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What is HIPAA?

medical recordsEveryone has a right to have their most private medical information protected.  Because new technology makes it easier than ever to share confidential medical information, those who are involved in patient care, or the handling of information must know how to protect patient privacy.   In recent years, federal legislation had added to that growing stack of forms you sign anytime you visit your doctor or hospital. While you’re signing your life away on consents to be treated, payment information, and filling in health your health history, you should also be signing a HIPAA form.
What is HIPPA?

HIPAA is the easy way to say the “Health Insurance Portability and Accountability Act,” a 1996 Congressional mandate that was created to both protect patient privacy and prevent abuse of funds, fraud, and misuse of the health care system in general.

According to the United States Department of Labor, HIPPA has two branches–one end helps ensure fair treatment and access to health insurance, while the other works to ensure patient privacy.  Here’s the nitty-gritty of what they have to say:

• “Limits the ability of a new employer plan to exclude health insurance coverage for preexisting conditions;
• Provides additional opportunities to enroll in a group health insurance plan if you experience certain life events or lose other health insurance coverage;
• Prohibits discrimination against employees and dependent family members based on any health factors they may have, including prior medical conditions, previous claims experience, and genetic information; and
• Guarantees certain individuals will have access to, and are able to renew individual health insurance policies.”
What are the Privacy Laws?

The privacy law portion of HIPPA basically means that you have federal protection that covers your healthcare information. Privacy and security rules are designed to make sure that healthcare disclosure is done appropriately. The laws say that you have the right to access and copy your own health records, that you have the right to know who sees your health information, and you can choose which friends or family members (if any) are allowed to have information on your condition.

Health care providers are under strict requirements to ensure that all patient information is protected and that they do not unnecessarily access information that is not necessary to do their job.  Being nosy will get you in hot water fast, thanks to HIPPA.
What if HIPPA isn’t followed?

It’s not a foolproof system. Nothing is. But, it does make it less likely that your healthcare information will be shared with people who aren’t supposed to know. But what do you do if a healthcare provider doesn’t honor the HIPAA regulations? Do you have any recourse?

Absolutely! Anyone can file a complaint. The rules are pretty simple. The department of Health and Human Services has a prepared complaint package ready for you to download and use. You can’t just call it in.

You have to fax, write or email the complaint, you only have 180 days in which to do so, and in your complaint, you need to name the person (or business) that violated your rights and how exactly they did so. If you need help and you want to file a complaint or if have any questions about the available complaint or consent forms, please e-mail the Office of Civil Rights at OCRMail@hhs.gov.

However, it is important to note that these rules do not provide an opportunity to sue over violations. The Department of Health does have the power to fine the offending entity up to $250,000.
Understanding HIPPA

Because HIPPA provides a national standard for health care information, everyone who works in the health care field who has access to patient data must become very familiar with these laws. Failure to do so can jeopardize your personal employment and could mean the end of the company you work for as well. In addition, HIPPA questions are often included in medical coding certification exams, and you will need to be prepared to respond appropriately.

Medical coders will have access to a virtually unlimited supply of protected patient information every day.  Make sure that this information is handled discreetly and with the utmost professionalism is essential to doing a great job.
Resources

Department of Labor overview of HIPPA
http://www.dol.gov/ebsa/faqs/faq_consumer_hipaa.html

About the Author

Rachel Ballard, RNC, BSN is a registered nurse with almost a decade of clinical experience in both acute care and public health settings.

Read Rachel's full bio here...

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