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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.

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What Information Protected under HIPAA?

HIPAA protects most individually identifiable health information held or transmitted by a Covered Entity (CE) or its Business Associate (BA), in any form or media, whether electronic, paper, or oral.

HIPAA calls this information “protected health information” or “PHI.” Individually identifiable health information is information, including demographic information, that relates to:

    • The individual’s past, present, or future physical or mental health or condition,
    • The provision of health care to the individual, or
    • The past, present, or future payment for the provision of health care to the individual.

Individually identifiable health information identifies the individual or there is a reasonable basis to believe it can be used to identify the individual.  For example, a medical record, laboratory report, or hospital bill would be PHI if information contained therein includes a patient’s name and/or other identifying information.

See Protected Health Information for more details.

Reference

U.S. Department of Health & Human Services

Health Information Privacy

HIPAA for Professionals

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Therapy Comply is a healthcare compliance firm that seeks to bring high quality web-based compliance guidance and one-on-one consulting services to small and medium size physical, occupational, and speech therapy practices.

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