The role of HIPAA compliant email in the medical claims process

Email improves the medical billing process in an often complicated administrative setting when used in an effective billing protocol. 

Understanding the medical claims process

The medical claims process consists of a structured approach by healthcare providers to receive payment for services rendered to patients. After a patient receives treatment, the healthcare provider needs to document the services provided and convert them into standardized medical codes. Once coded, a claim is sent to the patient’s insurance provider, upon which approval or rejection takes place. 

A study published in the Rev Electronica Enferm explains simply how it works in a hospital setting, “Through the hospital financial administration, provision of services and,  the consumption of materials and medications, will create the hospital bill and later, they will turn into currency.”

The process is commonplace among healthcare organizations of all sizes but can come with complexities. Providers need to have systems in place to remain updated on the changes in codes as well as having an efficient system in place to avoid rejections or delays in payments. 

See also: Speed up billing with HIPAA compliant forms

The role of effective billing protocols 

An effective billing system centers around thorough training and reliable processes to record services using the correct coding. Larger healthcare organizations like hospitals often have the funds to employ technology to streamline the billing process. While this technology can experience occasional errors it makes the protocol easier than manual processes. 

Small practices experience the need to integrate more targeted approaches to maintaining a proper billing process. With tighter budgets, versatile solutions like EHRs take a dual role as tools within the scope of billings. 

How to effectively use email within billing protocols 

As mentioned above smaller healthcare organizations have smaller budgets that require the smart use of effective tools in different roles. HIPAA compliant email has minimal overhead costs eliminating the need for tailored and possibly expensive mailing systems. 

For larger organizations, emails ability to facilitate rapid communication with an invaluable document trail across various departments and insurance companies simultaneously. 

Email, therefore, has a place in any healthcare organization. 

In larger organizations 

• Set up automated email systems to alert billing staff when claims are nearing submission deadlines. 
• Integrate billing email systems with EHRs to automatically generate and send billing documents like invoices and claims once a service is recorded in the patient's chart. 
• Use email notifications to update billing staff about real time statuses of claims whether they are accepted, denied, or pending. 
• Create an internal reporting system for any billing errors where staff can immediately report and document issues during the billing process. 
• Establish separate dedicated email channels for communications with each insurance provider to streamline queries, clarifications, and negotiations about claims. 
  
  

In smaller organizations 

• Make use of secure HIPAA compliant email systems. 
• Dedicated email channels should be used for billing communications to and from patients. 
• Create scheduled payment reminders before, on the date of, and after payment due dates. 
• Send email confirmations when payments are received, both for patient benefit and to keep a record of the transaction. 

See also: Top 12 HIPAA compliant email services

FAQs

What is TPO?

Treatment, Payment, and Healthcare Operations. 

Is consent necessary to send billing emails to patients?

No, consent is not specifically necessary to send billing emails. 

What is encryption?

It is a security method that converts data into code to prevent unauthorized access.