Tuesday, March 27, 2018 1 MEDICAL PRIVACY TUESDAY, MARCH 27, 2018 H EALTH I NFORMATION P ORTABILITY AND A CCOUNTABILITY A CT NOT HIPPA USES OF HEALTH CARE INFORMATION square5 Documenting individual conditions square5 Performance improvement square5 Law enforcement square5 Clinical research square5 Public health and safety square5 Billing and collections square5 Provider planning square5 Government planning square5 Media reporting
Tuesday, March 27, 2018 2 MEDICAL RECORD OWNERSHIP square5 Hospital owns their records. square5 Separate physician records owned by physician. square5 Patients and others have right of access but not ownership of original record. square5 I.e., the institution owns the paper or other material on which the information is recorded, and it has responsibilities concerning access to and use and disclosure of the information. A patient has an x-ray done and wants to have the x-ray for his records. Is he entitled to it? PRIVACY square5 HIPAA’s Privacy Rule (2003) provides that a covered entity may not use or disclose an individual’s Protected Health Information unless the use or disclosure is permitted under the Privacy Rule or the covered entity has obtained the individual’s authorization. HIPAA COVERED ENTITIES square5 Healthcare providers who transmit any health information electronically in connection with certain transactions square5 Physicians, Dentists, Nurses, Clinics, Chiropractors, Nursing homes, Pharmacies square5 Healthcare clearinghouses square5 Process health information and claims from other entities; typically using industry standard transaction codes square5 Health Plans square5 Health insurance co. square5 HMOs square5 Self-insured health plans square5 Medicare, Medicaid, Tricare square5 Business Associates square5 Billing companies square5 Claims processing square5 Utilization review square5 Data Analysis
Tuesday, March 27, 2018 3 BUSINESS ASSOCIATE DEFINED square5 Business associates are those who perform a function or activity involving the use or disclosure of protected health information. square5 Examples: claims processing or administration, data analysis, processing or administration, utilization review, quality assurance, billing, benefit management, practice management, and repricing square5 Business associates are also those who provide certain services to a covered entity. square5 Examples: legal, actuarial, accounting, consulting, data aggregation, management, administrative, accreditation, or financial services to or for such covered entity PROTECTED HEALTH INFORMATION (PHI) square5 PHI includes virtually all individually identifiable information, which is defined to include any health information including demographic information collected from an individual that: square5 is created or received by a healthcare provider, health plan or healthcare clearinghouse; and square5 relates to the past, present or future physical or mental health or
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- Spring '17
- health information, business associates, Federal Office of Health Information