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Esse Health Privacy Policies and Practices |
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HIPAA |
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HIPAA is the acronym for the Health Insurance Portability and Accountability Act of 1996. |
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Title I of HIPAA protects health insurance coverage for workers and their families when they change or lose their jobs. There are also parts that address safeguarding the Medicare and Medicaid system against fraud. |
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That part that is receiving all the attention is called Administrative Simplification or Title II. The Department of Health and Human Services (DHHS) has developed all the regulations to date since Congress was not able to meet the deadlines mandated by HIPAA. There are several regulations under this part of the Act. |
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1) Transaction and Code Sets: Compliance required by October 2003. This part requires that all medical providers and insurance companies use a standard format for transmitting electronic claims, claim status, eligibility and COB. It also mandates what diagnosis and procedure codes must be used and accepted (i.e. ICD-9-CM for diagnosis codes). |
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2) Privacy of Individual Identifiable Health Information: Compliance is required by April 14, 2003. This part has received the most attention due to its profound effect on the medical community. This rule defines what the patient's rights are concerning their health information and what is protected. It also outlines measures that must be put in place to ensure those rights are administered. One of the main provisions of this rule involves giving a notice to patients of what their rights are and what are considered standard uses of health information (treatment, payment, and operations). There will also be a new authorization for releasing health information for purposes other than those related to treatment, payment, and operations. Other provisions include obtaining business associate agreements, establishing a privacy official, and training physicians and staff on the regulations. |
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3) Security of health information, standard identifiers (i.e. physicians, insurance companies, and patients) and claims attachments: These guidelines have not been finalized yet by the DHHS. |
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Esse Health will be in compliance with the finalized regulations by the required deadlines. A task force dedicated to HIPAA has developed the necessary policies and procedures, and is currently in the process of training physicians and staff on the regulations. |
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If you have any questions regarding HIPAA, please call Brenda Adams at (314) 851-1030 or contact her by e-mail at badams@essehealth.com. |
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Return to Privacy Policies and Practices page |
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