HIPAA Privacy Rule

HIPAA Privacy Rule Training: Why do you need it and what are the requirements HIPAA Privacy Rule and an administrative safeguard of the HIPAA Security Rule set certain mandatory recommendations for training as HIPAA applies to different types of Covered Entity (CE) and Business Associate (BA). Also, training is recommended for the workforce to carry Read More →

Protected Health Information

HIPAA Privacy Rule: Protected Health Information The Privacy Rule protects all “individually identifiable health information” held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper, or oral. The Privacy Rule calls this information “protected health information (PHI).” “Individually identifiable health information” is information, including demographic data, that relates Read More →

HIPAA Privacy Rule

Business Associates And HIPAA Privacy Rule (HHS Explained) In general, a business associate is a person or organization, other than a member of a covered entity’s workforce, that performs certain functions or activities on behalf of, or provides certain services to, a covered entity that involve the use or disclosure of individually identifiable health information. Read More →

Privacy Rule

Entities Covered by the Privacy Rule: Health Care Clearinghouses (HHS Guides) Health care clearinghouses are entities that process nonstandard information they receive from another entity into a standard (i.e., standard format or data content), or vice versa. In most instances, health care clearinghouses will receive individually identifiable health information only when they are providing these processing services to Read More →

Healthcare provider group

Entities Covered by the Privacy Rule: Health Care Providers (HHS Guides) The Privacy Rule applies to any health care provider who transmits health information in electronic form. Every health care provider, regardless of size, who electronically transmits health information in connection with certain transactions, is a covered entity. These transactions include claims, benefit eligibility inquiries, referral authorization Read More →

Privacy Rule: Health Plans

Entities Covered by the Privacy Rule: Health Plans (HHS Guides) The Privacy Rule, as well as all the Administrative Simplification rules, apply to health plans, health care clearinghouses, and to any health care provider who transmits health information in electronic form. Individual and group plans that provide or pay the cost of medical care are covered Read More →

HIPAA Privacy Rule

HIPAA Privacy Rule (HHS Explained) The Privacy Rule standards address the use and disclosure of individuals’ health information—called “protected health information” by organizations subject to the Privacy Rule — called “covered entities,” as well as standards for individuals’ privacy rights to understand and control how their health information is used. Within HHS, the Office for Civil Read More →

HIPAA Privacy Rule

HHS HIPAA Privacy Rule and Care Coordination As part of the Department’s Regulatory Sprint to Coordinated Care, OCR is issuing a Notice of Proposed Rulemaking (NPRM) to modify the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule to support individuals’ engagement in their health care, remove barriers to coordinated care, and decrease regulatory burdens on Read More →

HIPAA for Professionals

HIPAA for Professionals: HHS Rules List To improve the efficiency and effectiveness of the health care system, the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Public Law 104-191, included Administrative Simplification provisions that required HHS to adopt national standards for electronic health care transactions and code sets, unique health identifiers, and security. At the same Read More →

HIPAA training

EmblemHealth Network providers EDI Claims Submission Network providers are required to accept EmblemHealth’s reimbursement schedule for services rendered. Network providers must not bill or seek payment from the member for any additional expenses (except for applicable copayments, coinsurance, or permitted deductibles) including, but not limited to: The difference between the charge amount and the EmblemHealth fee Read More →