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Compliance & Certifications

Your Data. Our esponsibility.

At The Medical Biller LLC, we understand that healthcare organizations trust us with one of their most valuable assets — patient data.

Protecting that data isn’t just a process for us; it’s a promise. Every policy, every tool, and every person on our team is committed to upholding the highest standards of compliance, confidentiality, and security across every stage of the revenue cycle.

Our Compliance Framework

We adhere to globally recognized compliance standards that ensure every claim, every transaction, and every patient record is handled securely and ethically. Our compliance framework is built on three key pillars:

1. HIPAA Compliance (Health Insurance Portability and Accountability Act)

HIPAA forms the foundation of our data protection practices.

We ensure that all Protected Health Information (PHI) is encrypted, securely transmitted, and accessed only by authorized personnel.
Every team member undergoes HIPAA awareness and privacy training, ensuring full adherence to U.S. healthcare regulations.
  • Why it matters: HIPAA compliance protects patient privacy and helps healthcare providers avoid costly data breaches or penalties.

2. SOC 2 Type II Compliance

We maintain robust internal controls verified by independent third-party auditors under the SOC 2 Type II framework.

This certification evaluates how effectively we manage data security, availability, processing integrity, confidentiality, and privacy.
Why it matters: It assures our clients that their sensitive business and patient data is safeguarded through continuous monitoring and structured risk management.

Other Key Certifications & Practices

  • Business Associate Agreements (BAAs): We execute BAAs with every client and partner to maintain legal accountability for PHI protection.
  • Employee Background Verification: Each staff member undergoes background checks, confidentiality agreements, and continuous compliance training.
  • Data Encryption & Access Control: We use AES-256 encryption, multi-factor authentication, and restricted-access systems to prevent unauthorized entry.
  • Regular Security Audits: Internal and external audits ensure our systems remain resilient against new cyber threats.

Why Compliance Matters in RCM

Revenue Cycle Management involves handling sensitive healthcare and financial data every day. Non-compliance can lead to data breaches, revenue loss, and legal repercussions.

By maintaining end-to-end compliance, we help clients focus on patient care — while we take care of their billing integrity and data protection.

Our Commitment to Transparency

We believe that compliance should never be hidden behind policies — it should be visible, measurable, and accountable.
That’s why we regularly update our clients about audit results, system upgrades, and compliance milestones.
“At The Medical Biller LLC, compliance isn’t a checkbox — it’s the foundation of every partnership we build.”

Want to Verify Our Compliance Certifications?

We’re happy to share documentation or verification details upon request.

Email us at info@themedicalbiller.com to learn more about our compliance infrastructure.

HIPAA Compliant Privacy Policy

1.Introduction and Applicability

This Privacy Policy describes how The Medical Biller (referred to as “we,” “us,” or “our”) uses and discloses your Protected Health Information (PHI) to provide billing, claims, and administrative services on behalf of the healthcare providers we serve (our “Clients”). We are a Business Associate under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and are bound by the same security and privacy rules that apply to Covered Entities.

2.Our Obligation Under HIPAA
We are legally required to maintain the privacy and security of your PHI and provide you with this notice of our legal duties and privacy practices concerning PHI. We will notify affected individuals following a breach of unsecured PHI as required by federal law.
3. Uses and Disclosures of PHI

We primarily use and disclose PHI for Treatment, Payment, and Health Care Operations (TPO) as defined by HIPAA, specifically for the Payment and Health Care Operations categories:

A. Payment

We use and disclose PHI to bill and collect payment for the healthcare services you received from our Clients. This includes:
Submitting claims and encounters to health plans, insurers, and government programs.
Determining eligibility, coverage, and authorization for services.
Managing collection activities for outstanding balances.

B. Health Care Operations

We use and disclose PHI for our necessary business functions to support our Clients’ operations. This includes:
Quality Improvement: Activities related to our billing accuracy, claim submission, and denial management.
Compliance: Conducting fraud and abuse detection, and internal auditing programs.
Administration: Business planning, development, and general administrative activities necessary to serve our Clients.

C. Disclosures Required by Law
We must disclose your PHI when required to do so by federal, state, or local law.
4.Other Permitted Uses and Disclosures

We may also use or disclose your PHI without your authorization for the following mandatory and routine purposes:
Public Health Activities: To public health authorities for the purpose of preventing or controlling disease.
Health Oversight Activities: To governmental agencies that oversee the healthcare system, such as audits and investigations.
Law Enforcement: In response to a valid court order, subpoena, warrant, or similar process.
Legal Proceedings: In response to a court or administrative order.
Workers’ Compensation: As authorized by and to the extent necessary to comply with laws relating to Workers’ Compensation.Serious Threat to Health or Safety: To prevent a serious and imminent threat to the health or safety of a person or the public.

5.Uses and Disclosures Requiring Your Authorization

The following uses and disclosures of PHI will only be made with your specific written authorization:
Marketing: Marketing communications (unless permitted without authorization under HIPAA, such as face-to-face communications).
Sale of PHI: Disclosures that constitute a sale of PHI.
Psychotherapy Notes: Most disclosures of psychotherapy notes (where applicable).
You have the right to revoke an authorization at any time, provided the revocation is in writing.

6.Your Rights Regarding PHI
You have the following rights concerning your PHI maintained by us (as a Business Associate). You must generally direct these requests to your healthcare provider (our Client), who is the Covered Entity: