HIPAA Privacy Policy

WellspringRCM is committed to protecting the privacy and security of your protected health information (PHI) in compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and all applicable regulations. This HIPAA Privacy Policy explains how we use, disclose, and safeguard your health information.

What is Protected Health Information (PHI)?

PHI refers to individually identifiable health information that relates to your past, present, or future physical or mental health, the provision of healthcare, or payment for healthcare services. This may include, but is not limited to:

• Medical history

• Treatment information

• Insurance details

• Billing and payment records

How We Use and Disclose PHI

We may use or disclose your Protected Health Information (PHI) for the following billing-related purposes:

• Claims Submission & Payment – To prepare, submit, and manage claims with insurance companies and payers to ensure timely reimbursement for healthcare services.

• Billing & Reimbursements – To process patient statements, payments, adjustments, and insurance reimbursements accurately.

• Revenue Cycle Operations – To perform audits, denial management, compliance reviews, quality checks, and staff training to improve billing accuracy and efficiency.

• Eligibility & Benefits Verification – To confirm patient insurance coverage, benefits, co-pays, and deductibles prior to claim submission.

• Coordination with Providers – To communicate with healthcare providers regarding documentation, coding, or medical necessity requirements for accurate billing.

• Appeals & Dispute Resolution – To prepare and submit appeals, reconsiderations, and supporting documentation in cases of claim denials or underpayments.

• Collections & Payment Follow-Up – To contact patients or payers regarding outstanding balances, claim status, or payment arrangements.

• Data Reporting & Analytics – To generate financial and operational reports for providers, including key performance indicators (KPIs), payment trends, and denial patterns.

• With Your Authorization – For any use or disclosure outside of billing, collections, or required compliance, we will obtain your explicit written consent.

Safeguards to Protect PHI

To protect your PHI, we have implemented strong administrative, physical, and technical safeguards, including:

• Secure servers and encrypted data storage.

• Role-based access restricted to authorized billing personnel.

• Regular monitoring, compliance reviews, and system audits.

• Ongoing employee HIPAA privacy and security training.

• Policies and procedures to prevent unauthorized disclosure.

Contact information:

If you would like to contact us to understand more about this Policy or wish to contact us concerning any matter relating to individual rights and your Personal Information, you may send an email to info@wellspringrcm.com.