Relating HIPAA to Billing

Topics: Health Insurance Portability and Accountability Act, Health care, Health insurance Pages: 4 (1248 words) Published: September 21, 2013

Relating HIPAA to Billing
HCR 220
April 22, 2012

Capstone CheckPoint
“The” central point” of medical services, and operations, is the “federal government’s” organization, the Centers for Medicare and Medicaid Services (CMS). This affiliation is a component of the Department of Health and Human Services (HHS). One of the priorities of CMS is to analyze efficiency, and productivity in assorted “health care management, treatment, and financing” functions. CMS guidelines are pivotal to success, and compliance in “health care” delivery, and billing. Carriers will usually alter their regulations to support that amended by Medicare. Another credit to CMS is the enforcement of “the most important recent legislation, or the Health Insurance Portability and Accountability Act (HIPAA) of 1996. Among the multiple assignments of this law is to “protect” personal “health information” detect “fraud and abuse,” and construct criterions for (composing, dispensing, maintaining and retrieving) protected health information (PHI) on “patient records,” especially those originating “electronically” (Valerius et al., p. 45-46). Several provisions within HIPAA concentrate on patient confidentiality; such as concealing, and preserving the integrity of “individually identifiable health information.” This practice will be observed by the “administrative, technical, and physical” realm of the office, in an effort to hinder infiltration, and unapproved exposure to such. Additionally, the “The Safeguards Principle in the Privacy and Security Framework” focuses on the “electronic” record, and restrictions for sharing of for “treatment, payment, and operations (TPO) (The United States Department of Health and Human Services, 2012 “Health Information Privacy”). The Privacy Rule’s safeguards commands the “reasonable” safety of “PHI from “intentional or unintentional use or disclosure,” which deviates from the Privacy Rule. This statute...

References: Healthcare Common Procedure Coding System. (2009). In Taber 's Cyclopedic Medical Dictionary. Retrieved April 22, 2012 from
 The United States Department of Health and Human Services. (2012). Health Information Privacy. Retrieved April 22, 2012 from
Valerius, J., Bayes, N., Newby, C., & Seggern, J. (2008). Medical Insurance:
an Integrated Claims Process Approach (3rd ed.). Boston, MA: McGraw-Hill.
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