What Is HIPAA and Its Privacy Rule?

If you are a person in the healthcare-allied services, you must be aware of HIPAA and its privacy rule. Health Insurance Portability and Accountability Act (HIPAA) is legislation that provides security provisions and data privacy norms to keep patients’ information safe. As a medical coding professional, you must have knowledge of HIPAA in general and some provisions, in specific that talk about privacy and security of patient data. This is imperative because medical coding companies and medical coders work with highly sensitive and private patient information.

What is HIPAA?

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a US federal law that set some standards to protect the personal and medical information of patients. The act comprises five titles or sections. In order to be eligible to provide medical coding services to US healthcare facilities, it is essential that medical coding companies know and are compliant with various HIPAA provisions in these titles.

  • Title I: This section is related to the provisions to protect coverage of health insurance for people who have changed or lost their jobs. Also, this section provides safety to people with pre-existing diseases or conditions by preventing group health plans from refusing to cover such people.
  • Title II: This section provides for the safety of patients’ data by directing the United States Department of Health and Human Services (HHS) to standardize electronic healthcare transaction processes. This section mandates the organizations to incorporate safe electronic access to the patient’s health information by complying with privacy regulations set by the HHS.
  • Title III: This section relates to the tax-related provisions and general medical care guidelines.
  • Title IV: This is related to reforms in health insurance.
  • Title V: This section is related to provisions regarding company-owned insurance and treatment of individuals who lost citizenship owing to income tax reasons.

Since, the means of collection, storage and access of patient information have moved from paper-based records to electronic formats and files, the risk of accessing, using and disclosing sensitive personal health data has increased considerably. To address this risk, the HHS has brought in privacy standards that provide for basic protection standards across the country. Simultaneously, to improve the healthcare system’s efficiency and effectiveness, administrative simplification provisions were included to bring in national standards for electronic healthcare transactions. Further, to protect the individually identifiable health information while using electronic technology for healthcare, certain provisions were incorporated mandating the adoption of federal privacy protections.

The HIPAA Privacy Rule

The Standards for Privacy of Individually Identifiable Health Information (The HIPAA Privacy Rule) is important for medical coding professionals as it –

  • Provides the national standards for protecting the privacy of health data.
  • Provides regulations for certain entities (covered entities) to use and disclose protected health information (PHI).
  • Offers more control to patients over their health information.
  • Sets limits for the use and release of health records.
  • Sets guidelines and standards that healthcare facilities must achieve to protect health information privacy.
  • Holds violators responsible for violating patients’ privacy rights.
  • Enables patients to find out and make informed choices as to how their information may be used or disclosed.
  • Enables patients to obtain a copy of their health records and request corrections.

Since healthcare providers who transmit health information in electronic form in connection with certain transactions fall under the covered entities, for the purpose of compliance with HIPAA, it’s necessary that they partner with HIPAA-compliant medical coding companies for good results and avoid penalties on violation of norms. So, it’s critical that healthcare facilities choose the best medical coding companies that are compliant with HIPAA and its privacy rule.

What Is HIPAA and Its Privacy Rule?