HIPAA is an acronym for Health
Insurance Portability and Accountability Act of 1996. It is a federal
law that has been amended to the Internal Revenue Code of 1996. It was
designed to improve portability and continuity of health insurance
coverage in the group and individual markets.
Under HIPAA there are specific standards that all health care
organizations are required to adhere to. To achieve HIPAA compliance,
health care organizations must implement physical, technical and
administrative safeguards. All this will ultimately ensure the integrity
and security of health care information.
Objectives of HIPAA
The main objectives of HIPAA are the following :
- To increase the efficiency and effectiveness of health
information systems through improvements in electronic health care
transactions.
- To maintain security and privacy of individually identifiable
health information.
Sample Processes and Information Impacted by HIPAA
- Health claims and equivalent encounter information
- Enrollment in and disenrollment from a health plan
- Eligibility for a health plan
- Healthcare payment and remittance advice
- Health plan premium payments
- Referral certification and authorization
- Coordination of benefits
- Prescriptions
Who's Impacted?
HIPAA's standards directly apply to the following groups of health care
entities:
- Health Plans
- Public and private payers
- Health care insurers
- Health Care Clearinghouses
- Health Care Providers
- Providers who transmit health information electronically.
- Providers who receive individual health information.
- Providers who electronically maintain health information used in
electronic transmissions between entities.
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