Is EZClaim HIPAA Compliant? How to Check (2024 Update)

✅ EZClaim states on their official website that they are a HIPAA compliant Revenue Cycle Management software suitable for use in healthcare.

EZClaim Medical Billing Software streamlines healthcare professionals' billing processes. It automates claim submissions, tracks payments, and manages denials. With user-friendly interfaces and robust reporting, it enhances efficiency, reduces errors, and accelerates reimbursement. EZClaim enables accurate medical billing, ensuring healthcare providers focus on patient care while optimizing their revenue cycle management.

They state on their website that EZClaim is HIPAA compliant which is clearly a positive sign, but the Health Insurance Portability and Accountability Act (HIPAA) legislation states that you can’t stop here and you need to thoroughly vet the vendor.

According to the HIPAA rules for Covered Entities and Business Associates:

'If a covered entity engages a business associate to help it carry out its health care activities and functions, the covered entity must have a written business associate contract or other arrangement with the business associate that establishes specifically what the business associate has been engaged to do and requires the business associate to comply with the Rules’ requirements to protect the privacy and security of protected health information. In addition to these contractual obligations, business associates are directly liable for compliance with certain provisions of the HIPAA Rules.'

Source: https://www.hhs.gov/hipaa/for-professionals/covered-entities/index.html

Below we provide some general guidelines on how to first quickly screen this vendor for the HIPAA compliance fundamentals, and if all initial checks pass successfully, then to proceed and do your own in-depth audit to ensure that this vendor will qualify as your HIPAA-compliant Business Associate.

Quick Check on HIPAA Compliance Fundamentals for EZClaim

A. Does EZClaim claim to be HIPAA compliant?

✅ They communicate they are HIPAA compliant which is a positive sign, as they legally commit from their side using such public statements.

'Yes, EZclaim is HIPAA compliant.'

B. Does EZClaim sign a Business Associate Agreement (BAA)?

✅ They state they will sign their standard BAA with covered entities/business associates, which is again a good sign because if they don’t sign a BAA then it’s a deal-breaker for HIPAA compliance.

'This Business Associate Agreement (“Agreement”) is made and entered into as an integral part of the Services Agreement to which it is attached.'

C. Does EZClaim claim they take measures to keep patient data private & secure?

✅ They publicly outline various of the privacy & security safeguards they have in place, but these can be very broad statements and you need to check the low level details here.

'We follow generally accepted industry standards to protect the personally identifiable information as well as the financial data submitted to us, both during transmission and once we receive it.'

Vendor Audit for Checking if EZClaim is HIPAA Compliant

There is no one-size-fits-all set of requirements when selecting a 3rd party vendor as one of your HIPAA-compliant Business Associates, but here are some general guidelines:

1. Eligible Plan

First, you need to determine on which plans they offer HIPAA compliance and whether pricing makes sense for you:

You need to contact the vendor directly about which plans are eligible for HIPAA compliance.

2. Legal Contracts

Then, you need to carefully review & sign their legal contracts, especially their Business Associate Agreement and Terms of Service (ask them for the latest versions - in some cases, you might need to sign an NDA):

EZClaim’s Business Associate Agreement
EZClaim's Terms of Service
EZClaim's Privacy Policy

3. HIPAA Safeguards

4. PHI Access

5. Re-assessment

Finally, at least once a year, reassess whether or not the vendor is still in compliance with HIPAA.

Source 1: U.S. Department of Health & Human Services HIPAA Privacy Rule Guidance Material
Source 2: U.S. Department of Health & Human Services HIPAA Security Rule Guidance Material

Final Remarks on EZClaim’s HIPAA Compliance Status

HIPAA compliance has no one-size-fits-all vendor assessment methodology but we have covered here various best practices on how to thoroughly evaluate EZClaim for HIPAA compliance, so that they can be eventually trusted to process or store your sensitive patient data.

Regardless of the above, for all your 3rd party vendors, you need to follow the fundamental HIPAA principle and always disclose to them the 'minimum necessary' information, which means only disclosing the amount of PHI you absolutely have to.

If you follow the 'minimum necessary' principle and you regularly evaluate your 3rd party vendors for their commitment to the HIPAA standards while having solid Business Associate Agreements with them in place, then you can minimize the risk of a potential HIPAA violation and decrease the probability of a damaging data breach happening in the first place.