Patients must be informed of their privacy rights and told how their personal information will be handled.

HIPAA Compliance

HIPAA was created to protect the privacy rights of individuals and ensure that individual patient information is only transmitted under specific rules and in a secure manner. Patients must be informed of their privacy rights and told how their personal information will be handled. HIPAA also established codes to identify diseases, the causes of illnesses, and the treatments administered. These codes must be used on all electronic medical claims.

HIPAA regulations that address standards for electronic health care transactions and codes are found in the section on provisions for simplifying administrative provisions, or Title II, Subtitle F. Claims submission, enrollment, and referral forms must conform to HIPAA regulations. HIPAA also governs the transmission of health care provider invoices and health care plan premiums.

Examples of covered entities, or organizations that must meet HIPAA compliance, effective since October 16, 2003, are Medicare, HMOs, Blue Cross/Blue Shield and other insurance companies, hospitals, and private physician and dental practices. Noncompliance can result in fines, penalties, or being barred from participating in Medicare programs.

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