...How HIPAA Violations Affect the Medical Billing Process HCR/220 October 7, 2012 How HIPAA Violations Affect the Medical Billing Process In this paper we will discuss how HIPAA violations affect the medical billing process and why HIV and AIDS information is more sensitive than other types of health conditions. We will also examine the social, legal, and ethical ramifications of improper information disclosure. In 1996 on August 21, the Health Insurance Portability and Accountability Act (HIPAA) was enacted by the Federal Government and signed into law by President Bill Clinton (HIPAA – The Health Insurance Portability and Accountability Act, 2011). According to “Health Insurance Portability and Accountability Act” (2012), “HIPAA does the following; provides the ability to transfer and continue health insurance coverage for millions of American workers and their families when they change or lose their jobs, reduces health care fraud and abuse, mandates industry-wide standards for health care information on electric billing and other processes, and requires the protection and confidential handling of protected health information” (What is HIPAA?). The main reason HIPAA was enacted was to protect patient’s personal health information regardless of its severity. Their personal health information is just that, theirs! For that reason, among many other, it is very important to know that a patient’s personal health information is not to be shared with any unauthorized...
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...What it is about HIPAA that make a health care worker pause and/or cringe when it is mention? It usually because he or she is about to commit or committed a HIPAA violation. Health insurance portability and Accountability Act (HIPAA) of 1996 arise from the Privacy Rule issued by the U.S. Department of Health Human Services. HIPAA set the guidelines for usage, release and protection of individuals’ identifiable health information in any various forms such as electronic, paper or oral. Any HIPAA violation will results in fines, loss of job and possible criminal prosecution. The severity of punishment and ease of committing a HIPAA violations should intensify health care workers every actions. Yet, that is not the case because handling of patient health information on a daily basis have lead many health care worker to become complacent. If I would to guess the most common HIPAA violation is conversation about a...
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...Administrative Ethics Paper Heather Simmons HCS/335 September 19, 2011 Claudia Haywood Administrative Ethics Paper Health care organizations are responsible for the privacy and proper handling of people’s personal medical and financial information. The Health Insurance Portability and Accountability Act (HIPAA) has been set into place to set the standards to organizations on how to handle patient information and how to deal with any situation that may arise to the best interest of the patient and the organization. There are situations that will arise, and the organization must be prepared to handle it. An instance may arise when the U.S Department of Health and Human Services (HHS) may have to get involved. The HHS is an organization designed to help enforce the HIPAA rules and regulations and make sure organizations are in compliance with HIPAA. Recently, a major health care organization in Massachusetts, The General Hospital Corporation and Massachusetts General Organization Inc. (Mass General), settled to pay the U.S. Government $1,000,000 because of a HIPAA violation. Documents containing protected health information (PHI) were lost and never recovered from an employee losing a folder containing 192 patient’s records. The employee took the records from the hospital and while riding the subway returning back to work, the employee left the records on the train. The investigation of the missing records was started from a patient discovering their record was lost and...
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...Khishigjargal Enkhtur Emily Cox Homework Assignment #1 7th, September 2017 1. Explain the significance of HIPAA? Give an example of a HIPAA violation, and explain why the example is in violation of HIPAA laws. HIPAA is biggest laws in the America. HIPAA includes information privacy, IT for guarding all medical information. The Laws have been increasing gradually in recent years the reason is the cyber attacks. HIPAA privacy rule initiates to protect the patient’s private data. HIPAA security rule is dedicated to protect of cyber protected medical data set standard for a patient. HIPAA enforcement rule is forms instruction for examinations into HIPAA compliance violations. The main purposes of HIPAA are to provide continue health insurance...
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...HIPPA Joe Smith Independence University HCA 542A Mod 11:2011 8wk-online Final Paper October 10, 2011 HIPPA This paper will begin with a brief background and history on the Health Insurance Portability and Accountability Act (HIPAA). Following the background will be details about issues that are address within the Health Insurance Portability and Accountability Act. The purpose of this paper is to provide a foundation with providing some information about HIPAA. Background The Health Insurance Portability and Accountability Act (HIPAA) was enacted by Congress in 1996 in response to several issues facing health care coverage, privacy, security and fraud in the United States (ALL THINGS MEDICAL BILLING, 2011, para. 2). Before HIPAA, rules and regulations varied by state, there was no real consistency. Also, there was confusion as to which regulations were applicable and to whom. Did the rules apply in the states where the organization was doing business or where the organization was based? There was also no uniformity between state and federal requirements (ALL THINGS MEDICAL BILLING, 2011, para. 3). With regard to privacy, there were numerous uncoordinated federal acts which addressed privacy in some form. Prior to HIPAA, there was no standard authority for enforcement of fraud and abuse that applied to state and federal health care programs (ALL THINGS MEDICAL BILLING, 2011, para. 4). Congress recognized the increased use...
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...HIPAA Regulatory Paper Amanda Burns HCA/210 July 7, 2013 University of Phoenix HIPAA Regulatory Paper The Health Insurance Portability and Accountability Act (HIPAA) was passed in 1996 by congress to ensure the protection and privacy of patient health information whether that be in a clinic, hospital, nursing facility, or dental office. The major focus of HIPAA is making sure that as patient information that is being shared whether by mail, phone, or electronically that information that is disclosed is protected. There is information that as healthcare providers we need to know to protect our patient rights and ourselves as the providers. HIPAA has implemented some new rights concerning health information of a patient called Protected Health Information (PHI). The privacy rule calls all “Individually identifiable health information,” PHI. We should also be aware that there is the possibility of being fined if there is a violation or breach to comply with the rules and regulations whether they are violated accidentally or purposely. If an employee violated a HIPAA regulation without knowledge of doing so than that employee can be fined 100 per violation with a maximum amount of 25,000. The maximum penalty is 50,000 per violation with an annual maximum amount of 1.5 million. No one wants to find themselves owing this kind of money and more importantly, we should care about our patient’s privacy enough to constantly be aware of how we handle their personal information....
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...How HIPPAA Violations Affect the Medical Billing Process, Part Two Amber Padgett HCR/220 October 19, 2014 Felecia Pettit-Wallace The purpose of this paper is to relate to ways that the Health Insurance Portability and Accountability Act (HIPAA) violations may affect the medical billing process. While researching, the findings conclude that confidentiality of health information was adopted centuries ago. The findings of the research show that although, HIPAA laws have been put into place to protect the privacy and confidential heath information of patients; HIPAA laws are sometimes violated. The medical billing coders are sometimes careless when handling confidential information; however medical health records should be protected adequately. The coder that violates the HIPAA laws concerning the confidentiality and privacy of patient health information can suffer serious ramifications. The ramifications of these violations could result in serious penalties such as disciplinary actions by the employer, monetary fines, and jail time, or both. HIPAA violations ranks number one among the complaints received by the Office of Civil Rights each year. Humans take pleasure in the right to privacy in every aspect of life. The right of protecting the confidentiality and privacy of identifiable personal health information takes first priority and is greatly cherished among most. The Hippocratic Oath, dating back centuries required physicians to keep medical information concerning...
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...HIPAA provides rights to patients over health information and limits who can see or receive health information. Patients or patient’s personal representation has rights to their own medical records; however do not have access to psychotherapy notes. HIPAA privacy rules limits on who can see your medical records. Any information pertaining conversations with medical staff, health insurance, billing information and health information is protected. For example, employers cannot see you medical records and can’t be shared; unless you give your employer, a written consent or authorization. If rights are being denied based on discrimination or a violation of HIPAA privacy or security rule occurs; a complaint can be filed. Therefore; HIPAA does affect medical records, but it also protects our health information. A complaint is filed; when a cover entity has violated health information either by privacy rights or violation of privacy rules or security rules. Any person can file the complaint. The complaint must be filed in writing either by paper or electronically. When emailing the complaint, a signature is not needed for consent forms or the complaint. An email represents the signature. The complaint must name the cover entity and description of the violation act of what you believed that was violated and what happened. The complaint must be filed within 180 days from the day the incident occurred. For an extension, you must show a good cause to the office of civil rights. A complaint...
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...Administrative Ethics Paper Kerri Love HCS/335 October 21, 2014 Jennifer Hilkert Administrative Ethics Paper Patient privacy is a very important aspect to all businesses within the health care field. Whether businesses like it or not, there are strict guidelines that everyone has to follow regarding patient privacy. According to the Department of Health and Human Services (2014), “the HIPAA Security Rule outlines national standards designed to protect individuals’ electronic protected health information that is created, used, or maintained by a covered entity.” Businesses have to be careful about what they share with their employees through any type of electronic media because it can be saved. It is important to remember that all patient health information is covered under the HIPAA rule and the HIPAA security rule. Both of these rules help protect patients’ privacy whether it is in a file or electronic format. There are many things that could happen if either of these rules is breached. If the information is through electronic medical records, it can easily be stolen if there are not enough guidelines set up to protect the information. Hackers like to be able to hack into the system and steal any information they can. If a business has their information stolen, it is important to make sure they file a grievance and take the necessary steps to render the situation. If they do not make sure they do what they are supposed to do, they can be fined a lot of money regarding...
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...HIPAA Privacy Rule is one the most important regulations in the Health and Human Services (HHS) because it sets the guidelines forcing medical practices to keep patients date securely and privacy. The Privacy Rule mandates that the minimum amount of protected health information (PHI) is to be accessed or requested by HIPAA covered entities (www.hhs.gov, 2014). Nowadays, healthcare providers need quick access to patient medical information anywhere at any time the patients present in order to provide efficiency and quality care to patients. Since people can access to patient’s information easily, the number of HIPPA violations increase dramatically. The advent of the internet has had a major impact on the healthcare industry in the last...
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...HIPAA Law of 1996 Timothy Glover HCA210 Introduction to Health Care Martha Schlagel 02/26/2012 HIPAA Law of 1996 HIPAA was enacted on April 26, 1996 to establish a set of national standards for the protection of certain health information. Standards for Privacy of Individually Identifiable Health Information (a.k.a. the Privacy Rule). HIPAA addresses the use and disclosure of individual health information, a.k.a. Protected Health Information. HIPAA establishes standards for privacy rights and controls how an individual’s health information is used and disclosed. Health and Human Services (HHS) Standards establishes standards and guidelines for the electronic exchange, privacy, and security of Protected Health Information. The Privacy Rule and the HHS Standards collectively are called the Administrative Simplification provisions. HIPAA applies to all covered entities that electronically transmit medical information such as billing, claims, enrollment or eligibility verification * Health Plans * Health Care Clearinghouses * Health Care Providers * Business Associates Protected Health Information (PHI) is any health information that contains any of a number of patient identifiers including name, Social Security number, telephone number, medical record number or zip code. The regulations protect all PHI in any form (electronic, paper-based, oral) that is stored or transmitted by a covered entity. De-Identified Health Information...
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... However, with the new technology being created every day, along with the increasing use of both smartphones and social media, using these outlets for patient-provider relationships can enhance overall patient trust and care. That being said, ensuring that patient privacy is not violated has to be the number one priority. Advances in technology and media can pose great triumphs for healthcare further down the road, as long as the appropriate measures are taken to ensure that HIPAA standards are being met at all times while using these outlets. Understanding HIPAA’s Guidelines for Securing Patient Information HIPAA’s Privacy Rule sets the guidelines for the use and disclosure of protected health information (HHS, n.d). This Privacy Rule protects all identifiable information that is held or transmitted by a covered entity. These entities include health providers, health plans, healthcare clearinghouses, or its business associates. It protects this information in any form, whether electronic, paper, or oral. (Terry, 2015). Identifiable information can include any of the following: an individual’s past, present or...
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...The healthcare industry is considered a trillion-dollar industry, growing rapidly with technology and employing millions of healthcare workers in numerous fields. “On August 21, 1996, the U.S. Congress passed the Health Insurance Portability and Accountability Act (HIPAA). The primary goals of the act are to improve the portability and continuity of health-care coverage in group and individual markets; to combat waste, fraud, and abuse in health-care insurance and health-care delivery;” (Ramutkowski & Pugh p.50) Being aware and familiar with the Health Insurance Portability Act not only benefits the patient but also protects the employee from falling into such a situation as this Nurse did. This paper will discuss the article’s issue and its effects, how the article uses current facts about healthcare and the issue addressed, the managerial responsibilities related to administrative ethical issues, and any proposed solutions. The article “Staff Nurse Faces Jail Time for HIPAA Violations” took place in 2008 years after the HIPAA law was enacted. “What had begun as routine file maintenance ended in arrest and possible jail time for a licensed practical nurse who shared medical information with her spouse.” (Latner p.1) Mrs. A had been employed at this physician’s office for over 4 years when the incident occurred. Her husband Mr. A was pending a lawsuit from a current auto accident which would put a strain on their family financially. Mrs. A (RN) decides to take measures...
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...medical savings accounts, to improve access to long-term care services and coverage, to simplify the administration of health insurance, and for other purposes. HIPAA Colloquial acronym(s) Enacted by the 104th United States Congress Citations Public Law Stat. Pub.L. 104–191 110 Stat. 1936 [1] [2] Legislative history [3] • • • • • • • • • Introduced in the House as H.R. 3103 [4] by Bill Archer (D-TX) on March 18, 1996 [5] Committee consideration by: House Ways and Means Passed the House on March 28, 1996 (267–151 Passed the Senate on April 23, 1996 (100-0 [6] ) [7] ) [8] ) and by the Senate on , in lieu of S. 1028 Reported by the joint conference committee on July 31, 1996; agreed to by the House on August 1, 1996 (421–2 [9] August 2, 1996 (98–0 ) Signed into law by President Bill Clinton on August 21, 1996 e v t [10] The Health Insurance Portability and Accountability Act of 1996 (HIPAA; Pub.L. 104–191 [1], 110 Stat. 1936 [2] , enacted August 21, 1996) was enacted by the United States Congress and signed by President Bill Clinton in 1996. It has been known as the Kennedy–Kassebaum Act or Kassebaum-Kennedy Act after two of its leading sponsors.[11] Title I of HIPAA protects health insurance coverage for workers and their families when they change or lose their jobs. Title II of HIPAA, known as the Administrative...
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...parts of the administrative simplification requirements of HIPAA? • Electronic transactions and code sets standards requirements • Privacy requirements • Security requirements • National identifier requirements 2. Name 3 factors used to determine whether you need to comply with HIPAA. a. Whether the health plan is self-insured or fully insured b. Whether the plan sponsor receives PHI or SHI c. How the plan sponsor utilizes SHI. 3. What are the three categories of entities affected by HIPAA Medical Privacy Regulations? • Health Care Providers: Any provider of medical or other health services, or supplies, who transmits any health information in electronic form in connection with a transaction for which standard requirements have been adopted. • Health Plans: Any individual or group plan that provides or pays the cost of health care. • Health Care Clearinghouses: A public or private entity that transforms health care transactions from one format to another. 4. What would Business Associates of covered entities consist of as it pertains to HIPAA’s regulation? HIPAA defines a business associate as an individual or corporate "person" that: • performs on behalf of the covered entity any function or activity involving the use or disclosure of protected health information (PHI); and • is not a member of the covered entity's workforce. 5. Who is covered by the Privacy Rule in HIPAA? Give some examples. • Health care providers who transmit...
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