Protected Health Information and HIPAA

(EMAILWIRE.COM, December 12, 2006) Troy, MI – Protected Health Information (PHI) is any health information that is created for or received by a health care provider or a health plan that:

• Relates to an individual’s past, present or future physical or mental health condition, or to payment for an individual’s health care; and
• Identifies or can reasonably be used to identify the individual; and
• Is transmitted or maintained in any format-oral, written, or electronic

Some common examples of documents or information containing PHI include: medical records, prescriptions, claims, correspondence that contains claim information, explanation of benefits (EOB) notices, bills and invoices, claim denial letters, and health plan participation data appearing on computer monitors or stored on tapes or disks.

HIPAA applies once a health plan has an individual’s PHI. Therefore, health information that your company receives independent of its health plan functions is not protected by HIPAA. That would include when an employee calls in sick, or when he or she submits a doctor’s report to substantiate a claim for short-term disability or FMLA leave. In those situations, the company is not getting the information in connection with a health plan and the information is not covered by the company’s HIPAA privacy policy (although other company policies may apply).

This information has been provided by the HIPAA Roadmap (http://hipaa.infoally.com). The HIPAA Roadmap is an online training program that covers the rules and regulations of HIPAA.

For more information about the HIPAA Roadmap or to preview a demo of the program, contact Andy Hill at 248-822-2868 or at sales@assetlearning.com. You can also visit the website at http://hipaa.infoally.com for more information about the HIPAA Roadmap.

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