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Health Insurance and Portability Act of 1996 (HIPAA)

Congress has passed legislation to simplify healthcare administration called the Health Insurance and Portability Act of 1996. In August 1997, this act became law and calls for the electronic transmission of integral financial and administrative transactions, including billing, electronic claims processing, eligibility, and payment and remittance advice.

What is HIPAA and Why is it so important?

Since 1996, health care providers have been required to modify their office procedures to protect patient health information. The latest bill providing the guidelines for these regulations is the Health Insurance Portability and Accountability Act (HIPAA).

These rules guarantee that patient information is provided ONLY after the patient has authorized its release. Ensuring the privacy of these records during electronic transmission requires software to securely encode the transmitted records thereby preventing unauthorized personnel from obtaining patient information. HIPAA applies to all health care providers who send or receive patient information or claims by electronics means. Therefore, it affects insurance companies and clearinghouses as well as health care providers.

QuickPractice is HIPAA compliant and conforms to the most recent rules and regulations. It is current to the latest standards and is updated on a timely basis. Service and support is available with the purchase of your Quickpractice product thus eliminating costly mistakes and personnel. Quickpractice is the only software you need to maintain HIPAA compliance.

Highlights and Advantages of HIPAA Regulations

  • Information is protected against loss, destruction, tampering and unauthorized use.
  • Improves the efficiency and effectiveness of healthcare by standardizing the interchange of electronic data for specified administrative and financial transactions.
  • Protects security and confidentiality of electronic health information.
  • Providers must obtain prior written consent from the patient before commencing treatment or payment.
  • Any disclosure of information for purposes other than treatment, payment or health care operations is forbidden without written consent of the patient.
  • Only the minimum necessary information may be released.
  • Patients have the right to access their medical information, receive notice of privacy policies, request amendments to their information, and file complaints regarding use and disclosure of information.
  • Healthcare and insurance providers are required to adopt a privacy policy, designate a privacy officer and establish procedures for responding to patients’ requests for information and amendments. They must train employees with respect to privacy policies.
  • Multiple sign in sheets must be eliminated.
  • Written permission must be obtained before placing a child’s picture on a bulletin board or adult’s name on a recognition board.
  • If you contract with a billing service, both you and the service must comply.
  • You are also required to comply if you contract with a managed care company or insurance company and transmit data electronically.

The following information must comply under HIPAA rules:

  • Health care claims
  • Health care records
  • Health care payment and remittance advice
  • Coordination of benefits
  • Health care claims status
  • Enrollment or disenrollment in a health care plan
  • Eligibility in a health plan
  • Health plan premium payments
  • Referral certification and authorization
  • First report of injury

The HIPAA regulations require that specific information appear on the consent form (a blanket form is unacceptable). The law provides specific guidelines as to the information required relevant to your type of service.

Fines of up to $250,000 and imprisonment of up to 10 years are in place for companies who do not meet the compliance standards by the deadline of April 14, 2003. QuickPractice software can update you and keep you current, thus saving you time and aggravation, and minimizing personnel costs.