Health Insurance Portability and Accountability Act
Congress has stated that the goal of HIPAA is to improve the efficiency and effectiveness of the health care system in the United States. All elements of the HIPAA ACT revolve around three key sets of standards that will affect our practice.
We strive to comply with HIPAA guidelines by learning to protect our patient's medical privacy.
We strive to comply with HIPAA guidelines by appropriately maintaining our patient information and billing processes in compliance with national standards.
We strive to comply with HIPAA guidelines by providing appropriate security of our patient records
Those three principles are the heart and soul of HIPAA for our facility. It is important that we follow these rules for the protection of our residents. However, these principles do impose some restrictions on both those who have the information as well as those who request the PHI.
PHI is health information that is created or received by a health care provider, a health plan or an employer. Any information that identifies a resident or leads to the identification of a resident is protected.
Disclosure is the release of this information to another business or individual, including family.
Payment is the activity taken by a health care provider to obtain reimbursement.
Health Care Operations include:
- Collected health information for assessments.
- Case management and care coordination.
- Information about treatment alternatives.
- Related functions that do not include treatment.
Reviewed qualifications, evaluation employee performance, conducting training programs, training of non-health care employees, certification and licensing;
Conducting a medical review, legal services, auditing functions, and fraud and abuse compliance programs;
Business planning, development and analyses related to managing and operating the facility;
Business management and general administrative activities of the facility. And, resolution of internal grievances.
- The facility will provide the notices of privacy practices at admission, when service is first provided, or, in the case of an emergency, as soon as reasonably possible after the emergency treatment.
- The facility will make a good faith effort to obtain a signed acknowledgement from the responsible party.
- The facility will provide a copy of the written notice to residents or other upon request.
- The facility will post a copy of the notices of privacy practices in a prominent location.
A current version of the notice of privacy practices will be maintained of the facility's website.
If there is a material change in the facility's policy, revised notices will be distributed promptly to residents and posted in a prominent location.
Copies of notices will be maintained for at least six years from the last date it was in effect.
Knowledge of violation or potential violation of this policy must be reported directly to the privacy officer.