Upcoming Webinars

Site Updates

Disclaimer

The analysis of any legal or medical billing is dependent on numerous specific facts — including the factual situations present related to the patients, the practice, the professionals and the medical services and advice. Additionally, laws and regulations and insurance and payer policies are subject to change. The information that has been accurate previously can be particularly dependent on changes in time or circumstances. The information contained in this web site is intended as general information only. It is not intended to serve as medical, health, legal or financial advice or as a substitute for professional advice of a medical coding professional, healthcare consultant, physician or medical professional, legal counsel, accountant or financial advisor. If you have a question about a specific matter, you should contact a professional advisor directly. CPT copyright American Medical Association. All rights reserved. CPT is a registered trademark of the American Medical Association.

Menu
Log in


Log in

Does HIPAA Apply to My Practice?

HIPAA applies to:

    • Health plans
    • Health care clearinghouses
    • Health care providers who conduct certain financial and administrative transactions electronically. These electronic transactions are those for which standards have been adopted by the Secretary under HIPAA.

Electronic Transactions include:

    • Health claims or equivalent encounter information;
    • Health claims attachments;
    • Enrollment and disenrollment in a health plan;
    • Eligibility for a health plan;
    • Health care payment and remittance advice;
    • Health plan premium payments;
    • First report of injury;
    • Health claim status; and
    • Referral certification and authorization.

This means that if you file any claim and/or check the enrollment status with a public or private insurance company, HIPAA applies and you will need to follow all of the rules.  If you are a cash only practice you may not need to follow HIPAA under Federal law but your state may require you to follow HIPAA for general medical records requirements or if you provide services through telehealth. 

Reference

U.S. Department of Health & Human Services

Health Information Privacy

HIPAA for Professionals

About Us

Zachary Edgar JD, LLM is the managing partner for Therapy Comply.  Zachary is a healthcare attorney that specializes in federal and state healthcare regulatory issues particularly for physical, occupational, and speech therapy practices.  

Learn More 

Join Us

Join today as a yearly or monthly member and enjoy full access to the site and a significant discount to our live and recorded webinars.  Members also have access to compliance and billing support.

Join Today 

Find Us


Powered by Wild Apricot Membership Software