Medical Billing Resources, Inc.

There has been a great deal of attention paid to compliance issues related to healthcare billing regulations. The Office of the Inspector General (OIG) released guidelines designed to assist organizations that prepare claims for medical services rendered by the nation’s healthcare providers. These guidelines are provided as a method of preventing fraud, waste and abuse.

The nature of the services which Medical Billing Resources (MBR) provides, and the third party relationship with its clients provides unique challenges in developing and maintaining a compliance program that will promote adherence to applicable federal, state and private healthcare program requirements. MBR supports a variety of healthcare providers, with many specialties and consequently different statutory and regulatory frameworks. It is with this in mind that MBR coordinates these efforts with it’s clients. The key to a successful compliance program is open and frequent communication.

The development and enforcement of a compliance program helps to protect both MBR and its clients from fraud and abuse related issues.

In response to the obvious importance of this issue, MBR adopted a position of strict compliance with all regulations that affect the proper billing and collection of healthcare services. All possible efforts are made to ensure that the company, and it’s clients adhere to regulations in an effort to avoid exposure to fraud and abuse issues. Although MBR provides its billing services primarily based upon the data supplied by the clients, it has developed a compliance program that guides and monitors it’s ability to review this data and advise it’s clients. Routine communication with each of the company’s clients regarding current and future regulations is considered essential. MBR has always provided management reports to its clients that highlight problematic areas that need to be addressed. These reports now become an integral component of our overall compliance effort.

An effective compliance program provides a mechanism that brings public and private sectors together to reach mutual goals of reducing fraud and abuse, improving operational efficiencies, improving the quality of, and reducing the cost of healthcare. Attaining these goals provides positive results to business, government, and individual citizens alike, in addition to fulfilling the legal responsibility to ensure the submission of accurate claims to government and private payers.

All MBR employees are committed to maintaining compliance with all regulations governing the services the company provides to its clients. Each employee is inserviced toward becoming familiar with all aspects of the company’s comprehensive compliance program, and is instructed toward that end. MBR administration is dedicated to promoting the integrity of the company’s varied services, and has every confidence that it’s customers are supplying it with accurate and regulatory compliant data.

	HIPAA

The Internet poses unique opportunities and challenges to the healthcare industry. It enables the industry to lower transaction and operational costs while providing better service to customers, business partners, and physicians. Leveraging an open network such as the Internet also raises concerns about the privacy of individually identifiable patient information. To address these security concerns, the United States Congress passed HIPAA “The Health Insurance Portability and Accountability Act”, a set of standards that simplify electronic transactions and define minimum requirements for network security. As healthcare organizations strive to leverage the Internet, they need to deploy a security architecture to meet government regulations and ensure the trust of patients. The Administrative Simplification section of HIPAA is designed to improve the efficiency and effectiveness of the healthcare system by standardizing the electronic data for specified administrative and financial transactions, while protecting the security and confidentiality of that information. As a healthcare provider it is important that you prepare for, and remain compliant with HIPAA regulations. It is advisable that you create forms informing your patients about your policies in regards to their medical information. In addition, consent forms are needed addressing other disclosures such as transfer of record, referral or consultation, etc.. There should also be a separate consent form for the patient to sign indicating the use and disclosure of all protected health information. A copy of this must be forwarded to your billing company to be kept with the patient’s record. Patients have the right to request restrictions on the use of their protected information. It is imperative that health care providers work closely with their billing partner on this issue. All entities need to be compliant. Noncompliance will put all parties at risk. MBR is committed to the privacy of all patient’s protected health information (PHI), and the security of that information as it relates to transmission. MBR is committed to meeting all requirements of HIPAA regulations. The company has developed a comprehensive HIPAA compliance program. Our employees receive well-structured training in this regard. The program provides two types of training. The first is general, addressing all aspects of HIPAA. A “company developed” manual is utilized that addresses the company mission statement, a HIPAA overview, key HIPAA definitions, specific issues and processes, details concerning privacy/security/electronic standards, and a host of web-sites that provide meaningful reference. The second form of training is more specific to the individual employee’s functions with-in the company. MBR will continue to ensure compliance, and continue to keep of clients informed of it’s progress and any issues that may affect them. Our compliance officers are always available to answer any questions, or address any concerns.