Hipaa For Health Care Professionals

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ISBN: 9781418080532 | 1418080535
Cover: Paperback
Copyright: 2/11/2008

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HIPAA for Healthcare Professionals clearly explains HIPAA concepts and brings meaning to the concepts through examples, real-life scenarios, thought-provoking questions, and discussion. Perfect for any allied health professional, coverage includes key information on the HIPAA ruling including fundamentals, privacy issues, explanation of the security ruling, and dispels HIPAA myths.

Preface	p. iii
About the Authors	p. v
Acknowledgements	p. vi
Introduction to HIPAA	p. 1
Introduction	p. 2
How the Rules Came into Existence	p. 3
Titles of HIPAA Law	p. 5
Health Insurance Access, Portability, and Renewal	p. 5
Preventing Health Care Fraud and Abuse; Administrative Simplification; Medical Liability Reform	p. 5
Group Health Plan Requirements	p. 7
Other Titles in HIPAA	p. 7
HIPAA: An Organizational and Business Challenge	p. 8
Who Is a "Covered Entity?"	p. 10
The HIPAA Officer	p. 11
Summary	p. 12
Review Questions	p. 24
References	p. 25
Privacy Issues Explained	p. 26
Introduction	p. 27
To Whom Does Title II Apply?	p. 27
What Is Protected Health Information?	p. 28
Authorization versus Consent	p. 30
Concerns about Protected Health Information and Possible Disclosures	p. 32
Required Disclosures	p. 32
Permitted Use and Disclosure without Authorization	p. 33
For Individual Access	p. 33
For Treatment, Payment, and Health Care Operations	p. 34
When Permission to Disclose is Received	p. 35
When Incidental	p. 36
For Public Interest or to Benefit the Public	p. 36
For Research	p. 38
Permitted Use and Disclosure with Authorization	p. 38
Disclosure of Psychotherapy Notes	p. 38
Disclosure for Marketing Purposes	p. 39
Disclosure for Directory Purposes	p. 40
Limiting Uses and Disclosures	p. 40
Minimum Necessary Uses	p. 41
Business Associates under the Privacy Rule	p. 42
Training of the Public and Workforce	p. 43
Amending Protected Health Information	p. 44
Enforcement Guidelines	p. 45
Civil Penalties under HIPAA	p. 46
Criminal Penalties under HIPAA	p. 47
What the HIPAA Privacy Rule Covers	p. 49
Summary	p. 50
Review Questions	p. 51
References	p. 52
Transactions and Code Sets	p. 54
Introduction	p. 55
Purpose of Transaction Standards	p. 56
Designated Code Sets	p. 59
Diagnosis Codes	p. 60
Inpatient Procedure Codes	p. 61
Outpatient Procedure Codes	p. 61
Dental Procedures	p. 62
Drug Codes	p. 62
Nonmedical Code Sets	p. 63
ASC X12 Nomenclature	p. 64
Data Overview	p. 64
Architecture	p. 65
Use of Loops	p. 68
Sample of EDI Claim Data (UB-04, Hospital Billing Form)	p. 69
Limitations of Electronic Claims	p. 74
Remittance Advice and Secondary Payer	p. 74
Working with Outside Entities	p. 75
Trading Partner Agreements	p. 76
Business Use and Definition	p. 76
Enforcement of Transactions and Code Sets	p. 77
Summary	p. 78
Review Questions	p. 79
References	p. 80
Security Rule Explained	p. 82
Introduction	p. 83
Core Requirements	p. 84
Administrative Safeguards	p. 85
Security Management	p. 86
Assigned Security Responsibility-Security Officer	p. 88
Workforce Security	p. 88
Information Access	p. 89
Security Awareness and Training	p. 90
Security Incidents	p. 90
Contingency Plans	p. 91
Evaluation of Security Effectiveness	p. 92
Business Associate Contracts	p. 92
Physical Safeguards	p. 92
Facility Access Controls	p. 93
Workstation Use	p. 94
Workstation Security	p. 94
Device and Media Controls	p. 95
Technical Safeguards	p. 96
Access Control	p. 96
Audit Controls	p. 98
Integrity	p. 98
Person or Entity Authorization	p. 99
Transmission Security	p. 99
Organization Requirements	p. 100
Policies, Procedures, and Documentation	p. 101
Impact on Organizations	p. 101
Challenges to Compliance and Enforcement	p. 102
Summary	p. 104
Review Questions	p. 106
References	p. 107
Unique Health Identifiers and HIPAA Myths	p. 109
Introduction	p. 110
Reasons for Identification Numbers	p. 111
Employer Identifier	p. 111
Health Care Provider Identifier	p. 113
Health Plan Identifier	p. 115
Personal Identifier	p. 115
What Is Important to Know about HIPAA?	p. 118
Locating the Latest Title II Rules and Changes	p. 119
Legal Ramifications of HIPAA	p. 120
Myths about HIPAA	p. 123
Summary	p. 128
Review Questions	p. 129
References	p. 130
HIPAA for Health Care Professionals	p. 131
Covered Entity Charts	p. 132
CMS Regional Offices and Government Resources	p. 135
HIPAA Non-Privacy Complaint Form	p. 147
Security Standards Matrix	p. 150
Resources for HIPAA Information	p. 153
Introduction to HIPAA-Chapter 1	p. 153
Privacy Rule Resources-Chapter 2	p. 153
Transactions and Code Sets Resources-Chapter 3	p. 153
Names and Web Sites of Designated Standards Maintenance Organizations (DSMOs)-Chapter 3	p. 154
Security Rule Resources-Chapter 4	p. 154
Identifier Rule Resources-Chapter 5	p. 155
Glossary	p. 157
Index	p. 166
Table of Contents provided by Ingram. All Rights Reserved.

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Hipaa For Health Care Professionals

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