Patient information is crucial for medical billing, as it is a part of the process that contributes to a reasonable revenue.

At the same time, this information is extremely sensitive and open to misuse.

To protect valuable data and provide complete integrity, healthcare providers must be HIPAA compliant.

HIPAA-compliant medical billing lays the foundation for absolute security and trust among patients. It is indeed an integral part of medical billing.

When healthcare providers choose medical billing software, HIPAA must be on their priority list.

HIPAA medical billing software is not only for the safety of patient information, but it also protects healthcare providers and practices from reputational damage.

If you are a healthcare provider unaware of HIPAA and its role, then this blog is for you.

This blog will bring attention to the importance of HIPAA medical billing software. Together with this, the blog highlights major factors that healthcare providers must ensure while choosing medical billing software.

What is HIPAA

Health Insurance Portability and Accountability Act, (HIPAA), is a regulatory safeguard meant for medical billing. It is imposed on all healthcare providers and practices to protect patient information from unauthorized use.

Established in 1996, HIPAA aims to reinforce the privacy, security, and confidentiality of patient information collected for record-keeping in medical billing.

HIPAA compliance is mandatory for healthcare practices or individual practitioners who incorporate Protected Health Information (PHI) in their medical billing system.

This means they must follow standards and fulfill regulatory compliance during different steps of medical billing. 

There are three different rules under HIPAA, and they are:

Privacy Rule

This rule sets the standard for usage and disclosure of patient data to protect PHI. Only when the patient gives access to information the data can be further accessed by someone else.

Security Rule

This rule highlights the fact that healthcare practices must maintain the confidentiality of the PHI. Along with that, they must regulate its accessibility for ultimate security.

Security rules involve certain guidelines or laws to prevent data breaches with various safeguards such as physical, technical, and administrative safeguards.

Healthcare providers must keep a record of their safety approach under HIPAA compliance.

Breach Notification Rule

This rule is meant to manage cyber-attacks and underlines the ways to report the breach.

Healthcare providers and practices must also report any violations under this rule other than following the guidelines to protect patient information.

Consequences of Non-Compliance with HIPAA

HIPAA dictates various aspects of patient information protection to prevent misuse of any kind.

That is why failing to keep up with HIPAA and not fulfilling the requirements is essential to avoid the consequences.

In the case of failure, the consequences can be anything from hefty penalties to legal action. Another, heavy damage that healthcare practices may have to bear is reputational damage.

To save the organization from all this, healthcare providers always make sure to meet compliance.

Now that we know about HIPAA, it’s time to learn about HIPAA medical billing software.

We know that patient information is sensitive, and its protection is significant. We cannot ignore the requirement of HIPAA even when choosing medical billing software.

Instead, the software must be HIPAA compliant to protect healthcare providers from the repercussions.

There are two major reasons why HIPAA compliant medical billing is essential, and they are:

  • The medical billing software allows the electronic submission of claims and comes under PHI, leading to the HIPAA rule coming into force.
  • Medical data holds various vital records and details that must be kept safe from third parties.

Medical billing is challenging and that is why healthcare providers choose to use medical billing software for their administrative functions. However, before deciding they must consider HIPAA compliance and select optimized software.

So here are the things that HIPAA medical billing software must take care of:

HIPAA Medical Billing Software: A One-on-One Guide

PHI contains every aspect of patient's data, including their personal information, medical treatment, and ailments.

The need for protection arises as the patient’s address and payment information are also a part of this data.

The first point will be that medical billing software must recognize HIPAA and follow all rules to be compliant. This involves maintaining confidentiality, integrity, and availability of PHI.

If the software is compliant then it is good, but you must also check for additional safeguards to be great for a healthcare practice or a provider.

There are three types of safeguards that together make HIPAA effective for a healthcare practice and they are:


The administrative safeguards are related to the privacy rule and all it means to lay down various legal practices. All the rules must be followed to handle PHI accurately and this is the responsibility of people who work with medical billing software.

This is all about realizing the responsibility of protecting information and healthcare providers must ensure this.


Physical safeguards are about the security of the hardware where the PHI is recorded. This is related to maintaining the security of the premises. The goal is to protect those servers where patient information is stored.


Technical safeguard is the responsibility of medical billing software. Healthcare providers can trust HIPAA medical billing software to take care of technical safeguards.

This involves setting up a complete network security system to scrutinize incoming and outgoing traffic. It must lay down an encryption plan for two-step authentications.

The HIPAA medical billing software must also reinforce transmission security and manage emergencies.

Together with all this, patient information must be secured with a unique ID and assigned security responsibility.

Bottom Line

HIPAA medical billing software is not just a feature, but it is a necessity for healthcare providers to improve their medical billing.

Software that offers a complete range of features is truly essential to protect patient information.

Unify Medicraft is the ultimate medical billing software for your healthcare practice. It is HIPAA compliant as it incorporates all the aspects of safety and security.

It is ensured that no patient data is leaked with all technical safeguards in place. So, improve your security and prevent patient information from being misused with HIPAA medical billing software – Unify Medicraft!