Medical billing and coding specialists work in the healthcare field and their duties include processing patient data that includes insurance information and medical records. Dealing with sensitive information on a daily basis is something medical billing and coding specialists encounter every day in their career. Security is of the utmost importance as they handle insurance, patient and provider information. They are also responsible for transferring patient medical information between electronic and physical means which is very sensitive .
A medical billing and coding specialist must be in compliance at all times. This means as an employee they must be in alignment with guidelines set before them. An easier term for compliance could …show more content…
You should only code what is documented. The codes that are recorded need to be the same as what the physician has documented in the patient’s chart. A second item that follows the rules of being complaint is to make sure codes are reported in the correct order. Failing to do so can make a claim invalid and cause the claim to be returned. It is very important to stay up-to-date with coding changes in regards to being complaint. Codes change frequently at is the responsibility of the coder to be kept abreast of the changes. Another rule one must follow to be compliant is to use the correct modifiers when needed. “Modifiers are sometimes used to identify the area of the body where a procedure was performed, multiple procedures in the same session, or indicate a procedure was started but discontinued. Modifiers do not change the definition of the procedure codes they are added to.” insert citation here This could be another reason a claim would not be compliant and could further disrupt the process of being …show more content…
HIPAA came into law in 1996 under the Clinton administration. It was developed to increase security for patient information and to hold medical professional accountable. Healthcare providers and insurance companies must follow guidelines that HIPAA established to keep patient’s information secure. Some of the guidelines that HIPAA enforces are: requirements for privacy and security for handling medical records, simplify the billing and processing of claims, guidelines for electronic transactions and electronic recordkeeping. HIPAA is known for the “Privacy Rule”. This is the rule that states a patient’s Protected Health Information (PHI) can not be shared or given to anyone that is not a provider or insurance company. PHI can not be shared with anyone outside of the medical community or health insurance platform unless the patient has given their written permission and must document who is able to access PHI. With the “Privacy Rule” also comes the “Security Rule” HIPAA is responsible for. The “Security Rule” is in place to set forth standards of collaboration to protect a patient's medical information. Providers and insurance companies must work together to keep medical information safe. They do this by using Electronic Healthcare Records and Computerized Physician Order Entry systems. HIPAA developed standards that must be followed when using
A medical billing and coding specialist must be in compliance at all times. This means as an employee they must be in alignment with guidelines set before them. An easier term for compliance could …show more content…
You should only code what is documented. The codes that are recorded need to be the same as what the physician has documented in the patient’s chart. A second item that follows the rules of being complaint is to make sure codes are reported in the correct order. Failing to do so can make a claim invalid and cause the claim to be returned. It is very important to stay up-to-date with coding changes in regards to being complaint. Codes change frequently at is the responsibility of the coder to be kept abreast of the changes. Another rule one must follow to be compliant is to use the correct modifiers when needed. “Modifiers are sometimes used to identify the area of the body where a procedure was performed, multiple procedures in the same session, or indicate a procedure was started but discontinued. Modifiers do not change the definition of the procedure codes they are added to.” insert citation here This could be another reason a claim would not be compliant and could further disrupt the process of being …show more content…
HIPAA came into law in 1996 under the Clinton administration. It was developed to increase security for patient information and to hold medical professional accountable. Healthcare providers and insurance companies must follow guidelines that HIPAA established to keep patient’s information secure. Some of the guidelines that HIPAA enforces are: requirements for privacy and security for handling medical records, simplify the billing and processing of claims, guidelines for electronic transactions and electronic recordkeeping. HIPAA is known for the “Privacy Rule”. This is the rule that states a patient’s Protected Health Information (PHI) can not be shared or given to anyone that is not a provider or insurance company. PHI can not be shared with anyone outside of the medical community or health insurance platform unless the patient has given their written permission and must document who is able to access PHI. With the “Privacy Rule” also comes the “Security Rule” HIPAA is responsible for. The “Security Rule” is in place to set forth standards of collaboration to protect a patient's medical information. Providers and insurance companies must work together to keep medical information safe. They do this by using Electronic Healthcare Records and Computerized Physician Order Entry systems. HIPAA developed standards that must be followed when using