients appeared first on The HIPAA Journal.
The HIPAA Journal has not downloaded any of the leaked data, so cannot confirm the accuracy of the groups’ claims. The group claims to have published a huge variety of documents, including EMRs, test results, patient histories, and billing information. Generally, it does serve as confirmation of a cyberattack.
The data in the appointment software included names, dates of birth, Social Security numbers, health insurance information, and appointment information, which may have included the treating physician name, date/location of the appointment, and the appointment type (surgical, MRI, etc).
Medical assistants should follow professionalism and ethical standards in other duties such as filling out paperwork, billing, bookkeeping, and communicating with insurance companies and other healthcare providers. Medical assistants also need to obey other local and workplace patient health information policies.
Do you know how to manage insurance claims to minimize denials and maintain your cash flow? Practice management skills like scheduling, billing, documentation, and compliance can protect you from professional burnout and set you on a path to success. But do you know how to set up an efficient scheduling system?
Later, in September, the Mental Health Parity and Addiction Equity Act (MHPAEA) was amended to prohibit health plans and insurers from limiting access to mental health or SUD benefits in ways that differ from physical health benefits. Billing and coding Billing and coding issues can often lead to healthcare fraud.
According to the National Association of Insurance Commissioners, around 110,000 malpractice claims will be filed in the U.S. They will notify your malpractice insurance carrier. Avoid discussing the incident with anyone outside your insurer or assigned defense attorney — including colleagues, staff, or even the patient’s family.
In June, HIPAA-regulated entities notified the HHS’ Office for Civil Rights (OCR) about 70 data breaches impacting 500 or more individuals, which is well above the 12-month average of 59 large data breaches per month. dba Frank D. dba Frank D. Lanterman Regional Ctr.
EHR revenue cycle management represents far more than simply connecting clinical and billing systems. Essentially, EHR RCM signifies the integration of billing processes with clinical operations, leading to the improvement of financial performance while ensuring the delivery of optimal patient care.
The Bianlian hacking group claimed responsibility for the attack and gained access to names, Social Security numbers, addresses, dates of birth, driver’s license numbers, medical record numbers, health insurance information, billing information, and limited treatment information.
The compromised email account was reviewed and found to contain patients full names, addresses, dates of birth, medical and treatment information, dates of service, provider and facility names, procedure codes, billing and claims information, patient account identifiers, and payor information.
You’ll use these words daily, from scheduling patients to handling phone calls and working with insurance. Another important word is “HIPAA.” Insurance and Billing You often talk to patients about their insurance when working at the front desk.
They’ll also want a candidate to elaborate on any experience filling out forms, reviewing medical records, or performing billing and bookkeeping services. An interviewer will want to evaluate a candidate’s knowledge of the Health Insurance Portability and Accountability Act (HIPAA).
Million Data Breach Settlement appeared first on The HIPAA Journal. Legal action was taken against Azura Vascular Care over the data breach, with the plaintiffs alleging the defendants failed to implement reasonable and appropriate cybersecurity measures to prevent unauthorized access to its network and sensitive patient data.
But what exactly is RAG in healthcare, and more importantly, how can your organization implement it successfully while maintaining HIPAA compliance and ensuring patient safety? Compliance Challenges : Many AI solutions weren’t designed with HIPAA requirements in mind, creating potential compliance risks.
Lab supervisors may also have an assistant perform billing work or talk with insurance providers, processing claims and ensuring a patient receives correct statements. They must follow patient confidentiality standards within the Health Insurance Portability and Accountability Act (HIPAA) and any other federal or local regulations.
Henry Ford Health encouraged patients to use the website and patient portal to submit information, review their health records, book appointments, schedule visits, pay bills, and communicate with providers. The post Henry Ford Health Settles Tracking Technology Lawsuit appeared first on The HIPAA Journal.
With a platform that collects and connects data across billing, scheduling, clinical care, and patient communication, CollaborateMD allows your staff to focus on delivering better outcomes while we handle the behind-the-scenes complexities. Speed and Accuracy in Billing and Payment: Reduce claim errors to accelerate reimbursement.
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It’s also crucial to maintain patient confidentiality and follow Health Insurance Portability and Accountability Act (HIPAA) regulations. Common administrative duties include: Answering phone calls: Throughout the day, patients call healthcare facilities about appointments, health inquiries, insurance issues, or payments.
It can bring a refreshing shift from scattered patient files and billing information to seamless, stress-free workflows and revenue management. Billing and Claims Management : Ensure smooth processes for medical billing , insurance claims, and payment collection. What happens if systems are mismatched?
HIPAA is a short form of the Health Insurance Portability and Accountability Act , a law devised to protect patients’ personal information regarding their health conditions. A medical billing and coding professional plays a big part in ensuring that this health information is handled as it should be.
Suspicious activity was identified within its computer network, and the forensic investigation confirmed that an unauthorized third party accessed its systems as a result of a security breach at a former third-party billing vendor.
Many doctors and practices have tried to outsource their billing, only to find disastrous results. In these unfortunate cases, their next plan is to bring billing back in-house and cancel the billing service. Either way, successful practices wisely try new ventures while monitoring results and responses.
Basic systems at the lower end provide essential documentation and billing functions, while premium solutions include advanced analytics, population health management, and specialty-specific workflows. These servers must handle database operations, application hosting, and backup functions while maintaining HIPAA-compliant security standards.
HIPAA compliance safeguards all patient portal messaging, ensuring that sensitive health information remains protected during electronic communication. Custom e-prescribing systems can integrate with pharmacy networks, insurance formularies, and clinical decision support tools to optimize medication selection and cost-effectiveness.
Balancing Administrative Duties with Clinical Work Challenge: Administrative responsibilities, such as documentation and billing, can detract from direct client work. Ensure compliance with Health Insurance Portability and Accountability Act (HIPAA) regulations when using technology.
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