By ElsieCJenkins July 27, 2025
For chiropractors, it’s not only about providing great care — it’s also about safeguarding patient information at every turn, including when you process payments. HIPAA regulations come into play whenever you deal with confidential health information, including billing and payment processes. In this article, we’ll consider what chiropractors need to double-check to ensure their payment processes remain secure, compliant, and reliable for every patient.
Are Chiropractors Covered Entities Under HIPAA?
Chiropractors are covered entities under HIPAA. They are healthcare providers who transmit and handle protected health information (PHI). Covered entities, as defined by HIPAA, are healthcare providers or healthcare plans that engage in activities such as billing, processing insurance claims, payment processing, and patient care.
Whether it involves treating, operating, or providing insurance, chiropractors must make sure to very strictly adhere to HIPAA guidelines to ensure that patient information is secure and confidential.
Important Things to Consider to be HIPAA-Compliant During Payment
Make Patient Statements Secure and Clear
To stay HIPAA compliant, patient statements should contain only the very necessary information to facilitate payment, without including sensitive medical data. If patients wish to view more, the system should provide them with secure means to do so, such as through a login or scanning a QR code. This much more effectively protects private data while still providing patients with the necessary information to understand their bills.
Eliminate Manual Data Entry
Each time someone manually types in information or deals with paper forms, there’s a very much possibility of errors or data breaches. Allowing patients to input payment information directly into a secure system eliminates such possibilities. It is also time-saving, speeds up the payment process, and makes it more secure for all parties involved.
Have a Signed BAA with Partners
If you contract with external companies to process payments or data, ensure they have a Business Associate Agreement (BAA) in place. This will ensure they comply with the same standards for maintaining patient information privacy and security. It ensures data isn’t disclosed or viewed without consent, protecting both the organization and the patients.
Prevent Mistakes with Automated Statements
Most data breaches occur due to simple errors, such as mailing letters to the incorrect address. Automating statements prevents these kinds of errors. These systems can produce clean, secure, and accurate statements and even assist in determining the most effective times to remind patients to pay. This protects patient information and can also assist with faster payment collection.
Simple and Secure Methods Chiropractors Can Use to Collect Payments
Collect Payments During the Visit
Most chiropractic clinics request patients to pay immediately after treatment. Accepting payment by credit card, cash, or mobile payment when the patient is in the clinic prevents missed payments in the future. It also keeps things convenient for patients as they don’t need to recall paying later.
Provide Online Payment Options
Having a secure and flexible payment like online system enables patients to pay from the comfort of their own homes at their convenience. It saves staff time, reduces paperwork, and protects payment information. Online payments are useful for patients who may forget or are too busy to pay in person.
Take Payments Over the Phone
Patients sometimes forget to pay or are unable to pay immediately due to various circumstances. A friendly, quick call to remind them — and allow them to pay securely over the phone — can do the trick. HIPAA-compliant phone calls protect patient information and enable the clinic to efficiently collect past payments.
By making payments easy in person, by phone, or online, chiropractors can ensure that payments continue to flow in without interruption while maintaining patient data security. This increases trust and keeps the practice financially stable.
Why HIPAA Compliance Matters So Much for Chiropractors
HIPAA wasn’t established solely to create additional regulations — it aimed to protect patients’ confidential health information and ensure that all healthcare professionals, including chiropractors, treat that information with care.
The Office for Civil Rights (OCR) within the Department of Health and Human Services oversees this. It has the authority to inspect practices or impose fines when regulations aren’t adhered to.
In 2023 alone, there was a gigantic increase in healthcare data breaches — more than 133 million patient records were revealed, which was 156% higher than the previous year. This highlights the vulnerability of patients’ data. Even small chiropractic clinics must comply with HIPAA regulations to avoid legal issues.
Ignorance of these important rules is no excuse, and even slight ignorance can result in substantial fines. Compliance with HIPAA not only safeguards your patients’ information but indicates that your clinic is responsible and dedicated to doing the right thing — something every patient who enters your office appreciates.
How Chiropractors Can Stay HIPAA Compliant
Most chiropractors are exposed to unseen threats that can cause them a severe HIPAA breach if not checked properly. The use of outdated or unsupported software provides hackers with an opportunity to steal patients’ information, making it critical to update systems and conduct regular audits.
Keeping paper files exposes data to loss or unauthorized viewing, so providers can switch to secure, cloud-based systems to ensure more advanced security. Another significant problem is employee errors, such as discussing patient information publicly or failing to lock screens, which highlights the importance of ongoing HIPAA training.
Clinics also fail to conduct annual risk analyses, which they are required to perform to identify and correct security weaknesses before they become expensive issues. Last but not least, lacking adequate data backup and recovery procedures may result in severe consequences when systems crash or are hacked.
By taking note of these measures—secure storage, software updates, staff training, risk assessments, and sound backups—chiropractors can safeguard patient information, sidestep expensive fines, and maintain their reputation much more effectively.
Comprehensive Chiropractors' HIPAA Compliance Checklist
Begin by conducting a comprehensive risk assessment annually and documenting your findings on paper, so nothing falls through the cracks. Ensure that your employees receive regular HIPAA training, ensuring everyone understands how to protect patient information. Ensure that all of your partners, including billing companies and EHRs, also comply with HIPAA guidelines.
Utilize robust security features, including encryption, firewalls, and access controls, to ensure that only authorized personnel can access patient information. Back up your data securely at all times and be prepared with a plan in case there’s an unforeseen issue.
Keep your policies current by regularly reviewing and revising them, and ensure that all personnel adhere to them. Finally, monitor your systems and equipment daily to detect any anomalies before they become a significant problem.
HIPAA Compliance Violation Penalties Chiropractors Should Know
Violation Category | Minimum Penalty per Violation | Maximum Penalty per Violation | Maximum Annual Penalty |
No Knowledge (You didn’t know and couldn’t have known, even with reasonable care) | $100 | $50,000 | $1,500,000 |
Reasonable Cause (Due to reasonable cause, not willful neglect) | $1,000 | $50,000 | $1,500,000 |
Willful Neglect – Corrected (Fixed within the allowed time, usually 30 days) | $10,000 | $50,000 | $1,500,000 |
Willful Neglect – Not Corrected (Not fixed within the required time) | $50,000 | $50,000 | $1,500,000 |
Rules of HIPAA Compliant Communication
Remember that patient communication is important, but you must be extremely careful to remain HIPAA compliant. Regardless of how you contact us—by phone, text, mail, or email—you must adhere to specific rules to ensure that your patient information is always confidential and secure. First, always verify each patient’s contact information, such as phone numbers, mailing addresses, and email addresses, before using it.
It’s also advisable to obtain written permission from the patient. Additionally, if you’re dealing with a third-party partner, you should have a signed Business Associate Agreement (BAA) in place before exchanging any protected health information (PHI).
Making phone calls is easy, but you still need to be cautious. In addition to routine appointment reminders, you should obtain consent from the patient before discussing anything treatment-related by phone. It’s simple enough for someone else to pick up the phone, and before you know it, confidential information can unintentionally be shared with the wrong individual.
When leaving voicemail messages, keep them concise—mention only the patient’s name, your practice, and a callback number to minimize the risk of someone listening in on private information.
Texting appears fast and convenient, but regular SMS isn’t secure enough to safeguard PHI and isn’t HIPAA compliant. Well-known ones, such as iMessage or WhatsApp, are also not compliant because they don’t provide signed BAAs.
If your practice wishes to text patients securely, you need to seek out texting platforms designed specifically for healthcare that offer encryption and a signed BAA. Ensure that only trained, authorized personnel use these to prevent errors.
When mailing patient information, double-check addresses to ensure you’re sending it to the correct individual. HIPAA requires the use of certified mail, as regular mail is insufficient, as it cannot ensure that the data reaches the intended recipients.
Emailing patients is risky as well. While it’s usually best not to email PHI, it can be done if the patient provides written consent and is aware of potential risks. Even so, your practice must employ a secure, HIPAA-compliant email encryption service to safeguard sensitive data.
HIPAA Privacy Rule vs. HIPAA Security Rule
The HIPAA Privacy Rule and the HIPAA Security Rule are both intended to safeguard patient information, but each addresses a specific aspect. The Privacy Rule is more comprehensive and establishes the standard for how all protected health information (PHI) must be handled, whether in paper, verbal, or electronic form.
This means that your practice needs to inform your patients about how their information is used. Develop written privacy notices, train employees to comply with them, and secure patient files so that only authorized personnel can access them.
The HIPAA Security Rule, on the other hand, targets just electronic protected health information (ePHI) — any patient information that is stored or transmitted digitally. It encourages you to maintain electronic data as private, accurate, and available as necessary.
This involves managing who can view ePHI, tracking system activity to identify any suspicious activity, preventing unauthorized access, and ensuring that data transmitted electronically is secure. All these together assist you in safeguarding patient trust while keeping your practice compliant and effective.
What Is the HIPAA Breach Notification Rule?
The HIPAA Breach Notification Rule requires healthcare providers and their business associates to notify individuals when a breach occurs that compromises the security or privacy of protected health information (PHI).
When a breach occurs that impacts fewer than 500 patients, it must be reported to those patients and the Department of Health and Human Services (HHS) on or before March 1 of the subsequent year. If the violation involves 500 or more patients, it must be disclosed to patients, the HHS, and local media within 60 days of being discovered.
What Is PHI and ePHI?
PHI is short for Protected Health Information. It’s any information that identifies an individual and is related to their past, present, or future health. This would include items such as a client’s name, address, phone number, email address, birthdate, or social security number. In a small practice, PHI can also include treatment plans, test results, and payment information such as insurance and billing records.
ePHI is merely PHI that’s stored or transmitted electronically. It might be emails, text messages, electronic health records, or computerized billing systems. HIPAA requires you to safeguard both PHI and ePHI, so you must secure this data as confidential and private, whether on paper or electronically, to maintain the trust of your clients.
Common HIPAA Violations Related to Technology
When it comes to technology in your practice, there are several ways HIPAA violations can happen if you’re not careful. Sending client details through regular email is risky because anyone could receive and read them.
Losing a phone or laptop without password protection or encryption can also expose client data. Posting about clients on social media, even without their names, can threaten their privacy.
Sharing your passwords or allowing people to use your login can expose sensitive records to the wrong hands. Sending PHI via apps such as ordinary texts or WhatsApp, which are not encrypted, can be risky to client data. Finally, walking away from your computer without logging out may leave private data open to unauthorized use.
What Happens if Someone Files a HIPAA Complaint Against You
If your clients believe their privacy rights have been violated, they may make a complaint to the Office for Civil Rights (OCR). If the OCR accepts the complaint, it will initiate an investigation and will require you to provide information about what occurred. You must cooperate fully and provide information requested of you. The OCR will notify you of its decision after reviewing your information.
If they do discover a breach, you may need to revise your policies, educate your employees, or implement additional measures. In some instances, penalties may apply. You may need to sign an agreement agreeing to comply with specific requirements and report to the OCR for a specified period.
What HIPAA Documentation Should Chiropractors Keep
As a part of remaining HIPAA compliant, chiropractors must maintain detailed records. These are written policies and procedures that your practice maintains to safeguard client information, as well as ongoing risk assessments to identify potential security vulnerabilities.
Maintain duplicates of client privacy forms, requests, or complaints they file. You should also retain signed Business Associate Agreements and other contracts with third-party providers.
Keep records of employee training sessions, disciplinary action taken, and individuals with access to patient information.
Lastly, record detailed notes about the response of your practice in situations such as natural disasters or security breaches. This documentation helps demonstrate that your practice is working diligently to comply with HIPAA regulations for safeguarding patient information.
Conclusion
Ensuring your payment processes are HIPAA compliant isn’t only a matter of legal compliance — it also ensures you maintain your patients’ trust and keep your practice functioning smoothly. By examining your procedures and using safe, compliant software, you can process payments securely and with confidence.
FAQs
What are HIPAA technical safeguards?
These safeguards include encryption, password protection, and access controls to protect electronic patient information from unauthorized access.
What is a Business Associate?
A Business Associate is any individual or entity that deals with protected health information on behalf of a healthcare provider, such as billing services or cloud storage.
What is a Business Associate Agreement (BAA)?
A BAA is an agreement that is legally bound and compels the Business Associates to maintain patient information private and secure per HIPAA guidelines.
What is a HIPAA risk assessment?
It’s an audit that healthcare professionals must perform to detect and correct potential threats to patient privacy and the security of information.
What are the consequences if a chiropractor fails to comply with HIPAA requirements?
They may receive fines, required corrective measures, and reputational harm, even if the offense was not intentional.