I currently file claims electronically. Could I avoid HIPAA if I hire a billing service to file claims for me or if I revert to filing only paper claims?
You cannot avoid the HIPAA requirements by hiring another entity, such as a billing service, to conduct these transactions electronically for you. And, while you could revert to conducting solely paper transactions, doing so would have many negative effects for most physicians. Your business processes would be disrupted by having to prepare paper claims and check eligibility and claim status by telephone. You would also incur unnecessary costs. For example, a paper transaction today can cost anywhere from $5 to $15 compared to 85 cents to $1.25 each for electronic transactions. Reverting to paper would also cause particular problems for you if you receive Medicare payments. First, you would experience delays in receiving payments, because Medicare by law cannot pay paper claims until 28 days after receipt (as opposed to 14 days for electronic claims). Second, effective October 16, 2003, Medicare is prohibited by law from paying paper claims except for those from small practices (those
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