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Is Medical Billing Information Protected Under HIPAA?

Tuesday, August 9th, 2022

Electronic medical billing requires access to protected health information to accurately bill and receive payment for medical treatments. While not covered entities, medical billing companies are often contracted as business associates and fall under HIPAA regulations.

Title II of HIPAA applies directly to medical billing companies. It dictates the proper uses and disclosures of protected health information (PHI) and simplifies claims and billing processing.

electronic medical billing

What is Protected Health Information (PHI)?

Protected health information is “individually identifiable” health information. It specifically refers to three classes of data:

  1. An individual’s past, present, or future physical or mental health or condition.
  2. The past, present, or future provisioning of health care to an individual.
  3. The past, present, or future payment-related information for the provisioning of health care to an individual.

As listed in item three, payment-related information tied to healthcare provisioning is protected data under HIPAA. This can include information about insurance carriers and payments, billing statements, receipts, credit card numbers, bank accounts, and other financial information.

To be classified as PHI, payment-related information must be tied to an individual identifier. For example, a medical bill with a patient’s address can be tied back to a specific individual. These identifiers can sometimes be quite indirect. There are 18 types of identifiers for an individual (listed below). Any of one of these, combined with information on healthcare payments, would constitute PHI:

  • Name
  • Address (all geographic subdivisions smaller than a state, including street address, city, county, zip code)
  • All elements (except years) of dates related to an individual (including birth date, admission date, discharge date, date of death, and exact age if over 89)
  • Telephone number
  • Fax number
  • Email address
  • Social Security number
  • Medical record number
  • Health plan beneficiary number
  • Account number
  • Certificate/license number
  • Any vehicle or other device serial number
  • Device identifiers or serial numbers
  • Web URL
  • Internet Protocol (IP) address numbers
  • Finger or voiceprints
  • Photographic images
  • Any other characteristic that could uniquely identify the individual

The Risks to Medical Billing Companies

It should be evident that medical billing companies work with a lot of PHI. As such, they must take steps to protect that information under HIPAA regulations.

Third-Party Risk

Many healthcare systems contract medical billing companies to process claims and bill patients and insurance companies. These companies can present significant risks to protected health information if not adequately vetted. All third-party companies that handle PHI on behalf of a covered entity must sign a business associate agreement. This document discusses how sensitive medical billing information will be stored, secured, and transmitted. It is also essential to ensure that the billing companies understand their obligations under the privacy and security rules and have implemented the proper physical, technical, administrative, and organizational standards. This can be verified via security audits and assessments.

Third parties like medical billing companies are often targets for cyberattacks. From 2020 to 2021, cyberattacks on business associates increased by 18%. The rich trove of financial and health data they have is often more comprehensive and less secure than a hospital’s electronic health records system. Unlike covered entities who frequently work under HIPAA regulations, third parties may not wholly understand it. As a result, they may fail to take the technical steps needed to secure sensitive data.

How to protect electronic medical billing information

Like many healthcare organizations, financial institutions are also undergoing digital transformation and are moving to digitize healthcare payment processes. Digitization is an effective way to reduce payment times and improve patient satisfaction. However, it also introduces risk. Digital systems that contain healthcare billing information must implement the proper safeguards, including:

  • Organizational requirements that describe how policies and procedures will be implemented and obligations concerning business associate contracts.
  • Administrative requirements related to how employees access PHI.
  • Physical safeguards that encompass the security of computer systems, servers, and networks, access to the facility and workstations, data backups and storage, and the destruction of obsolete data.
  • Technical safeguards that ensure the security of data transmitted over an open electronic network and the storage of that data.

Protecting Electronic Medical Billing Information In Databases

Digital billing information that is stored in electronic databases or online web portals must be secured in the following ways:

  • Using a secure and HIPAA-compliant web and database host.
  • Limiting access to only authorized users.
  • Requiring unique logins and complex passwords with multifactor authentication to access ePHI.
  • Encrypting the contents of the database so they cannot be accessed if there is a breach.
  • Making regular backups of the database and storing them independently of the main system.

Sending Healthcare Billing Notifications Digitally

Many people now prefer to receive electronic medical billing notifications via email. A survey of 3,000 US consumers found that 85% are already using e-billing, and 47.6% find it is faster to pay bills electronically. However, using email, text messaging, or other digital communication forms introduces new risks and requires remediation to protect ePHI in transmission. These safeguards include:

  • Encrypting messages in transit
  • Authenticating user identities and sending domains
  • Requiring unique user logins and complex passwords
  • Protecting against threats with anti-virus software, email filtering, and other malicious scanning tools.
  • Creating audit logs and reviewing them for suspicious activities.

Services like LuxSci’s Secure High Volume Email can integrate with existing systems to send automated encrypted billing notifications via API or SMTP.

Using Secure Email APIs to Improve Operational Efficiency

Tuesday, May 10th, 2022

APIs are just one tool that organizations can use to streamline operations and automate processes. This article explains how secure email APIs can save time in healthcare communications.

secure email api

What is an API?

API is an acronym that stands for “Application Programming Interface.” APIs enable companies to open up their applications’ data and functionality to external third-party developers, business partners, and internal departments. They allow services and products to communicate and leverage each other’s data and functionality through a documented interface. APIs simplify app development by allowing applications to work together.

APIs help business and IT teams collaborate. One example is the Weather Underground API. If a smartwatch developer wanted to display the weather on the watch face, they could use the Weather Underground API to source current weather data and local forecasts. Application developers do not have to create an entirely new weather database and keep it updated. Instead, the API enables them to use the Weather Underground’s meteorological data in their application.

APIs enable information to flow both ways. The smartwatch can display Weather Underground forecasts, and the API can report data back to the Weather Underground. This functionality enables interoperability and data sharing.

Email APIs

An email API gives applications the ability to send emails and retrieve analytics. Email APIs are often used to send transactional emails from applications like CRMs, EHRs, and other databases. Trigger-based emails are ideal for sending with an email API. In this situation, emails are sent when pre-determined conditions are met. For example, an order confirmation is a transactional, trigger-based email. A person buys a product online, the transaction is processed, and an email is sent to the buyer with their transaction details. The email is sent automatically with an email API.

Benefits of Secure Email APIs

Imagine if it was an employee’s responsibility to create and send every order confirmation email. It would be completely overwhelming. Besides saving time, some of the main benefits of email APIs include:

      • Easy to use and implement
      • Cost savings
      • Email deliverability improvements
      • Email list management
      • Reporting and analytics functionality
      • Personalization and customization
      • Enterprise-grade security

How to Use Secure Email APIs to Improve Operational Efficiency

Healthcare organizations are under increasing pressure to improve the patient experience. Online shoppers expect to see those order confirmation emails within a few minutes of finalizing their orders. Healthcare consumers using online communication tools expect the same experience from their healthcare providers. By expediting and personalizing patient communications, APIs can help increase patient satisfaction.

Thanks to the introduction of electronic health records, healthcare organizations have access to more patient data than ever before. Developers can use secure email APIs to send timely, trigger-based emails from EHR platforms.

Some examples of the types of emails that healthcare providers can send using an email API include:

  • Welcome emails
  • Appointment reminders
  • Patient satisfaction surveys
  • Flu shot and vaccine reminders
  • Password resets and other transactional emails

It works like this: the developer creates the email templates in advance and the criteria for email sending. The email is automatically sent when the conditions are met. For example, a developer may trigger a welcome email to send when:

1) a new patient is added to the database and

2) their first appointment date is set.

Email APIs can also pull information from the patient record to personalize the email. The welcome email may include the patient’s name and the date of their first appointment.

Other than updating the patient record, office administrators do not need to take additional actions to send the email. The email API automatically sends customized emails when appropriate.

Security and Privacy Considerations

Of course, developers working with patient data should not ignore HIPAA. It is essential to choose a vendor that understands the requirements. Failing to follow proper protocols can put patient data at risk and lead to data breaches.

For developers looking to create their own HIPAA-compliant APIs, the Office of the National Coordinator for Health Information Technology has put together a helpful guide. LuxSci also has API developer documentation to help integrate applications with our secure email API.

Conclusion

Email APIs are an essential part of digital health transformation and interoperability. Healthcare organizations should explore how APIs can improve their workflows and improve efficiency. LuxSci provides HIPAA-compliant and secure email APIs with Secure High Volume Email Sending. Contact us today to learn more.

Increasing Operational Efficiency with Email Automation

Tuesday, April 12th, 2022

If you work in a busy healthcare practice, administrative tasks can create additional costs and barriers to care. Common communications like appointment reminders, billing statements, and other external messages take a lot of time to create and send. By automating these emails, it’s possible to increase operational efficiency and improve patient outcomes.

email automation

What is Email Automation?

Email automation allows organizations to automatically send emails based on pre-determined triggers or behaviors. Receipts, shipping notifications, password resets are all common types of automated transactional emails. The main message content is created in advance. Then, variables are used to insert custom information into the template automatically. Most importantly, the email is sent when a certain action is taken. Many people are familiar with automated emails in the form of receipts. For example, you make an online purchase and a receipt is automatically emailed to you with the exact details of your purchase. Next, we explore some examples for how email automation can increase operational efficiency in the healthcare system.

How Email Automation Works

There are many ways to utilize email automation to streamline patient communications. One example is appointment reminders. This is a good message to automate because:

  1. The message is generally the same for every recipient
  2. Variables can be used to customize the content: the patient’s name and the date/time of their appointment.
  3. There is a clear event to trigger the email (the date of the upcoming appointment).

Let’s look at an example of an appointment reminder email:

An administrator creates a template with the message content and layout. It may read something like: “Hi [patient name], This notice is to remind you of your upcoming appointment with Dr. Smith on [X date] at [X time]. Please call our office at 555-555-5555 if you need to reschedule.”

Next, connect the email program to a patient database, like an EHR or CRM. If properly integrated, it is possible to pull in the correct information to replace the variables (in brackets above) for the email recipient. For example, the if the email was sent to a patient named Jane Doe, the email program would pull in the correct details from her record to read: “Hi Jane Doe, This notice is to remind you of your upcoming appointment with Dr. Smith on May 2, 2022 at 1pm. Please call our office at 555-555-5555 if you need to reschedule.”

Finally, set up a trigger point to instruct the email program under what conditions to send the email. For an appointment reminder, the administrator may choose to send the email one week before the appointment, so the recipient has ample time to respond.

Once the template, variables, and trigger are set up, ongoing attention from office staff is not required. Each day appointment reminder emails will be sent out when the conditions of the trigger are met.

The Benefits of Email Automation

By automating common administrative email communications, it frees up staff time to focus on patients. Many healthcare providers still have staff members call patients to remind them of upcoming appointments. By automating this task, it streamlines operations and frees up staff time to focus on other tasks more directly tied to improving patient health outcomes. Using email (and/or text message) reminders can also help decrease no-show rates and reduce the costs of rescheduling.

Email automation is just one tool that can help streamline administrative workflows, provide cost savings, and improve the health outcomes of patients.

Don’t Forget HIPAA

Automated emails like appointment reminders, billing messages, and test results all contain ePHI and must be protected under HIPAA guidelines. Review our HIPAA guidelines for email and take steps to secure systems before starting to automate and send transactional emails containing ePHI.

Get Started with Email Automation

To get started, there are a few internal questions that need to be answered.

First, identify the data source- do you have a database or EHR that contains the information needed to trigger and personalize email messages? Next, how will these emails be sent? Do you have an email marketing platform with automation capabilities? Finally, how will these messages be secured?

Once these questions are answered, LuxSci’s Secure High Volume Email service can help securely scale your operations. Contact us if you are interested in learning more about automating email workflows for your healthcare practice.