Medical

Healthcare, like almost every other business area, deals with a lot of user-sensitive data.

Unlike many other commercial activities, providing medical services means knowing how to handle and store this highly sensitive information. Physicians and other care providers have several considerations when managing their patient data, ranging from legal compliance to cybersecurity. And data management isn’t only about ensuring that the information is secure; it ultimately can provide opportunities for greater care through insights and data analysis. Let’s take a quick look at some helpful ways healthcare providers can protect, manage, and leverage patient data.

HIPAA Legal compliance

HIPAA (Health Insurance Portability and Accountability Act) was enacted in the U.S. in 1996 to protect patient health information. It includes rules and regulations that healthcare providers, including doctors, must follow to be compliant. Here are some of the key components of HIPAA compliance:

1. Privacy Rule: The Privacy Rule restricts who can have access to Protected Health Information (PHI). PHI includes a broad array of information, from the individual’s past, present, or future physical or mental health conditions, to the provision of health care and payment for that care. Doctors must have safeguards in place to protect this information and can only disclose it under specific conditions.

2. Security Rule: The Security Rule stipulates that doctors must have physical, technical, and administrative safeguards in place to protect electronic PHI (e-PHI). This can include secure computer systems, locked file cabinets for paper records, and policies to handle data breaches.

3. Breach Notification Rule: If there is a breach of unsecured PHI, the doctor must notify the individuals affected, the Department of Health and Human Services (HHS), and in some cases, the media.

4. Enforcement Rule: This rule provides guidelines for investigations into compliance. If a doctor is found to be in violation of HIPAA, they could be subject to penalties.

5. HITECH Act: The Health Information Technology for Economic and Clinical Health (HITECH) Act was enacted as part of the American Recovery and Reinvestment Act of 2009, and expands upon the original HIPAA legislation. Among other things, it increases penalties for HIPAA violations and extends some of the requirements of HIPAA to business associates.

HIPAA violations can be quite costly for providers, with maximum penalties for noncompliance of 1.5 million dollars per incident. 

The role of data in healthcare

The digitization of medical records is far from new, with electronic health records (EHRs) being the norm in the industry for many years. Physicians and other providers collect, store, and share digital patient records, and the number of records continues to grow. The widespread use of EHRs has resulted in large data sets.

To ensure HIPAA compliance, doctors should do the following:

• Risk Analysis and Management: Regularly perform risk analysis to identify potential vulnerabilities to the confidentiality, integrity, and availability of e-PHI.
• Training: Regularly train all staff members about the importance of HIPAA compliance and how to follow the rules.
• Policies and Procedures: Develop and implement clear policies and procedures to comply with the Privacy, Security, and Breach Notification Rules.
• Business Associates Agreement (BAA): Ensure that any third parties that may handle PHI on your behalf (known as “business associates”) are also compliant with HIPAA regulations. This is often handled through a BAA.
• Access Control: Limit access to PHI to only those employees who need it to perform their job duties.
• Data Encryption: Encrypt e-PHI, both at rest and in transit, to protect it from unauthorized access.

One reason for this growth is the use of connected devices for delivering care and monitoring patient well-being. Internet of Things (IoT) devices connect patients with care providers and collect data that can help diagnose and monitor patient health.

This increased data has been shown to reduce hospital-acquired conditions and increase cost savings through innovations in billing, bundled payments and debt collection. Data can undoubtedly improve the quality of care, but it can also overwhelm providers. Data burnout is a growing problem with providers because all of the information leads to overwork. Cumbersome health records software is a culprit, and so, is the often puzzling and complicated process of navigating insurance reimbursements.

Cybersecurity practices for providers

Data security is one of the most significant risk areas of concern under HIPAA. All businesses need to pay close attention to cybersecurity. But the vast amount of collected data in healthcare, the sensitive nature of that data, and the consequences of noncompliance means that healthcare providers have to be especially vigilant. Also, cybercriminals are only getting more sophisticated, with new, unknown threats developing on a near-daily basis.

Today, delivering healthcare means providing security for patient data. Cybersecurity is not just a technical concern, it is a patient safety issue. Providers rely on health IT vendors, adding a layer of complexity, and it has become clear that while HIPAA provides a basic framework for data protection, it is not sufficient in today’s data-heavy world.

This last practice may be the most effective, as human error is most often the culprit in data loss. For example, if a person uses the same username and password combination across multiple digital services, the risk of compromised credentials skyrockets. This is because cybercriminals have had so much success in data breaches that collect user login information. So, suppose a banking login is stolen, and the same combination of credentials is used for logging into an EHR system. In that case, it’s entirely possible that a hacker would attempt logging in with the credentials. This is because vast amounts of compromised login data exist.

To avoid this one major problem, organizations can educate users on password policies and how to recognize such threats as phishing emails.

Overall, data management can be an obstacle to the delivery of care and can affect the business of healthcare. Providers should prioritize data management, as it can lessen the burden of modern medical practice, ensure compliance, and protect patient data.

Nexa has assisted several hospitals and medical professionals to recover money from their past due accounts effectively. If you need a debt collection agency: Contact us

How Health Care Providers can Successfully Navigate a Sea of Nonpayment

As anyone who’s been paying attention to discussions about the nation’s health care system will already know, there is much talk about a pervasive health care financial crisis. Much of the focus of this dialogue is centered on the perceived high cost of care, and difficulties with insurance. And, almost all of the discussion is patient and insured-centered. The financial impact of unpaid medical bills for providers is often left out of the mix, but growing medical debt is indeed a crisis for the healthcare profession as well.

And, if you look at some of the figures reported by health care providers, the problem is a dire one that can threaten the health care system in the country. Separate reports by the “American Hospital Association” and “The Hamilton Project”, part of the Brookings Institution show unpaid medical bills totaling between $40 and $57 billion dollars. These figures are shockingly huge and can represent up to 10% of a hospital or medical provider’s annual costs. Not only do unpaid bills cause a drain in a provider’s cash flow, but the collection process can be complicated and costly in itself.

The Source of the Debt

While the cost of health care has risen due to innovation and new life-saving technologies, the culprit in increased unpaid medical bills is a shift in the amount that insurance providers cover. In the past, insurance covered close to 90 percent of medical costs for those insured. Research now points to that figure sliding to 70 percent. The combination of increased cost and decreased coverage has landed both patients and providers in a sticky situation with a little sigh of relief.

So, how can hospitals and health care providers proceed if this trend persists or even gets worse? The key is not so much in reducing costs or creating an organization that can absorb receivables. Rather, the solution exists in patient relationships.

Creating a Customer Experience that is Ever-Aware of Financial Responsibility

There will always be situations where patients cannot pay for their care. Indigent patients are already accounted for by many hospitals and providers through charity care, or the practice of writing off medical bills for those who truly cannot afford coverage. Providers should include these provisions in their operations, as it recognizes ethical and moral duties to provide care that are closely associated with the tradition of medical practice. A charity care program also recognizes this inevitable truth that some simply cannot afford care for a variety of reasons, and a hospital will never be able to eliminate this source of financial drain. For example, a patient could very likely be facing a financial struggle related to their injury or condition. Even the most financially stable person can have their lives upended by unexpected medical needs.

However, many of the unpaid medical bills plaguing hospitals and providers are owed by those who have the ability to pay. This ability to pay may be uncomfortable, and the patients may not want to pay, especially if they feel that insurance should cover the expenses. For these patients, hospitals can take steps to include billing discussions in the patient onboarding and pre-procedure process.

Billing should be an openly discussed topic. That way, financial problems can be addressed at the outset. It’s not a matter of denying care, but rather shining light on cost and setting expectations about the billing process.

Decreasing Debt Through Persistency and Politeness

The keys to billing success are persistence and politeness. The collection process is an important and inevitable process for some patients, but from some patient perspectives, the collection agency is removed from their care provider, so they are more likely to simply walk away from a debt they do not want to pay. So, try avoiding the collection process from the outset. Medical debts can hit the credit report of a patient only after 180 days and have less impact than other types of debts.

Providers that fully explain a patient’s financial responsibility and encourage payment plans are more likely to see unpaid bills diminish. With a user-friendly billing practice, payment can simultaneously be in mind and also out of the way so it doesn’t become a burden to either party.

For example, Duke University Health System makes billing a priority — not through aggressive collection practices, but through strategy with the patient. Payment plans are discussed in advance, and financial problems are identified in an open and positive relationship that keeps the focus on overall care. The result? Lower unpaid bills than the national average.

This is not to say that collection is to be avoided. In fact, aggressive collections practices are necessary when patients who are able and aware of their costs refuse to pay. Hospitals should try avoiding collections when possible, but also keep in mind that collections is a key component of revenue cycle management and better cash flow. Hospitals must also be keenly aware of the complexities of insurance and train employees to analyze benefits so that there is clear communication between patients and providers. With a balance of optimized billing practices and frank and open billing discussions, providers and patients can minimize financial distress related to care.

References used:
https://www.modernhealthcare.com/article/20120106/BLOGS01/301069983/a-closer-look-at-hospital-write-offs
https://www.theatlantic.com/business/archive/2015/10/hospital-charity-care/410020/
https://www.tennessean.com/story/money/industries/health-care/2016/03/07/why-more-than-half-hospital-bills-dont-get-paid/81297202/

Hospitals and medical practices in Florida are experiencing a growing problem with those they treat: Patients aren’t paying their bills. This trend does not seem to end or reverse very soon — and it’s causing unease and financial distress for doctors, Nursing homes, LTC’s (Long term care centers), hospitals and medical practices. Hospitals are suffocating under the mounting debt of patients and have been hiring professional debt collectors as their only way out.

Need a Medical Collection Agency: Contact us  Key services a medical collection agency must offer in Florida: Compliance with Florida Collection Laws and HIPAA Regulations Amicable Patient Communication and Debt Resolution Tailored Collection Strategies for Medical Practices Skip Tracing to Locate Hard-to-Reach Patients Credit Reporting to Major Bureaus When Appropriate Flexible Payment Plan Options for Patients Secure Online Payment Portal for Easy Bill Settlement Regular Progress Reports and Transparent Account Management Pre-Collection Services to Resolve Debts Early Legal Support for Unresolved Cases, If Needed These services ensure effective debt recovery while maintaining compliance and patient relations.

Florida has one of the highest percentages of senior citizens in the United States. With age often comes more complex healthcare needs and chronic conditions, which can increase the demand for medical services and pose challenges for healthcare providers. Florida’s climate and environment contribute to specific health issues. Heat-related illnesses, tropical diseases, and health effects from hurricanes or flooding can pose challenges to healthcare providers.

Medical debt in the state of Florida

As Florida remains one of the 14 states refusing to accept the federal offer to expand Medicaid to cover the State’s most vulnerable and needy, it now ranks among the states where residents are more likely to have difficulty paying their medical bills.

In 2016 the nonprofit Commonwealth Fund, a health policy think tank and advocate for coverage, published a survey on medical debt in Florida. The survey found that 41 percent of residents had trouble paying their medical bills in the prior year, had medical debt or were contacted by a collection agency about unpaid medical bills.

Although residents of Florida reportedly already had difficulty settling their medical bills, the launch of the Affordable Care Act’s coverage expansions in 2014, worsened the problem as legislators refused to expand Medicaid resulting in mounting unpaid bills, prompting hospitals to seek the assistance of debt collectors or file lawsuits in an attempt to collect old debts even when the statute of limitation had passed.

These methods are not always fruitful as Florida hospitals are still facing extreme difficulties recouping their funds. The fact that Florida does not have any unique medical debt collection laws outside of the Florida statute of limitations which time period can be affected by numerous factors e.g. the 5 year period on debt collection for written contracts and promissory notes and the 4 year period for Oral contracts and open-ended accounts (including credit cards), puts hospitals in an extremely disadvantaged position. The patient’s credit history cannot contain medical debts entry until the invoice due date is 180 days old and the credit report must be removed once the bill is paid off by the patient or their insurance company.

The Aftermath of unpaid medical bills for Hospitals in Florida 

As a result of these numerous unpaid bills, even the most prestigious hospitals are stuck with massive bad debts. In 2015 alone, U.S hospitals accumulated almost $36 billion in unpaid medical bills. And due to the slow nature of lawsuits, the debt just keeps growing.

Many hospitals across the country don’t want to foot the bill any longer and are now experimenting with pre-payment strategies for patients, with a growing number requiring payment before scheduled care and offering no-interest loans.

The trend is expected to make progress in the upcoming years and Hospitals in the state of Florida must follow suit to stay afloat or risk closing their doors. As Florida ranks high when it comes to unpaid medical bills, hospitals will significantly benefit from a system where patients can choose from a variety of options which provides them more time to pay their bills and give certainty to hospitals.

Conclusion

Hospitals in Florida are saddled with numerous unpaid medical bills from patients. Since Florida does not accept the federal offer to expand Medicaid, these bills keep piling up. Florida Hospitals should adopt the new trend and create a payment before scheduling strategy for patients. Pandemics like Covid-19 have put a combined loss of billions of dollars for hospitals in the state.

Hire a Collection Agency

When a patient has failed to pay for 90 days despite all your efforts, hire a Debt Collection Agency without wasting more time.

Collection Letters Service of Collection Agency

The upfront cost for 5 Collection Letters is about $15 per account.  Debtors pay directly to you, no other fees. Low-cost option.  Good for accounts less than 120 days past due.

Collection Calls Service of Collection Agency

Contingency fee only. No upfront or other fees.  Agency gets paid a portion of the money they recover.  No recovery-No fees. Best for accounts over 120 days. A debt collector calls your debtor many times. If everything fails, a possible Legal Suit is recommended by the attorney.

 

The California medical debt collection process is far more complex than other states because collectors have to follow federal laws as well as the extra set of rules that state lawmakers have enacted.

While the FDCPA only covers third-party debt collectors, California’s Rosenthal Act covers any person or entity that is collecting consumer debts, including the original creditors (It means several debt collection rules and restrictions that apply to professional collection agencies also apply to your medical office ! ).

Are you sure your in-house employees are aware of these collection rules? And unfortunately, these rules keep changing over time.

Need a Medical Collection in California? Contact Us

 

In California, we strongly recommend that you or your staff should not indulge in debt collection activity other than soft reminders for the first 60 days only. Any accidental violation of debt collection laws by you can bring a lawsuit to your medical practice. Let the collection activity be done by seasoned debt collectors who are constantly trained to collect maximum money while following all the latest federal and local collection laws.

If a debtor disputes a debt within 30 days of the first communication from the collector, the collector must stop collection efforts until they provide verification documents of the debt.

What a Medical Collection Agency must Offer:

• Compliance Assurance: Adherence to California state and federal laws, including HIPAA and FDCPA.

• Patient-Friendly Tactics: Use compassionate, respectful language with patients.

• Regular Reporting: Provide consistent updates on collection activities.

• Custom Payment Plans: Flexible options to help patients settle their balances.

• High Recovery Rates: Efficiently collect outstanding debts.

• Medical Collection Expertise: Knowledge of healthcare billing and insurance.

• Secure Data Handling: Ensure patient data confidentiality.

• Technology Integration: Use advanced systems for tracking and reporting.

• Multilingual Support: Cater to patients with different language preferences.

• Dispute Resolution Skills: Handle any payment disputes effectively.

• Transparent Fee Structure: Clear and upfront pricing without hidden costs.

• Tailored Strategies: Customized approaches for different types of debts.

• Positive Reputation: Good standing with local medical providers.

• Legal Support if Needed: Assistance with legal processes when required.

California Medical Debt Collection Statistics

The overall burden of medical debt is estimated to be at least $220 billion, affecting a broader population, with about 100 million Americans experiencing some form of medical debt.

It is estimated that over one trillion dollars are owed to the medical profession due to unpaid medical expenses.

As the most populous state in the country, California gets hit hard when citizens fail to pay their medical bills. It has the highest debt in the country behind New York and Texas. To date, medical debt in California has surpassed 4.6 million dollars.

Need a Medical Collection Agency in California: Contact us

California Collection Medical Laws

California has done its due diligence to make sure that patients can receive medical treatment, regardless of their monetary stature. For instance, some patients may be eligible for payment plans without interest, and there is a cap on the amount that a patient can be charged as determined by California’s government-sponsored health care programs.

In California, the statute of limitations for breach of a written contract (i.e. the medical bill) is around four years. After this time period has passed, healthcare providers are at liberty to seek payment from patients via a California medical collection agency. However, there are certain stipulations set in place on the patient’s behalf. A hospital may not seek claims before a five-month negotiation period, which is when both parties may determine a payment plan.

Under state law, California medical debt collection agencies may not harass, threaten, mislead, or use abusive language in order to obtain overdue medical payments. They also cannot garnish wages unless the case has been taken to court and a judge has approved this method. 

Credit reporting can be done only after the debt is 365 days old and must be removed from the patient’s credit history report once he or the insurance company pays off the debt. 

Problems Faced Doctors and Hospitals in California

These protections for patients have created many problems for California doctors and hospitals. In 2016, California passed a law to eliminate “surprise billing” which ultimately made it unlawful for doctors to tack on extra charges after the patient has been discharged. This benchmarking process has doctors fearing the imminent closure of more and more hospitals. Doctors have also suffered from being let go from their insurance companies and have seen a subsequent pay decrease from hospitals.

California Insurance Information

California’s Medicaid program is referred to as MediCal. It gives the necessary monetary assistance for individuals who are

• Low Income
• Seniors
• Pregnant women
• Disabled
• Foster Care
• Diagnosed with diseases such as cancer, HIV, or tuberculosis

The California Health and Safety Code enforces the rules and regulations regarding charging patients and governing collection agencies. They ensure that a patient cannot be billed more than the amount set by MediCal. Medical providers may not turn away uninsured patients. Instead, they must offer them hospital charity care, and payment plan options and use reasonable care to determine if their healthcare provider can cover their expenses. 

To run a successful medical practice or hospital, you need to be able to get paid in full for the services you provide. If you are a doctor or work on the business side in a hospital in the state of Texas, you know the aggravation of medical debt collection. This is a problem the medical community all over the country faces but in Texas, there are state-specific challenges to deal with. Here is the current state of Texas medical debt collection.

Medical Debt in Texas

Debt, in general, is a problem in the United States and Texas is one of the “leaders” in this issue. 71 million Americans have debts that are currently in collection. Texas is second, only to Louisiana, in the percentage of residents who have debts in collection. A hefty 44% of all Texans face collection which equates to approximately 12.7 million Texas residents or, almost 18% of the total number of Americans with pending dent collection. A big portion of this debt is related to medical bills. The overall median medical debt in collections for a person in Texas is $850.

Need a Medical Collection Agency in Texas: Contact us

Texas Medical Collection Laws

Medical debt collectors in Texas are beholden to the Federal laws on the books that relate to debt collection. These can be found by looking at the Federal Trade Commission website. There are some Texas-specific laws that creditors need to know. One is that Texas is a homestead state which means, in most cases, a debtor’s home cannot be taken away to pay a debt. Also, wages can only be garnished in Texas in certain cases and unpaid medical bills are not one of them. These and other Texas laws relating to medical debt collection can be found on the Texas Attorney General’s website.

There is another, lesser-known, law in Texas that applies specifically to the timing of medical billing. A Texas civil statue states that you must “bill a patient or other responsible person for services provided to the patient not later than the first day of the 11th month after the date the services are provided.” This makes the timing of medical billing even more crucial in Texas.

Bond Requirement: In Texas, third-party debt collectors and credit bureaus must post a $10,000 bond with the secretary of state.

Communication: Under the TDCA, a debtor has the right to request in writing that a debt collector or creditor cease communication with them. Once a cease communication request has been made, the collector is limited to filing a lawsuit or discontinuing their collection efforts.

Statute of Limitations: Texas law sets forth a four-year statute of limitations for many types of debt, including credit card debt and medical debt. This means a debt collector cannot sue a consumer for a debt that is more than four years old.

Texas provides protections to consumers through state laws that align with the federal Fair Debt Collection Practices Act (FDCPA), along with some additional provisions under the Texas Debt Collection Act (TDCA)

Problems Faced by Doctors and Hospitals Texas

 While the issue of medical debt collection is not unique to Texas, many of the problems it causes here are. One of the biggest problems facing Texas doctors and hospitals is the financial viability of hospitals located in the most rural areas of the state. 131 rural hospitals across the country have closed their doors since 2010 and 23 of them (or just under 18%) have been in Texas. In addition to these hospitals that have closed, about 50% of Texas’ 150 or so rural hospitals are in financial danger.

Another challenge facing Texas doctors and hospitals is that the state has some of the largest amounts of uninsured residents in the country. There are more uninsured people in Texas than California even though the west coast state has 40% more people. These two factors are big challenges for doctors and hospitals in Texas and a major reason why medical debt is such a huge concern.