Is Billing Information Protected Under HIPAA?

is billing information protected under hipaa

The Health Insurance Portability and Accountability Act (HIPAA) established strict privacy regulations to keep patient information private. This means that healthcare providers — and any third-party companies they contract with — are responsible for protecting personally identifiable information.

Although many people know that HIPAA protections apply to medical records and details about health care services, they may not realize that HIPAA also applies to payment-related information. The short answer to the question, “Is billing information protected under HIPAA?” is yes, it is. As a medical billing and coding provider, PatientForces understands the nuances of HIPAA in medical billing and explains everything you need to know. 

1. Billing Information Is Protected Information

Under HIPAA, patient billing information qualifies as protected health information (PHI). Other types of PHI include information about an individual’s mental or physical condition and the health care they receive. 

Billing and payment information become PHI when it’s possible to link it to an individual by one of 18 identifiers. Identifiers include demographic information, like name, address, date of birth, and Social Security number, as well as health plan information, practice account numbers, and medical records. PHI can also include serial numbers and other identifiers on medical devices, photos, IP addresses, and fingerprints. 

2. HIPAA Violations Are Costly

Data breaches and HIPAA violations are becoming more common, especially as hackers actively seek to steal PHI. Between 2020 and 2021 alone, the number of health data-related breaches doubled. These violations cost healthcare providers, health plans, and medical facilities millions of dollars, in addition to the negative impacts on their reputations and revenue. 

Covered entities have to protect PHI to prevent fines, possible imprisonment, and class-action lawsuits. This means choosing third-party medical billing providers who understand HIPAA and taking steps to protect the data within their systems. Understanding your company’s data lifecycle from collection through destruction, conducting a risk assessment to identify vulnerabilities (and addressing them), and providing comprehensive HIPAA training to employees all help prevent violations. 

3. HIPAA Isn’t Just for Healthcare Providers 

The second question many ask after, “is billing information protected under HIPAA?” is, “Do I have to comply with HIPAA?”

Anyone who collects, stores, or uses PHI is a covered entity. This includes healthcare providers, insurance companies, and third-party service providers like medical billing companies. The law requires third-party companies to sign business agreements detailing their understanding of the data protection requirements and how they will store, secure, and transmit sensitive information. 

The answer to the question “Is billing information protected under HIPAA?” may be a simple “yes,” but keeping PHI payment and billing information safe isn’t quite so easy. Choosing a medical billing services provider with experience, in-depth knowledge of the rules, and a commitment to robust data protection is essential to compliance. PatientForces is a leader in this area, providing reliable, compliant medical billing and coding that puts data security and privacy first. 

To learn more about our services and how we can help your practice maintain financial health, call us at (727) 499-0351.

Parul Garg, CEO and co-founder of PracticeForces, has significantly contributed to the growth of over 1,000 U.S. medical practices through her expertise in medical billing and coding since the company’s inception in 2003. With a background in Computer Science and an MBA in Human Resources, her leadership and AAPC-certified coding skills have been pivotal in managing the company’s operations effectively.

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