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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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HIPAA Privacy Rule 

The main purpose of the Privacy Rule is to assure that individuals’ health information is properly protected while allowing the flow of health information needed to provide and promote high quality health care and to protect the public's health and well-being. The rule permits important uses of information, while protecting the privacy of patients.

Member Material: Downloadable Forms and Policies

Privacy Rule Definitions

Protected Health Information

  • What is “Protected Health Information”?
  • What are the HIPAA Identifiers?
  • How do I de-identify health information?

Organizational Requirements

      • Designate a Privacy Official
      • Workforce Training
      • Data Safeguards
      • Handling Complaints
      • Implement Workforce Sanctions
      • Mitigating Harmful Effects of Disclosures
      • Prohibition of Patient Waiver of Rights
      • Policies and Procedures
      • Making Changes to Policies and Forms
      • Maintaining Documentation

Minimum and Necessary Rule

  • What is the minimum and necessary rule?
  • How does the minimum and necessary rule apply to the entities work force?
  • Requirements when disclosure is made on a routine basis
  • What does a provider need to do when requesting PHI?

Limited Data Sets

  • What must be excluded from the data set?
  • What can the limited data set be used for?
  • What must be included in the agreement?

    Notice of Privacy Practices 

      • Delivery of the Notice
      • Content of the Notice

    Uses and Disclosures

      • Treatment, Payment, Health Care Operations
      • When Specific Authorization is Required
      • Requirements for a Valid Authorization
      • Patient has the Opportunity to Agree or Object

    When Patient Authorization Not Required

      • Public Health Activities
      • Victims of Abuse, Neglect or Domestic Violence
      • Health Oversight Activities
      • Judicial and Administrative Proceedings
      • Law Enforcement Purposes
      • Decedents
      • Cadaveric Organ, Eye or Tissue Donation Purposes
      • Research Purposes
      • Avert a Serious Threat to Health or Safety
      • Specialized Government Functions
      • Workers' Compensation

      Patient Rights under the Privacy Rule

        • Rights to Request Privacy Protection for Protected Health Information
        • Access to Protected Health Information
        • Amendment of Protected Health Information
        • Accounting of Disclosures of Protected Health Information

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