Whatis HIPAA?The Health InsurancePortability and Accountability Act (HIPAA) is a legislation proposed by U.S.Congress in 1996 that was proposed to provide the data privacy and securityprovisions to safeguard the medical information from the intruder. It strictlyprotects the health information and implements policies and procedures tosafeguard it in both paper and/or electronic format.
We believe that our medicaland other health information is private and is highly protected, and we want toknow who has this information, the confidentiality is protected. HIPAA givesrights to the individual over their health information and sets rules andlimits against those information on who can look at and receive healthinformation. HIPAA applies to all forms of individuals’ protected healthinformation whether it is in electronic, written, or oral format.
Healthinsurance companies, Health Management Organization, health plans company,government programs, and Health care providers must follow the HIPAAregulations during transmission of Health information. There is HIPAA privacyrule as well as HIPAA security rule which is a subset of HIPAA privacy rulethat protect the health information that are electronically transmitted. HIPAAsecurity rule is highly technical whose purpose is to make sure certaintechnologies follow the best practices.HIPAAin Medical BillingParkview Health System,Inc.
which is a nonprofit health care system that provides health care servicesto individuals in U.S is tied up with the agreement to settle potentialviolations of HIPAA. This violation includes any complaint from a retiringphysician alleging that Parkview had violated the HIPAA Privacy Rule. Theviolation happens due to leaving medical records unattended that wereaccessible to unauthorized persons that break the rule to protect the personalhealth information to ineligible candidate.
Negligence is happening everywherewith lot of people frequently that causes the breaches in the privacy ofpatient’s medical record and data security violations. Most of the people thinkthat the negligence can happen by an accident and will not bring big issues tothe data privacy, but in fact negligence can bring intruder to take over thesecured data of an organization. This is not only one violation case, there areall kinds of HIPAA violation cases out there – whether they violate thesecurity, administrative or technical safeguards, data breaches often occurwithin certain parameters. This violation can happen in many factors likemailing one patient’s bill to unknown or previous address, emailing the recordto unidentified email address, passing medication information to third personand many more. These violations occur due to unencrypted of their personaldata, employee negligence/error, data stored in unsecure devices, Businessassociates, and notifications sent to wrong person (What is a HIPAA Violation?,2016). .HowHIPAA Makes Medical Billing Secure There are differentlegislative workings at this period for the protection of Personally IdentifiedInformation (PII). There is not a dedicated patient’s medical data protectionlaw right now, but instead regulates primarily by industry on asector-by-sector basis.
There are numerous sources of privacy law that areacting in both the federal and state levels like FCRA (Fair Credit ReportingAct), FACTA (Fair an Accurate Credit Transactions Act), COPPA (Children’sOnline Privacy Protection Act), DPPA (Driver’s Privacy Protection), VPPA (VideoPrivacy Protection Act), HIPAA (Health Insurance Portability and AccountabilityAct). These sources ensure that the personal/organizational informationcaptured must be secured and should not be disclosed in the markerotherwise/unless authorized by the users. These organizations/firms ensure theConfidentiality of the data by making sure the data goes to the person to whomit belongs, Integrity of the date by making sure the data does not alter duringthe transformation, and Availability of that data by making sure that the datais available when it is needed. The CIA protect against any upcoming and anticipatethreats to the security or integrity, protect against disclosure, and manymore.There is a huge challengeto the country about the Health care system that spends too much onadministrative processes. Tremendous amount of money almost over $1.
3 trillionis spent per year in health care which is higher than 1/8th of USeconomy and close to 14% of GDP where on the other hand other industrializednations spend almost 7% of GDP. From 15% – 30% goes to administration due tolack of e-commerce and electronic exchange of information that can be bothpersonal and governmental, poorer quality of care, and more fragmented system.Its objective is to reduce the amount of risk that might occur intentionally oraccidentally disclosing the information or misuse of the information, or theloss or corruption of patient-identifiable information due to outdated system byprotecting and enhancing the rights of consumers giving them proper access totheir health information as well as controlling the appropriate use of thatinformation from the intruder. The Act improves to the efficiency andeffectiveness of healthcare information either in electronic format or paperformat by creating a national framework for health care privacy protection actthat builds on efforts by states, health systems, individual organizations andthe individual. HIPAATransaction Format Provider must protect allindividually identifiable health information, regardless of the method in whichthe data is maintained or transmitted (paper, electronic, oral) and comply withnational standards when conducting the named transactions electronically with acovered health plan.
Any transaction both in electronic format as well as paperformat standardized under HIPAA conducted by a provider must be done in theHIPAA format. Some health plans may require, under contractual agreements,providers conduct any transactions with them electronically must follow theHIPAA format. However, this is not aHIPAA requirement, rather, it is a business decision. Contact your payers, clearinghouse, orbilling service to discuss their HIPAA plans.