Information about what is protected health information under hipaa
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Frequently Asked Questions HIPAA Safe Guarding Protected Health Information 1. What is HIPAA?
2. Why is a federal law needed to protect health information? 3. How do these regulations protect the privacy of health information?
4. What are plan participants' rights under these new privacy regulations 5. What is Protected Health Information (PHI)?
6. How is Protected Health Information (PHI) stored? 7. How is PHI handled within NOAO?
8. Who has access to Protected Health Information (PHI) within NOAO? 9. How does our health plan use Protected Health Information (PHI)?
10. How is PHI handled when an employee retires or leaves the organization? 11. Are employees allowed to see their Protected Health Information (PHI)?
12. If employees have questions about privacy rights or Protected Health Information (PHI), whom should they contact? ? ---------------------------------------------------------------------
What is HIPAA? HIPAA is an acronym for the Health Insurance Portability and Accountability Act, which is a federal law enacted by Congress. The law has many provisions designed to improve people's access to health care throughout the country, as well as requirements for health care providers and health plans (i.e., insurers/HMOs and self-insured employer group health plans) to more efficiently and securely share health care data and information. The HIPAA privacy regulations establish standards for protecting individuals' medical records and other personal health information. The rules generally go into effect on April 14, 2003.
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Why is a federal law needed to protect health information? Today, more and more health information is routinely shared electronically among health insurance companies, health care providers (e.g., doctors, hospitals, clinics), and employers who sponsor group health plans. The original intent of HIPAA was to establish standards for smooth, consistent, and secure electronic transmission of health care data among these parties. However, as the regulations were being prepared, the need for standards to protect personal identifiable health information was recognized.
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How do these regulations protect the privacy of health information? The federal law enacted by Congress created national standards for the handling of Protected Health Information (PHI) by setting boundaries on how individually identifiable health information may be used and disclosed. It also enables individuals to be informed about how their PHI may be used.
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What are plan participants' rights under these new privacy regulations? All group health plan participants will receive a Notice of Privacy Practices, and are encouraged to read it. At National Optical Astronomy Observatory (NOAO) and National Solar Observatory (NSO), this Notice was sent via e-mail mail to current employees who are participants in any of the National Optical Astronomy Observatory health care benefits, including medical, dental, vision, or health care reimbursement accounts.
The Notice was also sent via U.S. mail to participants in the Retiree Health or COBRA plans. The Notice is also posted on the Human Resources web site, http://www.noao.edu/cas/hr/hrmain.html The Notice describes how the health plan is permitted to use Protected Health Information (PHI) and the rights of individuals on or after April 14, 2003. These include the rights to:
access their personal PHI and request amendments or corrections request an accounting of certain disclosures of PHI
make a complaint regarding any violation of the privacy rights protected by HIPAA. The Notice also explains the procedures for exercising these rights.
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What is Protected Health Information (PHI)? Under HIPAA, PHI is confidential, personal, identifiable health information about individuals that is created or received by a health plan, provider, or health care clearinghouse and is transmitted or maintained in any form. "Identifiable" means that a person reading this information could reasonably use it to identify an individual.
The National Optical Astronomy Observatory Group Health Plan privacy policies spell out how PHI can be used and who is authorized to use it. These policies are also posted on the Human Resources web site, http://www.noao.edu/cas/hr/hrmain.html Following are some (but not all) of the elements that make a piece of health-related information into PHI: name
address e-mail address
birth date (except year) Social Security number
employee number claim number
health plan beneficiary number. PHI includes written documents, electronic files, and verbal information. (Even information from an informal conversation can be considered PHI.) Examples of PHI include completed health care claim forms, detailed claim reports, explanations of benefits (EOB), and notes documenting discussions with plan participants.
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How is Protected Health Information (PHI) stored? PHI is stored in secure locations and/or systems that allow only people who are authorized to handle this information to do so. PHI may be stored in several locations. For example, it may be in files created by a health insurance company to record health care claims; it may also be in records kept by the doctors from whom employees and family members receive care; and it is probably on file with pharmacies for use with prescriptions. NOAO only stores PHI demographic information related to benefit eligibility, payment of contributions, and enrollment. Wherever PHI is stored, it must be secured in accordance with the HIPAA privacy regulations that go into effect on April 14, 2003.
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How is PHI handled within NOAO? As of April 14, 2004, only a select group of authorized staff employees within National Optical Astronomy Observatory will be authorized to handle PHI as it relates to the group health plan. These individual are listed below. PHI can be used only for the purposes described in the Notice of Privacy Practices. All professionals authorized to handle PHI are required to be trained in the processes and procedures that are part of their health plan responsibilities.
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Who has access to Protected Health Information (PHI) within NOAO? Within NOAO, only the following individuals who support the operation of the NOAO Benefits Plan are authorized to handle PHI:
Human Resources Manager Benefits Specialist
Employment Specialist Payroll Specialist
Sr. Payroll Specialist Business Manager
and/or Accounting who have direct responsibility for handling billing and/or collection information related to health care benefits. top
--------------------------------------------------------------------- How does our health plan use Protected Health Information (PHI)?
The health plan uses PHI to perform several essential functions that include verifying eligibility to participate in a NOAO sponsored health plan, transmitting enrollment data to carriers and managing the operations of the health plan. From time to time, the health plan may disclose PHI to government agencies and other bodies as required by law. At all times, the health plan follows strict procedures to safeguard the confidentiality of this information. The Notice of Privacy Practices describes the permitted uses and disclosures of PHI in more detail.
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How is PHI handled when an employee retires or leaves the organization? Employees' PHI remains secure and confidential even after they leave the organization or retire.
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Are employees allowed to see their Protected Health Information (PHI)? Yes. They may request to inspect their PHI on or after April 14, 2004. The procedures for exercising this right and others are explained in the Notice of Privacy Practices.
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If employees have questions about privacy rights or Protected Health Information (PHI), whom should they contact? ? The contact for questions about the health plan's privacy practices is the Privacy Officer:
Human Resources Supervisor National Optical Astronomy Observatory 950 N. Cherry Ave. Tucson, AZ 85719 Or hrnoao@noao.edu top
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