Can a billing service be a business associate of a covered entity and not be a health care clearinghouse?

Question: Can a billing service be a business associate of a covered entity and not be a health care clearinghouse?

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Answer : Yes; a billing service may be a business associate of a covered entity and not be considered a health care clearinghouse. Example: Billing Service 3 is a Business Associate but is NOT a Health Care Clearinghouse. A health care provider has a contractual arrangement with Billing Service 3 whereby Billing Service 3 conducts various claims preparation services and then transmits non-standard claims to Health Care Clearinghouse B for conversion into standard format and transmission to the health plan. The health care provider has a contractual arrangement with Health Care Clearinghouse B whereby Health Care Clearinghouse B receives the non-standard claims from Billing Service 3, converts the data to standard, and transmits the standard claim to a health plan. The health care provider is a covered entity because it is, through Health Care Clearinghouse B, transmitting a standard claim transaction to a health plan. Because Billing Service 3 is performing claims preparation services on behalf of a covered entity, Billing Service 3 is a business associate. Billing Service 3 is not a health care clearinghouse because it neither converts non-standard (paper or electronic) data into the standard claim transaction, nor does it out-source this function.