I have been encountered with a tricky BA question and hope someone can provide some insight.
Insurance companies engage certain agencies to audit provider records to verify if what the hospital billed was correct and if the insurance company has overpaid. Since these audit agencies are engaged by the Insurance Companies they will be the BA of the Insurance companies. However, they are going to a provider facility to verify the records, My questions are: 1. Are they allowed to do this under the HIPAA law? If yes, what type of relationship will they have with the provider? 2. If a payer engages an agency to audit provider records does the payer become the BA of the provider? Regards, Vikas --- The WEDI SNIP listserv to which you are subscribed is not moderated. The discussions on this listserv therefore represent the views of the individual participants, and do not necessarily represent the views of the WEDI Board of Directors nor WEDI SNIP. If you wish to receive an official opinion, post your question to the WEDI SNIP Issues Database at http://snip.wedi.org/tracking/. These listservs should not be used for commercial marketing purposes or discussion of specific vendor products and services. They also are not intended to be used as a forum for personal disagreements or unprofessional communication at any time. You are currently subscribed to wedi-privacy as: [EMAIL PROTECTED] To unsubscribe from this list, go to the Subscribe/Unsubscribe form at http://subscribe.wedi.org or send a blank email to [EMAIL PROTECTED] If you need to unsubscribe but your current email address is not the same as the address subscribed to the list, please use the Subscribe/Unsubscribe form at http://subscribe.wedi.org
