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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