and Medical Billing
and Medical Billing
HIPAA (The Health
Insurance Portability and accountability act of 1996) is a law which primary
goal was to “remove the health condition from health insurance considerations”
to upgrade and refine portability and continuity of the amount of protection
given by health insurance and combat misuse, fraud, and abuse in health
insurance and healthcare distribution.
legislation was split up into seven titles:
Title I – Health care access, portability,
Title II – Stop Health care fraud and
misuse, administrative simplification, and medical liability reform
Title III – Tax-related health provisions
Title IV – Group health plan requirements
application and enforcement.
HIPAA ensures the protection scope
of laborers after they lose or change their activity, it secures the protection
of patients’ therapeutic data, builds up principles for electronic therapeutic
exchanges, and sets up the disciplines for fake therapeutic revealing
institutionalized medicinal codes and set up the Electronic Data Interchange
frame that we utilize to send asserts electronically; this EDI has various
writings, each of which compares to a specific type of exchange between a
supplier and a payer.
The act states that the
motivation of Title II, Administrative Simplification, is to advance the
Medicare and Medicaid plans and the effectiveness of the health care system by
supporting the development of a health information system via the establishment
of standards and requirements for the electronic transmission of certain health
Is the operation of procuring
payments for services that healthcare providers give to patients. The majority
of the US population have some form of health insurance that will pay, to a
certain extent, part of the medical bill. The healthcare provider submits the
invoice to the insurance institution for payment. Most medical bills, nowadays,
are sent electronically, in which case, the provider sends the needed information
in a pre-defined format that the insurance institution requires. When the
insurance company receives a claim, it can either deny it, settle it or retain
it for further information.
Another important entity in the
medical billing business is the medical coder, who audits the patient’s records
to summarize and codify the services that the doctors supply to patients to
make sure that they send accurate codes to insurance institutions and that they
properly process the claims. Coding conveys the entire billing process.
In conclusion, HIPAA helps with
the privacy of patient information, as Medical Billing follows up on the claims
made by the insurers of the services they have already done. both are important
in the health industry.
and Medical Billing (2018, January). Retrieved from http://www.medicalbillingandcoding.org/section-3-review/
Medical Billing (2018,
January). Retrieved from https://en.wikipedia.org/wiki/Medical_billing