Fundamentals of HIPAA for Speech-Language Pathologists and Audiologists

Editor’s Note: This text is a transcript of the course, “Fundamentals of HIPAA for Speech-Language Pathologists and Audiologists” Learning OutcomesAfter this course, participants will be able to:Identify the key components of HIPAA.List at least three of the 18 pieces of protected health information (PHI).Describe the forms and documents needed for compliance with HIPAA.  When it comes to HIPAA or anything in this type of compliance space, I don’t want people to think like me but I do want you to use head.  When it comes to HIPAA, the golden rule is, "Do unto others as you would want someone to do unto you.” What that means is that we are all HIPAA consumers. We're all someone's patient, and someone is protecting our protected health information and medical records. So, before you do something, always think, “Would I want someone to do this in my case?” That will really help guide some rather difficult situations. HIPAA started in 1996 in the Clinton administration. It was a bipartisan piece of legislation that was the Health Insurance Accountability and Portability Act of 1996. When it first started, it only had civil penalties but over time, criminal penalties have been added because people didn't take it as seriously as they should have. It covers:Standard transaction code setsNational Provider IdentifierNational Employer IdentifierHIPAA 5010 (which was a system’s change to allow for the additional characters of ICD 10)HIPAA SecurityHITECH or Breach NotificationPrivacyCovered EntitiesBefore discussing each of those individually, I want to address who is a covered entity. Covered entities are typically health plans and a healthcare clearing house which is what exists between the computer in your office and the computer at the payers office. There's an entity that sits in the middle called a clearing house that makes sure that what you're sending to the payer meets certain criteria especially around HIPAA 5010. A covered entity is also any healthcare provider who electronically transmits health information in connection with insurance claims. I did not realize until yesterday, and I apologize for that, that school systems are having some providers submit claims to Medicaid.  If you submit claims electronically to an insurer, you are considered to be a covered entity.   Even if you are a school system, then you are a HIPAA covered entity.However, if you don't submit claims to insurance, you're not a covered entity....