By Dan Krager, Carole Krager
HIPAA for Healthcare execs in actual fact explains HIPAA innovations and brings desiring to the techniques via examples, real-life situations, thought-provoking questions, and dialogue. excellent for any allied health practitioner, insurance contains key details at the HIPAA ruling together with basics, privateness concerns, clarification of the protection ruling, and dispels HIPAA myths.
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Additional info for HIPAA for Health Care Professionals
Example text
They have views of the fractures provided through a PACS (Picture Archiving Communication System) maintained by the hospital. a) Any physician called in on a consulting basis must abide by the provisions of the Privacy Rule concerning all protected health information reviewed. Special authorization is not required since the disclosure is for normal treatment, payment or health care operations. b) Any physician, anesthesiologist, nursing staff, LPN, or CNA who attends to Mrs. Goodman must abide by the provisions of the Privacy Rule and not disclose anything that could relate a diagnosis with the patient’s identity.
34) Dr. Bones’s insurance billing specialist reviews the report, abstracts information for proper coding, and submits a CMS-1500 bill to the insurance company for Dr. Bones’s services in i nt r o d u c t i o n t o h ip a a surgery. While the specialist is working on the file, the repairman for the office photocopier comes to fix the machine. a) The claim form is transmitted using designated ANSI X12 standard format 837. Software encrypts the claim as it is sent and the receiving party translates it back to legible format for processing.
The definition of disclosure of protected health information (PHI) is the release, transfer, divulging of, or providing access to PHI to an outside entity. This is different from use of PHI. The use of PHI is the sharing, employment, application, utilization, examination, or analysis of individually identifiable health information (IIHI) within an entity that maintains such information. The main difference between these definitions is where the information will end up— inside or outside the covered entity.