Have you looked into what it’s costing your company to snail mail EOBs these days?

EOBs give an individual an increased understanding of their insurance coverage, the cost of care, and their out of pocket expenses. As a result, it’s absolutely critical that health insurers deliver EOBs quickly and effectively.

However, the most commonly used method for sending out EOBs, traditional mail or snail mail, has several drawbacks that can prevent important information about healthcare coverage from reaching people in a timely manner – not to mention the high cost insurers take on to send them. This can leave policyholders in the dark about their healthcare coverage, which can lead to confusion and dissatisfaction with their insurance provider when they receive an unexpected medical bill. 

Furthermore, because EOBs contain the protected health information (PHI) of policyholders or members, insurers are bound by HIPAA (the Health Insurance Portability and Accountability Act) regulations to ensure their secure delivery. Consequently, the risks inherent to sending paper EOB statements in the mail not only have security implications but also potential consequences for non-compliance.  

With all this in mind, this post discusses why healthcare insurers should send EOBs to their policyholders via secure email instead of traditional mail. We detail the various benefits of making the switch to email EOBs, which include enhanced security, better adherence to compliance regulations, higher deliverability rates, and significant cost savings. 

Security Benefits

Insurance companies that send out EOBs via email as opposed to traditional mail are less likely to be at risk for a data breach or leak of PHI.  Firstly, sending an EOB via email drastically decreases the risk of interception. When sent in paper form, an EOB could be:

• Lost, stolen or damaged in transit
• Delivered to the wrong address
• Not properly deposited in a letter or mailbox, then stolen
• Intercepted within the intended address by another individual who lives at or has access to the residence. 

Conversely, as detailed later in this post, email allows for various controls and processes, which mitigate the risks of unsuccessful message delivery.

Additionally, secure, HIPAA compliant email provides data encryption, which safeguards the sensitive patient data within EOBs during transmission and at rest by rendering it unreadable to malicious actors who might intercept it or gain access to it. Physical mail, in contrast, offers no such protection, as someone who intercepts a paper EOB notice can simply open it and freely read its contents. 

Finally, secure email delivery platforms, such as LuxSci, feature identity verification and access controls that enable healthcare insurers to restrict access to PHI, limiting its exposure. Similarly, HIPAA compliant email also provides auditing logging capabilities to track access to patient data, to quickly identify the source of security breaches.

Increased Delivery

Once a person opts-in, sending an EOB by email greatly increases its deliverability, up to 98% or more – almost instantly. By better ensuring a policyholder receives their EOBs, healthcare insurers increase the chance of successfully communicating the intended information they contain, namely, the cost of a service and how much they’re required to cover.

Additionally, the ability to track secure email in near real-time also enhances its deliverability, as it allows organizations to determine the cause of delivery failure and make subsequent attempts to get the EOB delivered. At the same time, the process of determining the reason for the message failure may also reveal security concerns; a process that is very difficult, if not impossible, to achieve with traditional physical mail.

Radical Cost Savings 

Simply put, sending EOBs via email instead of traditional mail can save health insurers massive amounts of money. By saving a dollar or more per EOB, the cost savings can quickly add up to millions of dollars per month in savings.

If you’re curious about just how much you can save with email EOBs, try our just-released email EOB ROI calculator. You can see how much your company can save with just a 30 percent shift from physical mail

The most significant cost reduction is the money saved on printing and mailing paper EOB statements. Additionally, the cost of administering the delivery of EOB notices is lowered when it’s done electronically. Resending EOBs in the event of their non-delivery also is much easier, faster and cheaper via email.

Compliance Benefits

Because sending an EOB via email requires HIPAA compliance, your communications are encrypted by default, protecting patient privacy and keeping PHI out of the hands of malicious actors, all while reducing the risk of HIPAA compliance violations. The security features built into HIPAA compliant email platforms, such as encryption, access control, and audit logs, help insurers satisfy the requirements of HIPAA’s Privacy and Security Rules in their compliance efforts.  

Another considerable benefit of using secure email to send policyholders their EoBs, or, in fact, any communication containing PHI, is that it’s far easier to implement breach notification protocols. HIPAA compliant email delivery platforms provide real-time tracking, so companies can pinpoint email message failures quickly and act accordingly. Similarly, intrusion detection systems and other cybersecurity measures that support email systems enable the faster detection and containment of data breaches. 

In stark contrast, physical mail is far more difficult to track. Consequently, security breaches via mail could go unnoticed for days or even weeks. If you’re unaware of a data breach, let alone have not yet contained or mitigated it, you’re unable to inform all affected parties, resulting in further HIPAA violations and a loss of customer trust. 

Reduced Carbon Footprint

It’s difficult to highlight the cost benefits of sending EOBs to policyholders by email without recognizing the positive environmental impact, too. Email EOBs cuts down on paper usage, for both the notices themselves and the envelopes they’re mailed in. Then there’s the matter of the electricity and ink involved in printing them, the emissions produced in their delivery, etc.  Opting to send EOBs via email reduces all these factors, which enables healthcare organizations to lower their carbon footprint and, where applicable, meet their sustainability obligations. 

Now’s the Time to Move to Email EOBs

LuxSci’s HIPAA compliant Secure High Volume Email solution enables healthcare insurers to instantly send EOBs to policyholders securely and at scale, extending into hundreds of thousands and millions of messages a month. 

Our HIPAA compliant email delivery platform features:  

• Dedicated IPs that isolate critical transactional messages, such as EOBs, from other email traffic, allowing our clients to reach deliverability rates of 98% or more. 
• Real-time tracking for determining the delivery status of EOBs, as well as troubleshooting unsuccessful delivery attempts.
• Flexible encryption through LuxSci’s proprietary SecureLine Technology, which automatically adjusts encryption according to the recipient to better ensure the protection of sensitive data, including for EOBs or any sensitive healthcare communication.

Contact us today to learn more about how your organization can begin the transition to electronic EoBs, reducing costs and improving the customer experience.

For healthcare organizations, choosing the right product and service vendors is essential for achieving HIPAA compliance. One of the key prerequisites of a HIPAA-compliant vendor is the willingness to sign a Business Associate’s Agreement (BAA): a legal agreement that outlines both parties’ responsibilities and liabilities in securing protected health information (PHI). 

However, despite what some healthcare organizations have been led to believe, simply signing a BAA with a vendor doesn’t guarantee your use of their product or service will be HIPAA-compliant. In reality, a BAA is just the beginning, and there are several subsequent actions both healthcare organizations and their supply chain partners must take to ensure the compliant use of PHI, especially over communications channels like email. 

With this in mind, this post explores some of the reasons why signing a BAA on its own doesn’t ensure the security of PHI and protect your organization from HIPAA violations.

Business Associate Agreements (BAAs) Explained 

As touched upon above, a BAA is a legally-binding document established between a covered entity (CE), i.e., healthcare organizations, and a business associate (BA), i.e, any company that handles PHI in providing a CE with products or services. For a BA to handle patient or customer data on behalf of a CE, following HIPAA regulations, there must be a BAA in place. 

A BAA details:

• Each party’s roles, responsibilities, and liabilities in securing PHI.
• The permitted uses of PHI by the BA and, conversely, restrictions on any other use.
• The BA’s responsibilities in implementing appropriate administrative, technical, and physical security measures to best protect PHI.
• The BA’s obligations to report any unauthorized use, disclosure, or breach of PHI.
• That the BA is required to assist with patient rights support, i.e., data access, amendments, and accounting of disclosures, when appropriate.
• The BA’s obligations in making records available for audits or investigations.  
• The CE’s right to terminate the contract if the BA fails to fulfil their obligations in safeguarding PHI.

Additionally, if a BA employs a third-party company, i.e., a subcontractor, that will have access to a CE’s PHI, they are required to establish a BAA with that company. This then makes the subcontractor a “downstream BA” of the CE, and subject to the same obligations and restrictions placed on the original BA. This ensures the security protections mandated by HIPAA flow down the entire chain of custody for sensitive patient and customer data.

Compliance Considerations After Signing a Business Associate Agreement (BAA)

Now that we’ve covered what a BAA is and the role it plays in ensuring data privacy, let’s move on to exploring some of the key things you have to do following the singing of a BAA to ensure HIPAA compliance.  

1. Both Parties Must Implement HIPAA-Required Data Risk Mitigation Measures 

First and foremost, while a BAA details each party’s respective responsibilities in implementing measures to protect PHI, both still actually need to implement those required security features to achieve HIPAA compliance. 

The measures required under HIPAA’s Security Rule, including encryption and access control, are designed to mitigate and minimize the impact of data breaches. So, if a company suffers a security breach and later audits show the required security policies and controls were not in place, they would be subject to the consequences of HIPAA violations, including fines and reputation damage.   

Also, while a BAA stipulates that the BA is responsible for implementing the HIPAA-required safeguards for the PHI under their care, it doesn’t specify exactly which security measures they must implement. Subsequently, that’s left to the BA to interpret based on their understanding of HIPAA requirements, and how they conduct their required risk assessments.

For example, if you have a BAA with your email services provider, that alone may not be enough to keep your company or organization HIPAA compliant. That’s because the provider may not have the security measures your organization needs, and instead have a carefully worded BAA that will leave you vulnerable.

Let’s say your email marketing service provider is a “semi-HIPAA compliant” provider. In these cases, they may not offer email encryption, or the necessary access control measures your organization needs to send PHI and other sensitive information safely. The so-called HIPAA compliance may be limited only to data stored at rest on their servers only.

In short, although a BAA outlines each party’s commitment to securing data, both parties still have to follow through on implementing risk mitigation measures. Additionally, though a healthcare company has its BA’s assurances that they’ll have the appropriate safeguards in place, CEs often only have limited visibility into its ongoing security posture. As a result, asking the right questions and working with a proven HIPAA compliant provider are critical steps healthcare organizations must take to ensure full compliance.

2. CEs Must Stick to “In-Scope” Services

While a BA may provide a CE with a range of services, many limit the coverage of their BAAs to particular “in-scope” services. As a result, if a healthcare organization were to use a service outside the coverage of the BAA, i.e., an “out-of-scope” service, they’d risk exposing patient data and incurring HIPAA violations.

And, even when a service is in-scope, the BA is still required to configure it properly for it to be compliant. These configurations could include:

• Enabling encryption
• Establishing access control
• Activating multi-factor authentication (MFA)
• Turning on audit logging 

With this in mind, it’s crucial to ensure that the “complete” service or tool – not just a part of it – is covered by a BAA before using it to process PHI. Similarly, check the terms of your BAA for configuration or security best practices that offer guidance on fully HIPAA compliant use, and make sure your responsibilities as a CE are 100% clear.

3. Staff Must Be Trained to Securely Handle PHI 

Another key reason that signing a BAA doesn’t automatically result in HIPAA compliance is the likely need for both parties to educate their staff on how to securely handle sensitive data, such as PHI.

Firstly, as discussed above, only some of the services offered by a BA may be covered by its agreement. Subsequently, a healthcare organization’s employees need to be sufficiently trained on the use and disclosure of PHI, namely, the services in which they’re permitted to process PHI and which, in contrast, services are non-compliant.

By the same token, as well as implementing the stipulated safeguards, BAs are responsible for training their workforce on how to use and, where appropriate, configure them. This will help ensure the limited, correct use and disclosure of PHI as allowed by the BAA. 

4. Reporting Requirements

A BAA stipulates that a BA must notify the CE in the event of improper or unauthorized use of PHI. More specifically, this includes: 

• Reporting immediately any use or disclosure not permitted by the terms of the BAA.
• Notifying the CE of security incidents resulting in the potential exposure of  PHI.

However, the commitment to reporting in the BAA and the ability to deliver on that commitment are two different things entirely. Firstly, the BA must implement the policies and infrastructure that allow for timely incident reporting. This includes conducting risk analysis, implemeting continuous monitoring, and developing a robust incident response plan. 

Additionally, a key aspect of prompt, comprehensive reporting includes the BA ensuring that their staff are sufficiently trained to detect and report security events. As part of their training on the secure handling of PHI, a BA’s employees must be able to recognize common security issues and threats, such as improper email configurations and phishing attempts, and how to report them.

5. Subcontractor BAAs

While CEs must sign BAAs with their BAs for the compliant use and disclosure of PHI, they don’t have to sign such agreements with any subcontractors the BA may employ. Instead, it’s the responsibility of the BA to enter into their own business associate agreements with their subcontractors. As a result, the original security obligations are passed all the way down the data’s chain of custody. 

While a CE can take certain measures to enforce this, such as requesting proof of subcontractor BAAs – or even the ability to review subcontractors before beginning engagement – ultimately, they have little control over their security postures. Ultimately, this means that they have to trust that the original service BA does their due diligence in selecting security-minded subcontractors, with the right PHI safeguards in place.  

HIPAA Compliance Beyond a BAA with LuxSci

LuxSci’s secure healthcare communications solutions – including HIPAA compliant email, text, marketing and forms – are designed specifically with the stringent compliance requirements of the healthcare industry in mind. 

LuxSci also provides onboarding, comprehensive documentation, and support to ensure your infrastructure configurations align with HIPAA requirements, so you can confidently include PHI in your healthcare engagement communications campaigns.

Contact LuxSci today to discover more about achieving compliance beyond obtaining a BAA.