UNDERSTANDING MEDICAL BILLS

UNDERSTANDING MEDICAL BILLS

This guide will help you, as a patient, navigate the medical 

billing process from the moment you contact a healthcare 

provider about an appointment until after you receive 

your bill in the mail.

To Text or Not To Text Patients? The Message from HIPAA.

 

Most of the 1.9 trillion texts Americans sent from their smartphones to friends and family last year wouldn’t be secure enough for healthcare settings. It’s unfortunate, because texting is a quick, easy and effective way to communicate.
It’s probably also no surprise that texting is the most popular smartphone feature, according to a 2015 Pew Research Center survey,  and 97% of Americans use their phones to text.
But like most other things, different rules apply in the healthcare world.
The HIPAA/HITECH privacy and security rules cover any communication with electronic protected health information (ePHI), including e-mail, social media and text messages. In an actual case, providers at a nursing facility requested nurses text them patient information. Even without evidence that an unauthorized person saw the messages, CMS intervened with a 10-point remediation plan to retrain staff, appoint a HIPAA security officer and revise their HIPAA policies and procedures.

Remember that texting leaves a record, unlike telephone calls. Plus it’s easier to know you’re reaching the correct person on the phone. The risk of texting sensitive patient information to another person is not zero – in public surveys, about one-third of people say they’ve mistakenly sent a text to the wrong person.
In addition, HIPAA/HITECH privacy violations can carry hefty fines, up to $50,000. So avoiding the temptation to text a colleague for a quick patient consult could save you money as well.

HIPAA Compliant Texting
Even so, the Joint Commission did not rule out all texting, according to Andrew A. Brooks, MD, orthopaedic surgeon and Chief Medical Officer at Tigertext, a secure mobile messaging firm.  In a piece for the American Academy of Orthopaedic Surgeons, Dr. Brooks points out that minimum requirements for HIPAA compliance include:
* Secure data centers—Onsite or offsite (cloud) data centers must use a high level of physical security and policies to review controls and conduct ongoing risk assessments.
* Encryption—ePHI is encrypted both in transit and at rest.
* Recipient authentication—Confirmation that any communication containing ePHI only goes to its intended recipient.
* Audit controls—The ability to create and record an audit trail of all activity, including text messages containing ePHI.
The sheer volume of text messages indicates an overall preference for this form of communication. The 1.92 trillion texts last year is almost double the 1 trillion sent in 2008, so who knows how many texts Americans will send going forward.
Texting Appointment and Wellness Reminders
Your practice may already send patients text reminders for upcoming appointments. There’s evidence this strategy can reduce your patient no-show rate. HIPAA rules generally do not apply to communications without ePHI.
Text reminders also seem to help patients with medication, healthcare and lifestyle reminders. As examples, researchers show chronic disease text messaging can help patients manage their diabetes, remind African-Americans with high blood pressure to take their medication, and help people increase their exercise and physical activity levels, although some say more research on best practices is needed.
Healthcare vendors offer apps that promise secure texting and would allow physicians and medical professionals to communicate within a HIPAA-compliant platform. Verify information complies with HIPAA because government agencies do not vet many of these apps. Also, if you chose to use a third-party secure texting platform, keep in mind the three requirements for securing PHI: confidentiality, integrity, and availability. Any platform chosen must satisfy all three elements, according to Mellette PC Healthcare Provider Attorneys in Virginia.
Another option, now that more than 80% of physicians use electronic health record systems, is to communicate with patients by sending e-mails through a secure patient portal. As you probably know, secure portals can help eligible providers meet Meaningful Use.
Whatever strategy you use, remind your staff to never transfer ePHI through non-secure methods of communication. And while we congratulate you on moving to the world of quick and convenient electronic communication with patients, here at Power Your Practice we also don’t want to see you financially penalized.
Figured out a great way to reach patients – and hear back from them – without violating HIPAA? Share your tips with colleagues below.

Damian McNamara

Damian McNamara is a Content Marketing Writer & Editor. He brings his journalism experience covering 18 medical specialties to cover practice management, cloud technology and health IT best practices to Power Your Practice readers.

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Summary

" ClaimPay* is dedicated to the management of the revenue cycle of any medical specialty, office, or clinic looking to outsource billing to a third party company."

Company Summary

ClaimPay* brings a doctors most needed resources to the table. We set out to increase profitability, with 10% to 35% more claims paid. Bringing accounts receivable up while decreasing accounts payable, allowing growth within the company and community. By effectively managing the revenue cycle we get the Doc paid.

These procedures include: Working directly with the insurance company. healthcare providers, and patients to get a claim processed and paid with in the minimum time expected.

As well as, handling all aged and collection accounts to insure balance is paid in full, with little write off's and with analytical report, showing the differences ClaimPay* has on your bank account. This allows the Physician more time to preform the quality care needed and is less of a hassle for the HR department.

Related: 6 Things I Wish Somebody Had Told Me When I Started My Small Business - 5

                                                                                           5. Sustainable competitive advantage

Every solution has competitors and alternatives, or it has no market. Thus, it needs an advantage to rise above the crowd, such as a patent and trademarks, unique market positioning or support from industry partners. Too many competitors or a product with minimal differentiation makes a startup risky.                                 

4 SIGNS YOU NEED TO OUTSOURCE

     



"As reimbursement pressure 
grows and underlying costs rise,
 margin pressure will persist."

-You may be 

told by your team 

that there are

 no costs left to cut. 

"Respectfully disagree."

Understanding Healthcare Start Up Issues

Health Care

Use this guide to help understand the laws and regulations that apply to health care businesses and the health care industry.

Click on one of the following links to jump to that section of the page:

• Antitrust
• Environmental Compliance
• Eye Care
• Facilities Management
• HIPAA
• Mammography Services
• Medical Device Reporting
• Medical Practitioners
• Medicare & Medicaid
• Taxes
• Workplace Health & Safety
• 

THE HEALTH CARE FOUNDATION

THE HEALTH CARE FOUNDATION
P.O. Box 308,
Longview, WA 98632

• (360) 423-3591
• Mary Jane Melink,
  Executive Director
• thehealthcarefoundation@gmail.com
• 
  
• 
  

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Sole Proprietors Insurance Costs and Definitions

Being a sole proprietor is the easiest way to start a new business. The business entity consists solely of one individual, the owner. Insurance coverage is very important for any business especially for a sole proprietor. It provides a safety net for sole proprietors in case of any unforeseen risks that occur in running the business. This is important since a sole proprietor guarantees a business with his own money as well as money from the business.

Errors & Omissions Insurance

Every business, regardless of size, should consider errors and omissions insurance. This is particularly important for sole proprietors who bear the financial burden of the business alone. This insurance covers when a business makes a mistake and the mistake causes financial harm to another individual or entity. This insurance protects a sole proprietor from having to fund the entire cost of defending against an action that occurs during work. This insurance can also be referred to as malpractice insurance or professional liability insurance. The average cost of errors & omissions insurance can vary from $500 to $2500 a year for a sole proprietor, as of July 2011.

General Liability

Another type of insurance for sole proprietors to consider is general liability insurance. This basic insurance covers injury claims, property claims and advertising claims. Most sole proprietors carry this kind of insurance since it covers all kinds of employment. Insurance companies require sole proprietors to fill out questionnaires answering numerous questions before they give quotes. Costs for general liability insurance depend on the location of the business, yearly revenue and the past claims history of the sole proprietor. It could be as low as $500 to as high as $15,000 a year for a sole proprietor, as of July 2011.

Related Reading: Sole Proprietorship & Health Insurance

Factors in Cost

There are many factors that are considered in determining the cost of insurance for a sole proprietor. These factors include the type of business being insured, the state where the business is located, the annual revenue for the business, the number of professionals providing service and whether or not there have been any claims in the past. Sole proprietors are the only individuals that need to be insured for their business, a factor that usually reduces the cost of the insurance.

Other Insurance

Besides general liability insurance, sole proprietors need to consider the cost of health insurance. Health insurance premiums can be deducted from sole proprietor's income for tax purposes. The price of a health insurance plan depends on a number of factors including the age of the individual and whether the individual smokes or is overweight. These risk factors typically lead to higher premiums. Health insurance premiums under a sole proprietor can range from $508.76 for an individual and $1,294.31 for a family as of July 2010.

ClaimPay MD - Payment Options

Need to Pay Your Bill?

ClaimPay MD offers convenient online payment by credit card or checking account. All you need is your ClaimPay MD's account number and ZIP code.

Account Billing Plan

ClaimPay MD's account billing plan* is similar to how credit card statements work. We bill you for individual insurance policies just as a credit card company bills you for purchases made at individual retail and service stores. Then we apply your payment on your monthly balance to your account, not to individual insurance policies—the same way a credit card company applies your payment to your monthly balance, not to individual purchases.

Flexible Payments
With the account billing plan, you may pay the minimum monthly amount due, the full account balance or any amount in between. If you pay more than the minimum due, we apply the difference as a credit to your account. You won’t receive another bill until the credit in your account is not enough to pay the minimum amount due..

Payment Schedule
We issue your statement at least 20 days before the payment is due. To continue your policies in force, you need to pay at least the minimum amount due. If we receive less than the minimum due, all the policies in your account could be canceled. If your policies are not canceled for the non-payment, the full account balance may be required on future billings.

View a sample personal insurance billing notice
View a sample business insurance billing notice

Electronic Funds Transfer

With electronic funds transfer, your payment is automatically deducted from your bank account each time your premium is due. No checks to write. No postage to pay. No need to worry about forgetting to make your payment.

Each payment appears on your bank statement for easy record keeping. When you use electronic funds transfer, you avoid transaction charges that are applied to monthly billings when you pay by check or credit card.

To sign up for electronic funds transfer:

• Download, print off, fill out and sign the Policyholder Authorization for Electronic Funds Transfer
• Attach a voided check or savings account slip
• Mail the Authorization Agreement and voided check or savings slip to your insurance agent

Be sure to pay the current amount due on your policy and any additional invoices you receive. This will ensure that your coverage is continued until your electronic fund payments begin.

Online Payment

If you are not set up for electronic funds transfer and need to make sure your insurance payment arrives on time, you can use your credit card (Visa®, MasterCard® or Discover®) or checking account to pay your bill online. All you need is your ClaimPay MD account number and the ZIP code shown on your billing statement. Enter your payment through our website:

Make Online Payment Now

Payment must be entered on the website by 6:45 p.m.Pacific Time, Monday-Friday (excluding holidays), to be credited to your account the same day.

The same transaction fees that apply to mailed payments are applied to each online payment. A payment entered on the website is applied to your credit card or taken from your checking account the following business day.

For website assistance, contact IT Support between 6 a.m. and 6 p.m. CT, Monday-Friday (excluding holidays).

Phone:
Toll Free:
Email: 

If you get voice mail, please leave a number where you can be reached.

If you have billing questions, contact your independent insurance agent.

Payment by Phone

To make a payment by phone, call (360)  and respond to the automated prompts. You can choose to pay by checking account, savings account or credit card.

Pay-by-phone is available to all direct-billed policyholders for standard invoices, as well as audits. Accounts currently registered for electronic funds transfer (automatic payments) are not eligible.

Payment by Mail

* Electronic funds transfer and online credit card and checking account payment are available to business insurance policyholders in the states where ClaimPay MD has business..