Confidentiality: What Is Its Role in Medical Billing?

Posted on June 17, 2010

While everybody is aware that doctors and their staff are subject to certain laws and regulations regarding their health care information, you may not know how that translates to supplemental positions within the health care profession.  For example, how safe are documents that are seen and processed by those in the field of medical billing and coding?  Do these workers have any responsibility in the area of patient confidentiality?  If so, how do you know they’re reliable?  Or if you’re entering into such a position, you may wonder what your duties are when it comes to handling such sensitive information.

To begin with, all health care professionals are subject to the same rules and regulations (including federal laws and any additional laws particular to the state of practice) as doctors, nurses, and anyone else involved in patient care or in direct contact with patient information.  On the level of federal regulations, this includes the Health Insurance Portability Accountability Act (HIPAA), which mandates confidentially concerning a patient’s medical history, including conditions, treatments, and test results, as well as extending to family records, physician visits (and anything said during those visits), and financial information.  In other words, what happens in the doctor’s office stays in the doctor’s office.

The scope of this act is broad, including virtually anyone who comes into contact with your medical records, whether they are employed by a private practice, a public facility such as a hospital, an insurance company, or even if they are freelance workers who contract to the medical profession.  This most definitely includes those that specialize in medical billing and coding, and is especially important to the integrity of the profession, since they are responsible for the transfer of information between doctors and insurance companies.  In addition, anyone who handles medical information is required to sign confidentiality and non-disclosure agreements.  Those who break the law and/or their contracts are subject to prosecution.  Unintentional violations can lead to fines up to $50,000, while more serious infractions, including offenses in which individuals knowingly obtain information with the intent of disclosing it (for commercial or personal gain, or in order to cause malicious harm) can lead to fines of up to $250,000 and/or imprisonment for up to 10 years.

But how sure can you be that your sensitive and private information does not get into the wrong hands?  After all, in an era of electronic transfer, where information can be plucked from the ether, it’s not outside the realm of possibility that someone could steal your information despite the best efforts of the people trying to secure it.  Luckily, with the advancement of technology, measures have been put into place to ensure that your data is transferred safely (and completely intact).  There are several options available to those who engage in medical billing to guarantee the privacy of information.  Before files are sent out, they can be encrypted and password protected.  Those in the medical profession take their jobs very seriously and understand the legal and ethical ramifications of dealing with patient confidentiality.  While nothing is life is certain (besides death and taxes), technological advances have virtually ensured that your private information can be handled, transferred, and stored with the utmost attention to security.