Founded in 1993, the Healthcare Billing & Management Association (HBMA) is the only trade association representing third-party medical billers. HBMA members process physician and other provider claims integral to the health care delivery system. They not only bill for medical services, but frequently perform all of the physician's administrative functions. Three out of four HBMA members are expanding their business to include accounts receivable management, consulting and practice management services.

Constant changes in Medicare, Medicaid, private health insurance legislation and regulations make it essential for third-party billers to maintain a presence in Washington, D.C. The HBMA was created to work with and educate Congress and the Administration on issues affecting third-party billers.

HBMA members typically provide services to specialty physician groups and primary care practices and process Medicare, Medicaid, and private health insurance claims. A typical HBMA member processes approximately 20,000 claims per month, totaling $20 million per year; some do much more. The association is deeply involved in legislative and regulatory issues affecting physicians, Medicare, Medicaid and the managed care industry.

Member Facts

A typical HBMA member:

• Accomplishes high levels of claims processing with fewer than 20 employees 
• Has been in business for over 10 years 
• Serves a client base of more than 20 physician practice groups and more than 50 physicians

Third-Party Billing Industry

The third party billing industry dates back to the 1950's. However, large billing companies did not emerge until the 1980's when it was required that hospital based physicians' services be billed separately. Healthcare billing companies come in all sizes, ranging from one person to publically traded companies with revenues of $300 - 400 million annually. Third party medical billing companies employ nearly 20,000 people nationwide, and process more than 17 million claims per month, representing more than $18 billion per year.

HBMA fosters, agrees and strongly urges its members to follow the OIG's guidelines for Third Party Medical Billing Companies.

HBMA'S Mission

• Hold members to the highest of ethical standards as established by the National HBMA Code of Ethics, as well as to eliminate, to the extent possible, unethical healthcare billers from our industry. 
• To promote the professional image of the healthcare billing industry. 
• To educate members.
• To foster cooperation and networking among HBMA members. 
• To cultivate working relationships with local Medicare, Medicaid, Blue Cross/Blue Shield and other insurance carriers, as well as state and other relevant government agencies. 
• To work with Congress and the Administration to achieve "billing friendly" policies on behalf of the billing industry.

HBMA Services

Member education:

• Fall Annual Meeting 
• Spring Educational Conference 
• Summer & Winter Owners & Managers Conference 
• Compliance Education Courses / Professional Certification Program 
• Certified Healthcare Billing & Management Executive (CHBME) 
• Monthly Government Relations Update 
• Monthly Newsletter 
• Discount programs with selected vendors

Issues

HBMA monitors and lobbies on various medical issues of interest to the members.

• Compliance issues as they effect third party medical billers and their relationship with their clients. 
• Privacy and confidentiality of ALL medical records. 
• Administrative simplification (i.e. uniformity and computerization of the claims processing system) and modernization of the health care industry. 
• Medicare and Medicaid physician reimbursement. 
• Healthcare Financing Administration (HCFA) issues related to provider identification, enrollment in Medicare and Medicaid, and reimbursement rules.