HIPAA Billing Compliance & Regulations

Medical billing portals generally need to incorporate PHI (Protected Health Information) that is strictly regulated by the government, especially when it's stored in a digital format. The official regulations require HIPAA compliance for all data that is classified as protected health information. The aforementioned obligation spans multiple different facets of electronic and digital security, focusing heavily on HIPAA privacy and security rules. Those particular principles are greatly involved with HIPAA-compliant medical billing software.

The underlying reason is the presence of highly sensitive personal and contact information about patients who are being billed for services completed at a medical facility. Patients will usually want to review the billings and access certain details about what occurred at that particular appointment or procedure they underwent and resulted in the billings. As a result of that, the data not only includes the person's contact information and their interaction with the medical facility, but specifics of what actually took place (such as name of medical procedure or type of administered medicine).

This kind of personal medical information may be part of the reason patients visit a HIPAA-compliant portal. Therefore, it's extremely important that access to this information is limited in scope to only those who absolutely need to receive it and always per the HIPAA security rules. The general concept is that such information is imperative to be encrypted at rest and all access must be logged. The system itself logs what data was accessed, by whom, and timestamps any changes to the information. Every time a content change occurs, the log is updated to reflect the previous state, the changed state and who performed the action.

Capabilities of a Medical Billing Portal & Security

From an architectural perspective, it's difficult to go back and add key functionality that should be part of the core medical billing portal. In other words, if a capability is not already there when the portal is built, it's probably going to be quite challenging to incorporate at a later time.

Key functionalities for HIPAA compliance include the ability to:

• Log and track every single transaction
• Restrict access to certain data by role
• Immediately remove access to data based on removing a role
• Delete any sensitive user data or PHI upon a patient’s request
• Maintain the functionality of the system when the above actions are performed

Additionally, it's necessary to look at the hosting and infrastructure itself to make sure that all of the data is stored in an encrypted fashion at rest. The physical application files are to be saved on an encrypted storage device. In case any of the resources are penetrated or made available through some form of security breach, their independent encryption will preserve data safety.

There are multiple layers of encryption and security to prevent Inadvertent access to patient information. Medical billing portals are typically configured with relatively lightweight information to be able to access the account. Usually this is getting to be a full name, a date of birth, and some form of case number. The above information may vary among medical billing portals, depending on what makes the most sense for the business and the desired customer experience.

However, there are a few standard fields that patients would need to fill in whenever they visit the medical billing portal; that information can be associated with an account for easier access. Upon association, patients will be able to sign up for a user account with a unique username and password. But the usual way of user interaction with the system is by providing certain fields that tie back to a non-PHI key.

This key can be used to look up the PHI data that's in a secure HIPAA API (Application Programming Interface). Essentially, we only deal with a key value whenever we're going through this application. What that key value provides is a patient identifier, which is linked to this particular patient, and can be used to access data that's securely stored in the HIPAA system.

To sum up, whenever that call is going across the wire to the HIPAA compliant system, it's vital to be encrypted and incorporate proper IP blocking restrictions. This ensures that only the IP address of the web application can reach into the HIPAA API server environment, which in turn needs to demand the presence of a valid private key.

We're identifying the patient by a unique identifier while sending a private key that only the web application secretly has stored within it so that it's encrypted. We’re also blocking all IPs from accessing the API endpoint, with exception of the web server itself that's hosting the web application for the medical billing portal. Ultimately, the infrastructure that's used on the HIPAA API needs to be virtually impenetrable because that's what's going to house the actual sensitive data.

By extension, there needs to be an exclusive whitelist or unique hole in that security, reserved for the web application only. Multiple layers intertwine to secure the system:

• A unique patient key
• A private key for the application
• A whitelisted IP address
• Some form of authentication whenever we're making a call to that API endpoint

This combination of layered security features makes it gravely challenging for anyone to penetrate or otherwise breach the integrity of the HIPAA API endpoints. Our site features a number of in-depth articles and detailed content on automated penetration testing tools that we recommend.

• Medical Billing Portal Overview
• Medical Billing HIPAA Compliance & Regulations
• Meet PHI Data Regulations with Data Tokenization
• HIPAA-Compliant Billing Software
• Portal Security and Penetration Testing Best Practices
• HIPAA-Compliant Database Software
• Sensitive Information Access Levels & Protection
• Administrative Security Measures Best Practices
• HIPAA-Compliant Web Hosting
• EMR Integration Solutions
• Secure Email Communication and Data Privacy
• Including Patient Insurance Providers and Physicians
• Integration Options for Medical Billing Portals