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HIPAA

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HIPAA Health Insurance Portability and Accountability Act * – PowerPoint PPT presentation

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Title: HIPAA


1
HIPAA
  • Health Insurance Portability and Accountability
    Act

2
Not a HIPPO!
Its HIPAA 1 P and 2 As
3
HIPAA
  • Who? What? Why? When?

4
Confidentiality in
  • Hospitals
  • Skilled Nursing Facilities
  • Doctors Offices
  • Employers
  • Schools
  • Anyone with your health information must keep it
    confidential and abide by HIPAA. It applies to
    ALL health care providers.

5
HIPAA is
  • Related to all medical records.
  • Written
  • Computerized
  • In use or stored.

6
What is Protected Health Information (PHI)?
  • According to HIPP all of the following can be
    used to identify a patient
  • Addresses
  • Dates
  • Telephone or fax numbers
  • SSN
  • Medical Record Numbers
  • Patient Account Numbers
  • Insurance Plan Numbers
  • Vehicle Information
  • License Number
  • Photographs
  • Fingerprints
  • Email Internet addresses

7
Protected Health Information (PHI)
PHI is information that is can identify an
individual personal health information.
Removing a persons name is no longer a
sufficient way to de-identify a patient. ANY
Health information that identifies someone or can
be used to identify someone MUST BE PROTECTED.
8
Why HIPAA?
  • Health information continues to grow and become
    more sophisticated.
  • It requires more protection than ever.
  • Identity theft.
  • Put in place penalties for violations of the law.

9
When HIPAA?
  • Mandated to be in place by April 2003.
  • Although the actual law was on the books much
    earlier in 1999.

10
So tell me what you know
  • Who has to obey HIPAA laws?
  • What does HIPAA stand for?
  • Where does HIPAA apply?
  • When was HIPAA mandated to be in place?

11
HIPAA
  • What does this mean to you?

12
HIPAA Compliance
  • Read only charts and information you need to do
    your job or assignment.
  • Ensure any questions you ask of others to enhance
    your learning are done when others are not within
    hearing range.

13
HIPAA Compliance
  • When discussing patient conditions in the
    classroom, do not use names or anything that
    would allow others to pick the patient out of a
    room.
  • Good A male in his mid-forties had
  • Bad The male in room 224.
  • Good A teenage girl
  • Bad The 16 year old girl, with brown hair
    wearing a plaid skirt

14
HIPAA Compliance
  • Discuss patient information/ condition only with
    those who need to know as a part of their job.
  • Do not discuss patient information in the halls
    or in public areas.
  • You never know who may be listening.

15
So tell me what you know
  • Explain what HIPAA Compliance means to you.
  • What can you do to protect patient privacy?
  • Describe someone in this room in a way where we
    may not know who they are.
  • Now describe someone in a way we will be able to
    guess.

16
Consents
17
Consents
  • Patients (only) may request their records be
    released to others for any number of reasons.
  • All consents must be in writing and need to be
    kept with the medical record.

18
Consents
  • Life insurance
  • Family records
  • Family physician

19
Consents
  • Some releases or authorizations require a
    non-staff member to sign as a witness.
  • Students may not fulfill this request.

20
What is TPO?
Treatment- Providing care to patients Payment- Ge
tting paid for caring for patients Operations- No
rmal business activities such as, quality
improvements, training, auditing, customer
service, and resolution of grievances.
21
So tell me what you know
  • Why are consents important?
  • Who can give consent?
  • Where should consents be stored?
  • What are a few examples of why a patient may want
    their medical records.

22
Covered Entities Business Agreements
23
Covered Entities
  • If a facility bills their sources of payment
    (insurance companies, MediCare, etc.) via
    electronic means, they become a covered entity.
  • Covered Entities may share information, as needed
    to do their job, without the consent of the
    individual.

24
Covered Entity Example of sharing information
appropriately.
  • For example, the hospital bills MediCare for a
    patients stay. MediCare request additional
    medical records to support the reason for the
    length of stay at the hospital.
  • The hospital may send the information to MediCare
    without consent.

25
So tell me what you know
  • Who is a Covered Entity?
  • When can a facility share information with them?
  • Does the patient need to consent when records are
    sent to a Covered Entity?
  • Does the patient need to consent when records are
    given to a marketing firm?

26
Why a Business Agreement?
  • If a healthcare provider does business with
    another who is not a covered entity.
  • The non-covered entity requires information about
    patients in the healthcare facility to do their
    job properly.
  • The healthcare provider may enter into a Business
    Agreement with the non-covered entity.

27
What is a Business Agreement?
  • A contract between a non-covered entity and a
    healthcare provider.
  • Non-covered entity agrees to use patient
    information strictly as a part of their job (i.e.
    billing, providing home health services, etc).
  • Non-covered entity will not use information
    inappropriately (sell info to marketing company,
    to solicit patient, etc).
  • Non-covered entity will protect information,
    destroy information properly, and abide by HIPAA
    rules and laws.

28
What is a Business Agreement?
  • The Agreement must be reviewed and approved by
    the appropriate Officer within the organization,
    often the Privacy Officer or Compliance Officer.
  • An example would be a DME company who provides
    custom wheelchairs to rehabilitated patients.
  • DME ? Durable Medical Equipment

29
So tell me what you know
  • Who needs a Business Agreement?
  • What is a Business Agreement?
  • Why is a Business Agreement necessary?
  • Can any staff member approve a Business Agreement?

30
Dont leave confused
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