Skip to content

HIPAA

New EFT & ACH Standards Will Streamline Payments, Create Reconciliation Problems

June 10, 2014

Established in 1996, HIPAA standards addressing major transaction types in the revenue cycle were not enough to achieve industry Administrative Simplification. Currently, less than one-half of medical claim reimbursements are made electronically. The Affordable Care Act (ACA) is pushing for transformation by implementing compliance initiatives including the mandated 5010 and Healthcare Operating Rules for EFT & ERA. These are driven by CAQH-CORE (The Council for Affordable Quality Healthcare – Committee on Operating Rules for Information Exchange).

Read More

HIPAA Healthcare Payments Educational Video

January 17, 2014

Former Health and Human Services Secretary and Governor of Wisconsin, Tommy Thompson is interviewed by healthcare payments expert, Mark Brousseau, President of Brousseau & Associates in Q&A Session #5. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) required the Secretary of the U.S. Department of Health and Human Services (HHS) to develop regulations protecting the privacy and security of certain health information. To fulfill this requirement, HHS published what are commonly known as the HIPAA Privacy Rule and the HIPAA Security Rule.

Read More

Outsourcing Healthcare Payment Functions: Not Just for Banks Anymore, But Billers Too!

December 19, 2013

Healthcare providers are now outsourcing more of their revenue cycle functions. Large banks saw this medical banking potential several years ago and moved quickly to offer added-value services such as EOB conversion and treasury management capabilities specifically for this niche.

Read More

5 Trends that will Shape Healthcare IT in 2014

December 19, 2013

The casual observer can be excused for believing that a single government web site represents the extent of healthcare technology. But behind the scenes, the following major technology trends will have a significant impact on the healthcare industry in 2014 and on revenue cycle management (RCM).

Read More

The Cloud is Loud for Financial/Healthcare Payments

September 4, 2013

A recent Gartner report highlighted “5 Cloud Trends in 2013 and Beyond”. Have you ever heard of how cloud computing aims to create “Webscale” systems, which are large configurations that have this ability to expand and contract as needed? They can be configured quickly, and yet go away quickly too. No longer are “large scale projects” a problem in a cloud hosted environment. A good example in healthcare payments would be a project to convert a large back-log of explanation of benefits forms. In this project, a large virtual cloud could be created with high capacity for a few days…then it goes away.

Read More

Don’t be afraid of HIPAA & HITECH!

August 15, 2013

Don’t be afraid of HIPAA & HITECH? Of course it’s easy to say that if you aren’t the person knee deep in interpreting the rules and regulations and building out the infrastructure of a solution. The recent Orbograph White Paper, “HIPAA/HITECH Compliance, Resiliency and Security” simplifies the concepts of following and complying with these rules. When you look at HIPAA and HITECH initially, it’s critical to start with a high level perspective. With that in mind, HIPAA is pretty much two primary rules!

Read More

A Simple HIPAA Compliant Solution for Banks Entering Medical Lockbox

June 10, 2013

Let’s say that a financial institution (FI) wants to provide a medical lockbox processing solution to its existing healthcare provider customers and/or prospective customers outside its geographic branch locations. Ideally the system would process both insurance payments as well as patient payments. In order to get into this business, particularly capturing and scanning EOBs, the FI will need to follow the rules and regulations around HIPAA/HITECH; a potentially daunting and intimidating process!

Read More