HIPAA – Insurance


( Health Insurance Portability and Accountability Act )

Also See other essentials from the links below.


Health Insurance Portability and Accountability Act (HIPAA) was introduced in 1996. The Act’s primary goals are to guarantee that health insurance coverage is :

  • Available to workers and their families when they change or lose their jobs.
  • Standardize the data content and format for electronic transactions (administrative simplification)
  • Privacy of confidential personal health care information
  • Secure physical access to records and national identifiers for providers, employers, and health plans.

Federal and State laws, including HCFA regulations, were formulated to prevent fraud and abuse in the health insurance industry, especially in Federal programs such as Medicare and Medicaid.

There are established laws, rules, and regulations that govern medical billing. Disregarding or a breach of these laws and regulations, in the course of our billing operations, can result in one or more of the following:

  • Rejection of claims
  • Delay in reimbursement
  • Reduction in reimbursement

Sterling HCS adheres to these rules and complies with Federal and State laws concerning such corporate activities.