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The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that regulates how patient information is managed, protecting their privacy. Medical assistants are required to abide by HIPAA laws to ensure proper confidentiality when collaborating with patients. What Is HIPAA?
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.
The plaintiffs claimed that Somnia was negligent by failing to implement appropriate cybersecurity safeguards to ensure the privacy and confidentiality of the data stored on its network, did not follow industry security standards, and was not fully compliant with the HIPAA Rules. The post Somnias $2.4
Behavioral health providers managing both clinical care and business operations face unique challenges: complex prior authorization requirements, extensive documentation standards, and insurance coverage barriers. Insurers denied 19% of in-network claims in 2023 , according to the Kaiser Family Foundation.
The files contained names, health insurance information, and diagnostic and/or clinical information. The lawsuit alleged an impermissible disclosure of protected health information in violation of the requirements of the Health Insurance Portability and Accountability Act (HIPAA). The lawsuit – Kaitlyn Hill.
The hackers encrypted files and stole data such as names, addresses, telephone numbers, email addresses, dates of birth, demographic information, Social Security numbers, drivers license numbers, medical record numbers, health information, payment information, and health insurance information. Bean of Siri & Glimstad LLP.
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 ransomware group obtained names, dates of birth, Social Security numbers, state ID/driver’s license information, health and insurance information, banking information, and biometric data. Million Settlement Agreed to Resolve WellNow Urgent Care Data Breach Litigation appeared first on The HIPAA Journal.
A New York woman has avoided a jail term for a criminal violation of the Health Insurance Portability and Accountability Act (HIPAA), having been sentenced to probation. The Federal Bureau of Investigation (FBI) investigated and DAgostino was arrested and charged for the HIPAA violation. in restitution.
The group had access to its network since June 14, 2025, and exfiltrated patient information such as names, addresses, Social Security numbers, dates of birth, driver’s license/state identification card numbers, medical record numbers, treatment information, and health insurance information. A lawsuit – Horvath v.
The document review was completed on January 30, 2025, when it was confirmed that the exposed information included first and last names, clinical/treatment information, medical provider names, medical record numbers, and patient account numbers. Individual notification letters were mailed on March 21, 2025.
Understanding the Challenges in Claims Processing Errors in medical claims processing have traditionally posed significant challenges for hospitals, insurers, and patients alike. Automatically flagging errors before claims are submitted to insurance providers. Reducing duplication errors in medical claims documentation.
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.
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. DocumentationDocumentation integrity involves the accuracy of the complete health record.
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?
Creating Software Specifications and Wireframes Developing a healthcare application is creating specification documents and wireframes that product users will love. Functional specifications documents aim to inform developers what, how, and why they have to build. Despite this, healthcare institutes fail to comply with HIPAA.
These sophisticated platforms must navigate an increasingly complex landscape of insurance policies, regulatory requirements, and technological demands while maintaining the highest standards of data security and patient privacy. Advanced systems include claim scrubbing capabilities that identify and correct common errors before submission.
Comprehensive Registration Data Management EHR registration systems capture and validate comprehensive patient demographic, insurance, and clinical information that forms the foundation for accurate billing and claims processing.
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.
All class members may submit a claim for two years of credit monitoring services, which include a $1,000,000 identity theft insurance policy. A claim may also be submitted for documented, unreimbursed, ordinary losses fairly traceable to the data breach up to $2,000 per class member.
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.
The stolen data included names, dates of birth, driver’s license numbers, Social Security numbers, medical record numbers, treatment and condition information, diagnoses, medications, and health insurance information. Million appeared first on The HIPAA Journal.
Secure a driver’s license and transportation: Ensure your vehicle is reliable and insured. These roles are increasingly in demand due to the rise of home healthcare, telemedicine, and patient-centric service models. Here are some compelling reasons to consider this specialized healthcare role: 1.
Class members may submit claims for reimbursement of documented out-of-pocket costs and expenses reasonably linked to the data breach, plus documented lost time up to a maximum of 10 hours at $25 per hour. The security failures are alleged to violate the FTC Act and the Health Insurance Portability and Accountability Act ( HIPAA ).
Individuals who were sent a notification that they were affected by the data breach may submit a claim for reimbursement of documented losses incurred as a result of the data breach up to a maximum of $10,000. Million Data Breach Settlement appeared first on The HIPAA Journal. Under the terms of the settlement, a $3.15
The stolen information included names, Social Security numbers, taxpayer identification numbers, medical or health insurance information, and other sensitive information. Claims may be submitted for up to $5,000 to cover documented, unreimbursed losses due to the data breach, and for cash payments.
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.
These regulations ensure that healthcare providers accurately bill patients and insurance companies while protecting sensitive patient information. Following health insurance policies and procedures. Real-world example: A violation of HIPAA due to ignorance of the rules can result in fines of $141 $35,581. The result?
Recent Videos Related Content Decoding malpractice premiums: Insider insights every physician should know Jennifer Wiggins June 27th 2025 Article Check out these essential insights on controlling malpractice insurance premiums, including specialty impact, location factors, policy types and available discounts for physicians.
Recent Videos Related Content Decoding malpractice premiums: Insider insights every physician should know Jennifer Wiggins June 27th 2025 Article Check out these essential insights on controlling malpractice insurance premiums, including specialty impact, location factors, policy types and available discounts for physicians.
On January 14, 2025, an employee emailed a document to a personal email account. The post Email Account Breaches Reported by Access TeleCare & Madison County, MS appeared first on The HIPAA Journal. It is currently unclear how many individuals had their data exposed in the incident.
But how will you handle confidential documents, client conversations, and courtroom documents? Another piece of legislation that assists in protecting confidentiality is the Health Insurance Portability and Accountability Act , better known as HIPAA. This would mean, for example, paper, digital, and emailed documents.
Faster TimetoMarket In a health insurance policy management system project, a client achieved a fourmonth launch timeline by outsourcing development and QA to a dedicated vendor. This rapid turnaround was possible due to the vendors agile processes, continuous integration pipelines, and prebuilt compliance frameworks for HIPAA and GDPR.
After learning that the insurance company (trying to play doctor) recommends a generic drug that is less effective and has more adverse effects because it does not carry the more expensive drug on its formulary, this gives the doctor cause for concern for their patient.
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.
It also consists information about demographics, medical insurance, and data acquired from wearable health devices. EHRs are HIPAA and HITRUST compliant to avoid disclosure of Patient Health Information (PHI) due to cyberattacks. Moreover, HIPAA compliance and Privacy Rules are to be included while exhibiting Meaningful Use.
Compliance and Security Upgrades HIPAA compliance audits: $5,000 – $15,000 Security assessments: $3,000 – $10,000 Data encryption upgrades: $2,000 – $8,000 Total Cost of Ownership (TCO) Analysis Understanding the total cost of ownership is crucial for making informed EHR investment decisions.
However, with this digital transformation comes the critical need for HIPAA compliant teletherapy platforms. What is HIPAA and Why is it Crucial in Teletherapy? The Health Insurance Portability and Accountability Act (HIPAA) sets the standard for protecting sensitive patient data.
Penalties for HIPAA violations can be issued by the Department of Health and Human Services’ Office for Civil Rights (OCR) and state attorneys general. In addition to financial penalties, covered entities are required to adopt a corrective action plan to bring policies and procedures up to the standards demanded by HIPAA. .
This comprehensive guide provides hospital and revenue cycle leadership with vital insights on preparing for CERT audits and establishing processes for compliant documentation. This section delves into the specific criteria and expectations set by CERT audits, emphasizing the need for meticulous attention to detail and documentation accuracy.
HIPAA violation cases are compliance investigations that result from a data breach being notified to the Department of Health and Human Services’ (HHS) Office for Civil Rights (OCR) or a privacy complaint being submitted to OCR via the complaints portal. There are many different types of HIPAA violation cases.
Just this year alone, we’ve seen some of the largest and most alarming healthcare data breaches in history, including those related to the American Medical Collection Agency, insurer Dominion National, and Inmediata Health Group, just to name a few. The team will be responsible for updating and managing your facility’s cybersecurity system.
That’s the mantra coming out of this week’s annual Capitol Conference convened by the National Association of Benefits and Insurance Professionals (NABIP). FYI you might know of NABIP by its former acronym, NAHU, the National Association of Health Underwriters).
Having a profound understanding of the HIPAA rules puts you one step ahead in the healthcare sector. HIPAA risk assessment ensures that ePHI is protected from threats and vulnerabilities such as fraud, data breaches, financial scams, identity thefts, etc. HIPAA Compliance Checklist 1.
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