| What is the main purpose of medical billing? Well it | | | | or disability. Thus Title I also protects health |
| is just to make sure that the service provider | | | | insurance of workers and their families if they |
| receives a fair payment for services provided and | | | | have to change jobs. |
| also so that the payment is received in time. The | | | | The second title of HIPAA contains a portion that |
| medical billing procedures are governed by certain | | | | increases the efficiency of data exchange for |
| laws. What are the main laws that govern medical | | | | healthcare financial transactions and protects the |
| billing? They include the following 3 laws; | | | | privacy of electronic data transmission and the |
| Fair debt Collection Act | | | | confidentiality of patient records. All medical |
| The Health Insurance Portability and Accountability | | | | providers are asked to send their claims |
| Act | | | | electronically in compliance with the act to receive |
| The Privacy Rule | | | | their payment. This includes electronic transmission |
| The Fair debt collection Act is a federal law that | | | | of major financial and administrative dealings, |
| dictates how and when a debt is to be collected. | | | | including billing, electronic claims processing and |
| This act is for the protection of all the patients | | | | reimbursement advice. Various offenses relating |
| and other consumers from unlawful threats. | | | | to health care are set and criminal penalties |
| The Health Insurance Portability and Accountability | | | | imposed. Besides creating several programs to |
| Act of 1996, better known as the HIPAA, was | | | | control fraud and abuse within the health care |
| enacted by the U.S. Congress in 1996. It has two | | | | system it imposes penalties when rules are |
| titles. | | | | violated. |
| Title I of HIPAA regulates the availability, breadth | | | | The privacy rule regulates the use and disclosure |
| of group and individual health insurance plans. It | | | | of Protected Health Information (PHI). PHI is any |
| amends both the Employee Retirement Income | | | | information about health status, provision of health |
| Security Act and the Public Health Service Act. | | | | care, or payment for health care that can be |
| This act also prohibits any group health plan from | | | | linked to an individual. Any person who believes |
| creating eligibility rules or deciding of insurance | | | | that the Privacy Rule is not being upheld can file a |
| premiums for individuals in the plan based on | | | | complaint with the Department of Health and |
| health status, medical history, genetic information, | | | | Human Services Office for Civil Rights. |