The Essential Guide to HIPAA Compliant Call Centers

Introduction

If you are a healthcare organization and are unsure whether your call center is HIPAA compliant, then this guide is for you! Healthcare call centers offer the same services and use the same calling features as a standard call center; however, they need to be HIPAA compliant in order to operate legally without jeopardizing sensitive patient information data. So how can you be a HIPAA-compliant call center? What features and security measures do you need for the same? Keep reading to find out!

What is a HIPAA Compliant Call Center?

HIPAA, or the Health Insurance Portability and Accountability Act, is a law that has set guidelines for organizations or companies dealing with protected health information (PHI).

Under this, most guidelines fall under security and privacy, and these guidelines dictate how PHI should be handled and recorded within the call center or company and how it should be shared with providers, staff, and vendors. 

So HIPAA-compliant call centers are essentially those that comply with and have implemented HIPAA guidelines, such as protecting passwords, encrypting data, and securely storing data as opposed to a standard call center. 

Keeping patient data secure is the only major thing that makes a HIPAA call center different. Rest, all the functionality, such as offering answers to customer questions, transferring calls, etc., remains the same. 

How HIPAA Compliant Call Centers Work? 

HIPAA-compliant call centers work just like any other call center, except for one thing- they deploy rules and procedures that keep confidential patient information or PHI safe at all cost. For this, they train their staff, give limited patient communication access to staff, and have a secure backup system, facility access control, and workstation security, among other things. 

Apart from keeping patient information secure from their end, they also implement HIPAA-compliant call center software to make sure that patient communication is being done as per the HIPAA guidelines. This includes encrypting calls and patient chats, securing call recordings, getting a business associate agreement (BAA) on your behalf, and more. 

Key Features of a HIPAA-Compliant Call Center Software

Call Center Software Capabilities: 

Advanced call routing

Advanced call routing in healthcare call centers can intelligently route calls to the most appropriate person based on pre-defined rules or real-time patient input. Calls can be routed based on factors like the nature of the call, agent skillsets, patient history, agent availability, etc. so that the callers can receive the best resolution. For example, a person calling regarding their appointment can be redirected to the appointment team, while a patient calling for billing-related issues, can be redirected to the billing team, and so on. 

Call pop

Call pop is an interesting feature that gives you the details of the patient calling you based on their previous information that was stored in your EHR/PMS tool. Using it, you can see details like their contact information, previous conversations, insurance information, previous diagnosis, etc. during a live call and help in improving the first call resolution rate of your healthcare call center. 

Integration with EHR/PMS to reduce AHT

A HIPAA-compliant call center software can easily be integrated with your existing EHR/PMS etc., and can help you in easily retrieving patient information. Because of this, agents can quickly access billing details, appointment schedules, and medical history and easily update patient information on a live call without switching multiple tabs. This helps in offering quick resolution to patients, thereby reducing AHT. 

Call monitoring for coaching agents

Best HIPAA-compliant call center software comes with advanced call monitoring features that help managers in coaching agents. This includes:

• Call barging: This feature allows the supervisor to join a call midway. This can be very useful in situations where an agent is stuck in a complex situation and needs the guidance of their supervisor to offer a better resolution to the patient. 
• Call whispering: This interesting feature allows the supervisor to join a live call with an agent without the patient being able to hear them. The call whispering feature can be very useful in training new agents and guiding them through challenging calls. 

Advanced queue management

This advanced HIPAA-compliant call center feature uses smart routing rules based on factors like agent availability, skill sets, type of query, urgency of call, etc., and then places the caller in the queue accordingly. For example, an urgent call may be given top priority and will be placed at the top of the queue, while less important calls, such as routine inquiries, are given low priority and are directed towards less busy agents. 

Omni-channel support

Although many people prefer getting in touch with call centers via call, there is a good percentage of people who do not. As such, look for a HIPAA-compliant call center that offers omnichannel call center support through phone calls, chat, and email. For non-urgent matters or general queries, you can offer resolution to patients via chat or email and keep your phone lines open for more pressing issues.   

Call analytics and reporting

This feature can give you access to key metrics and data like resolution rate, wait times, missed calls, call volume, etc., and help you get valuable insights on how your agents or team is performing, thereby helping you improve patient experience over time.  

Automatic call distribution

This cool feature can distribute calls automatically to the next best available agent based on patient input. This helps in reducing hold time in queues and ensures all your resources are being fully utilized.

Call recordings 

Being able to record and access agent calls can help supervisors and managers in accessing call quality, compliance, and training. This can be used to review agent performance and can also be used to address disputes, if any. Having said that, a call center for healthcare should offer security features to ensure that patient information and PHI are not compromised when accessing call recordings. 

HIPAA-Compliance related features

Secure communication channels

HIPAA-compliant call center software should use secure communication channels while calling or texting. This includes the use of strong encryption protocols for data in transit and at rest. Additionally, SMS and calls containing PHI should be encrypted end-to-end and should not be allowed any unauthorized access. To learn more about this, you should know about ways to stay HIPAA compliant and should have knowledge about HIPAA-compliant texting.   

Access controls 

HIPAA call center software must have access control features. This includes:

• Automatic session timeouts: This logs off a user automatically after a certain period of inactivity to prevent unauthorized access.
• Audit trails and logging: This tracks access to PHI and other sensitive data with user activity logs and can be used to find the culprit in case of any breaches.
• Granular permissions: This allows you to have complete control over who can access what.
• User authentication & encryption: Encryption ensures that sensitive patient information exchanged is encrypted during transmission. User authentication ensures that certain patient information can be accessed only via passwords, biometrics, etc.
• Multi-factor authentication: This requires users to put in two or more passwords, codes, etc., to access sensitive data.
• Role-based access control: This is the most important access control that HIPAA call center software should offer. This feature restricts access to PHI based on the role of the user in your organization. For example, Emitrr, a HIPAA-compliant call center software, offers access control on three levels: Owner, manager, and member, using which you can edit and control different permissions for different levels of users. Here’s how it looks: 

Audit Logs

Audit logs are detailed records that track all interactions and actions within a system. These essentially help in ensuring compliance and help in quality control by tracking user activity, system performance, etc. Here are different kinds of audit logs in a healthcare call center:

1. Call handling & routing logs

• What they track: Keeps track of call routing details, such as which agent or department received the call, where it was transferred, reason for escalation or transfer, etc. 
• Why they matter: This helps in identifying which patient calls are being routed incorrectly and helps in improving operational workflow. 

2. Call interaction logs

• What they track: These logs track call interaction details, such as time duration of calls, patient information, the agent involved, etc.
• Why they matter: They help in accessing the quality of customer service offered to the patients and in ensuring all calls are handled within the HIPAA or legal framework. 

3. Compliance logs 

• What they track: These track logs related to healthcare regulations such as compliance, HIPAA, patient consent, etc. 
• Why they matter: They ensure that call centers are adhering to healthcare laws and regulations and help them avoid lawsuits and hefty penalties.

4. Data modification logs

• What they track: These logs include changes made in patient data or their sensitive information. This shows who made the changes, what was changed, when it happened, etc. 
• Why they matter: These logs help healthcare providers offer transparency in case they are questioned about mistakes, frauds, or data alteration. 

5. Access & authentication logs 

• What they are: This shows logs, including when and which user accessed the system, with metrics such as login time, login attempts, IP addresses, etc.    
• Why they matter: These logs help in ensuring only authorized users access certain patient information. And helps in identifying unauthorized access, if any.

6. System error logs  

• What they are: These logs show any technical issues in the system, such as system crashes, call drops, or any other performance-related issues.
• Why they matter: These logs help the IT team understand what went wrong with the medical call center system and help ensure such issues do not occur. 

Data Backup and Recovery

Ensure that HIPAA-compliant call center software offers data backup and recovery features to ensure that critical patient data is regularly backed up in case of data corruption, system failure, etc. This feature helps you in staying compliant with HIPAA’s data protection requirements. 

Compliance with Other Standards

Lastly, make sure that your HIPAA compliant medical call center software also complies with related regulations like the HITECH Act, to ensure utmost confidentiality and data security.

What are the Benefits of HIPAA Compliant Call Centers?

1. Enhanced Security for PHI

A HIPAA-compliant call center takes extra measures to ensure that patients’ PHI and sensitive information is secured and accessed carefully. This is done by implementing security measures, managing access control, accessing audit logs, and more, unlike your standard call center.  

2. Legal and Regulatory Compliance

HIPAA-compliant call centers use call center software that complies with legal and regulatory policies essential to keeping patient data safe. This helps healthcare organizations comply with HIPAA rules and help them in avoiding hefty fines, and other legal repercussions. 

3. Increased Patient Trust and Satisfaction

When you prioritize keeping patient data safe by different measures, it shows dedication to the ethical handling of sensitive data and your commitment to protecting patient information. Eventually, it helps in building a good reputation and in fostering trust among potential patients. 

4. Streamlined Communication

HIPAA-compliant call center software ensures secure communication with patients, providers, staff, and other stakeholders through reliable channels. It also helps in improving customer service quality, reducing repetitive work, and utilizing the resources to the best capacity. 

5. Cost Savings

HIPAA volition can cost healthcare providers hefty penalties ranging anywhere from $100 to $50,000 per violation, and going up to $1.5 million depending on certain cases. HIPAA compliance for call centers keeps healthcare providers safe from such penalties and reduces the likelihood of lawsuits as well. 

6. Flexibility and Scalability

Healthcare call centers can be tailored to accommodate different aspects of healthcare needs and communication. Be it appointment scheduling, sending appointment reminders, handling tasks like insurance verification, patient inquiries, etc. There is so much that you can do with such software. 

7. Improved Operational Efficiency 

Some HIPAA-compliant call center solutions, such as Emitrr, offer not only calling but also SMS and email functionality; they also come with capabilities that help healthcare providers cater to other aspects of their practice. This includes sending appointment reminders, managing reviews and reputation, scheduling appointments, etc., and helping to improve overall operational efficiency. 

8. Competitive Advantage

Call centers that use HIPAA-compliant VoIP software with diverse security features such as different kinds of audit logs, different kinds of access control, and even different kinds of HIPAA communication channels such as chat and SMS can offer better service to their patients and can gain competitive advantage over other practices. 

Use Cases of HIPAA-Compliant Call Center

1. Covered Entities

Covered entities include those who are directly involved in the payment or processes of healthcare services. Examples include: 

• Hospitals and Clinics: For scheduling appointments, patient inquiries, and follow-ups.
• Pharmacies: To handle patient questions and prescription refills.
• Physician Practices: For consultations, managing referrals or for patient reminders.
• Health Insurance Providers: For claims processing, policy support or plan information.

2. Business Associates

Business associates include service providers or third-party vendors that work with covered entities and handle PHI on their behalf. And because of this, they may be required to offer customer service. Example includes: 

• Medical Billing and Coding Companies: To process and follow up on patient claims and billing.
• Telehealth Providers: For patient communication and remote consultations.
• Third-Party Administrators (TPAs): For handling employee benefits or healthcare plans.
• Outsourced Call Centers or BPOs: For offering services like medical transcription, customer support, or patient outreach.

3. Healthcare Support Services

Medical communication software may be required by individuals who directly assist healthcare providers and interact with PHI. Examples include: 

• Health IT Companies: For support with EHR (Electronic Health Records) systems or patient portals.
• Medical Device Companies: For technical support related to patient education or devices.
• Home Healthcare Agencies: To coordinate services or manage patient inquiries.

4. Government and Non-Profit Organizations

A HIPAA compliant communication software may also be required by healthcare-related public services, such as: 

• Medicare and Medicaid Services: For eligibility verification and member support.
• Non-Profit Health Organizations: For community health programs, fundraising, or patient assistance.

5. Any Organization Handling PHI as Defined by HIPAA

Any organization that handles PHI, such as—wellness program providers, disease management services, research & clinical trial organizations, employers offering group health plans, or legal firms specializing in healthcare, may require HIPAA-compliant communication software. 

Requirements for setting up HIPAA Compliant Call Center

Setting up a HIPAA-compliant call center requires you to implement a number of security, administrative, and technical measures to ensure the security and privacy of PHI. Here’s a comprehensive list of requirements needed for setting up a HIPAA call center: 

1. Administrative Safeguards

Administrative safeguards includes policies, procedures and training policies to manage PHI securely: 

HIPAA Training

You are required to provide regular training to your staff members on how to identify and handle PHI. As well as make sure that your employees understand HIPAA Privacy and Security Rules. 

Policies and Procedures

You need to come up with clear policies and procedures for managing PHI, such as data handling, breach reporting, and access controls. You should also come up with guidelines on recording and storing patient calls safely, if needed. 

Access Controls

Healthcare contact centers should strictly overlook who has access to patient data and information. This includes both- physical and electronic access. You need to limit access to call recordings or patient chats by implementing role-based access to systems that handle PHI or by having passwords and data encryption in place.  

Incident Response Plan

An Incident response plan is an essential component of a HIPAA-compliant call center. IRP helps in identifying, mitigating, and reporting security incidents or breaches involving PHI. The IRP essentially contains procedures to identify, mitigate, respond to, and report incidents involving PHI and is a top requirement for medical call centers. 

Business Associate Agreement (BAA)

Abiding with HIPAA guidelines is not enough, in order to prove to regulatory bodies and your patients that HIPAA rules are being followed by you, you also need to complete a BAA or Business Associate Agreement. A BAA is a legal document between you and a third party (VoIP services, software providers) that handles PHI on your behalf. 

2. Technical Safeguards

This includes measures to keep electronic PHI (ePHI) safe. 

Secure Communication Systems

Make sure to use HIPAA-compliant VoIP tools or SMS tools for communicating with your patients. 

Data Encryption

Make sure all communication, be it chat, voice, or email is encrypted. Encrypting PHI at transit and rest is essential to prevent unauthorized access to confidential patient information. 

Authentication and Access Controls

Make sure all your employees having access to PHI have unique IDs and strong passwords to avoid any leaks or breaches. Additionally, implement multi-factor authentication as well for an added layer of security. 

Audit Trails

It is essential to maintain logs of all modifications and access to PHI so that you can track unauthorized access in case of breaches. 

Secure Storage

Always use HIPAA-compliant local or cloud storage with access control and encryption to keep stored patient data safe. 

Call Recording Security

If you are required to record calls, then ensure they are also encrypted and stored securely, as well as can only be accessed by only authorized personnel. 

3. Employee Training 

Another important requirement that HIPAA-compliant call centers must maintain is- all employees handling PHI must be trained in HIPAA compliance. This includes educating them about what is HIPAA compliance, what comes under PHI, how to handle it, and what are the consequences of failing to comply with HIPAA guidelines. In short, call center personnel should understand:

• How to collect, transmit, and store PHI
• What HIPAA security safeguards how to implement them
• Penalties for HIPAA violations

Do I need physical phones to set up a HIPAA Compliant Call Center?

No, you do not necessarily need physical phones to set up a HIPAA-compliant call center. Many organizations use cloud-based or virtual phone systems that also meet HIPAA-compliant standards. The decision to use physical phones or VoIP phones depends on your business needs, budget, etc. However, we recommend going with VoIP, here’s why:  

Benefits of VoIP phone systems:

• Flexibility: VoIP can be integrated with your existing CRM/EHR/PMS tools and can help you simplify your workflow.
• Scalability: VoIP is easily scalable; you can always add or reduce the number of users and extensions as per your needs.
• Cost-effective: With VoIP, you only need to pay monthly fees, no need to pay for maintenance, hardware, etc.
• Remote work support: VoIP can be accessed on any device and from anywhere in the world, allowing for remote work. 

You can also check these detailed benefits of VoIP phone systems. 

Examples of HIPAA-Compliant VoIP Services

• Emitrr
• RingCentral
• Vonage 

Risks of Non-Compliance with HIPAA 

Legal consequence

Healthcare facilities that fail to comply with HIPAA regulations can end up facing several legal consequences. Punishment includes lawsuits, OCR, Office of Civil Rights fines, criminal penalties, and more. 

Hefty fines

There are four tiers of HIPAA violation. Depending on the type of HIPAA violation, you may be levied hefty fines ranging from $100 per violation to $$50,000 per violation, with no official upper limit. 

Potential jail time

HIPAA violation can also lead to potential jail time depending on the severity of the violation, with most severe cases leading to ten years of maximum prison time. 

Damaged reputation

Non-compliance with HIPAA can damage your healthcare organization’s reputation severely. Healthcare practices or hospitals that fail to keep patient data safe and fail to meet HIPAA requirements often lose patient trust and even struggle to get new patients and staff members. To avoid denting your healthcare reputation, make sure to follow HIPAA guidelines strictly. 

Best Practices for Ensuring HIPAA Compliance in Call Centers

Use secure communication channels

Ensure the communication channels you use, be it calling or texting, are end-to-end encrypted. In case you implement communication software, then make sure to check what their security measures are, whether they have secure cloud storage, call and chat encryption, 2FA, access control, etc., so that your patient communication always remains secure. 

Give proper staff training

Give your agents comprehensive training to handle calls with empathy and expertise. Your training should not only include documentation and medical terminology but also how to remain HIPAA compliant. For this, you can share modules on HIPAA, empathy, basic health knowledge, and emergency response and provider feedback, along with regular refresher training. 

Limit data exposure

Limit exposure to patient data based on employee level. For example, give access to transfer calls to agents but limit access to who can view the patient conversation or patient call recording. By limiting data exposure, you can keep patient data from getting into bad hands and can also easily track who accessed data in case of breaches. 

Conduct audits and monitoring regularly

Make sure to monitor calls regularly and conduct call audits. HIPAA-compliant VoIP software comes with many features such as silent monitoring, call whispering, etc., using which you can monitor a live call without the knowledge of the agent to see if they are giving resolution to patients in the right way. You can also access call recordings to conduct audits and give feedback to the agents. 

Maintain a BAA

If your call center offers services to healthcare providers, then make sure to sign and maintain a BAA. If you are using communication software to offer call center services in your healthcare organization, then make sure you sign a BAA with the communication software provider or third-party owner. 

Why Emitrr is the Best HIPAA Compliant Call Center?

Security and compliance (HIPAA, HITECH, BAA) 

Emitrr is a secure HIPAA and HITECH-compliant call center software. All communications that are done via the Emitrr platform and APIs are encrypted using industry-standard HTTPS/TLS (TLS 1.2 or higher) over public networks, which ensures secure traffic during transit. Emitrr also has a defined security incident management process to classify and handle security breaches.

Additionally, Emitrr makes its Business Associate Agreement (BAA) available for execution by subscribers. Overall, Emitrr adheres to all the security protocols that are essential to protect PHI. 

Call Pop feature for efficient call handling

Emitrr offers a unique call pop feature that allows your agents to access patient information and conversation history during a live call. This allows agents to save time and offer quick resolution without needing to ask for patient history and other information repeatedly. 

Multi-device and Multi-location support

Emitrr can be accessed on multiple devices, be it a laptop, desktop, etc., and it also offers multi-location support. So if you have multiple clinics or branches, then the account information and conversations of call the locations can be accessed easily on the same account. 

Advanced analytics to analyze team performance 

Emitrr offers advanced analytics and reporting tools that allow supervisors to access their team performance with metrics such as average wait time, average handle time, average talk time, missed calls, etc. 

Excellent VoIP features 

With Emitrr, you can access some excellent VoIP features, including but not limited to:

• Call routing
• Call transfer
• Call recording
• Edit & add extensions
• Omni-channel support
• IVR
• Call queue groups
• Business hours
• Missed-call-to-text
• Voicemail transcription
• And more!

Seamless integration with EHR/PMS/CRM

Emitrr integrates with over 1000+ EHR/PMS/CRM tools and software. So if you are already using a tool to manage your patients, then you can sync that with Emitrr and maintain your workflow without any hiccups. 

Excellent uptime

Emitrr has been well-tested under several circumstances and is known for offering 99.99% uptime. Using this hipaa compliant call-tracking software you are sure to get good call quality and performance. 

Additional features

Emitrr is not just limited to offering VoIP features. It also offers comprehensive SMS features, reputation management features, review management features, and appointment and scheduling capabilities. As such, Emitrr can be relied upon to cater to all aspects of your healthcare practice. 

Cost savings

Emitrr’s VoIP pricing starts at just $30 per month, and for the number of call center features it offers along with the quality of the product, it is one of the best value-for-money options to consider. 

Excellent support 

Emitrr has a solid 5/5 star rating on Capterra and is highly appreciated by customers for offering unparalleled customer service 24/7. 

FAQs

Conclusion

HIPAA-compliant call centers need to comply with strict HIPAA regulations, unlike a regular call centers. This not only includes following policies but also includes the way businesses communicate with their patients via call, SMS, or chat. To ensure HIPAA compliance, call centers should implement HIPAA-compliant software, such as Emitrr. Book a call with Emitrr to understand how we can help you manage your patient calls and interactions without any fuss.