HIPAA Compliance

HIPAA (Health Insurance Portability and Accountability Act) was signed into law on August 21, 1996. This law was designed to provide insurance portability, to standardize the exchange of administrative and financial data and to protect the privacy, confidentiality and security of healthcare information. It impacts all areas of the healthcare industry.
HIPAA does not require a practice to purchase a computer-based system as it applies only to electronic medical transactions such as record keeping and billing.

If you keep paper records of all of your patient visits, you can use Medi-Claims to electronically submit your claims for faster payment and compliance with HIPAA. Medi-Claims will convert your forms in our proprietary format that EDI Healthclaims Network automatically converts into the mandated standard format prior to reaching the payer. This proprietary format is monitored by EDI Healthclaims Network and updated by Medi-Claims anytime there is a change in HIPAA or insurance carrier requirements.

Note that Medicare and more and more insurance carriers are requiring all providers to use the standard format or have their claims processing automatically delayed. Medicare began discontinuing their free software and support in 2004.

The compliance deadline for the Privacy Rule and Transaction & Code Set Rule was 2004 and the Security Rule deadline is April 2006 for small businessesand one year earlier for large businesses. Any healthcare provider that electronically stores, processes or transmits medical records, medical claims, remittances, or certifications must comply with HIPAA regulations. Penalties for HIPAA non-compliance include fines up to $25,000 for multiple violations and $250,000 and up to 10 years imprisonment for knowing abuse or misuse of individually-identifiable health information.

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