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| Introduction | |
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| About the Authors | |
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| Acknowledgments | |
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| Introduction to HIPAA | |
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| Chapter Outline | |
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| Key Terms | |
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| Think About It | |
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| True Stories | |
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| Introduction | |
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| Overview of the Rulings | |
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| Development of the Rulings | |
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| Titles in HIPAA | |
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| Health Insurance Access, Portability, and Renewal | |
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| Preventing Health Care Fraud and Abuse | |
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| Tax-related Provisions | |
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| Group Health Plan Requirements | |
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| Revenue Offsets | |
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| Other Titles in HIPAA | |
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| General Provisions, Peer Review, and Administrative Simplification | |
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| Assuring Portability, Availability and Renewability of Health Insurance Coverage | |
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| HIPAA: An Organizational and Business Challenge | |
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| Summary | |
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| End of Chapter Questions | |
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| Scenarios | |
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| References | |
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| Privacy Issues Explained | |
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| Chapter Outline | |
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| Key Terms | |
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| Think About It | |
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| True Stories | |
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| Introduction | |
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| To Whom Does Title II Apply? | |
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| Who is a "Covered Entity"? | |
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| The HIPAA Officer | |
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| Locating the Latest Title II Rules and Changes | |
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| What is Protected Health Information? | |
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| Authorization Versus Consent | |
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| Protected Health Information Concerns and Disclosures | |
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| Required Disclosures | |
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| Permitted Use and Disclosure Without Authorization | |
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| For Individual Access | |
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| For Treatment, Payment, and Health Care Operations | |
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| When Permission to Disclose is Obtained | |
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| Disclosures that are Incidental | |
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| Disclosures for Public Interest or to Benefit the Public | |
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| Disclosures for Research | |
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| Permitted Use and Disclosure With Authorization | |
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| Disclosure of Psychotherapy Notes | |
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| Disclosure for Marketing Purposes | |
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| Limiting Uses and Disclosures | |
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| Minimum Necessary Uses | |
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| Business Associates under Privacy Ruling | |
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| Training of Workforce and the Public | |
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| Enforcement Guidelines | |
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| Summary | |
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| End of Chapter Questions | |
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| Scenarios | |
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| References | |
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| Transaction Standards and Code Sets | |
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| Chapter Outline | |
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| Key Terms | |
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| Think About It | |
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| Introduction | |
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| Purpose of Transaction Standards | |
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| Designated Code Sets | |
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| Diagnosis Codes | |
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| Inpatient Procedure Codes | |
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| Outpatient Procedure Codes | |
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| Dental Procedure Codes | |
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| Drug Codes | |
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| Non-medical Code Sets | |
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| ASC X12 Nomenclature | |
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| Data Overview | |
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| Architecture | |
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| Use of Loops | |
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| Sample of EDI Claim Data | |
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| Limitations to Claims Encounters | |
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| Remittance Advice and Secondary Payer | |
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| Working with Outside Entities | |
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| Trading Partner Agreements | |
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| Business Use and Definition | |
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| Summary | |
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| End of Chapter Questions | |
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| Scenarios | |
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| References | |
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| HIPAA Security Ruling | |
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| Chapter Outline | |
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| Key Terms | |
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| Think About It | |
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| True Stories | |
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| Introduction | |
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| Core Requirements | |
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| Administrative Safeguards | |
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| Security Management | |
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| Assigned Security Responsibility--Security Officer | |
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| Workforce Security | |
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| Information Access | |
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| Security Awareness and Training | |
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| Security Incidents | |
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| Contingency Plan | |
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| Evaluation of Security Effectiveness | |
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| Business Associate Contracts | |
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| Physical Safeguards | |
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| Facility Access Controls | |
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| Workstation Use or Access | |
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| Workstation Security | |
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| Device and Media Controls | |
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| Technical Safeguards | |
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| Access Control | |
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| Audit Controls | |
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| Integrity | |
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| Person or Entity Authentication | |
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| Transmission Security | |
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| Organizational Requirements | |
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| Policies, Procedures, and Documentation | |
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| Impact on Organizations | |
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| Challenges to Compliance | |
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| Summary | |
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| End of Chapter Questions | |
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| Scenarios | |
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| References | |
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| Unique Health Identifiers and Misconceptions | |
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| Chapter Outline | |
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| Key Terms | |
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| Think About It | |
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| Introduction | |
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| Reasons for Identification Numbers | |
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| Employer Identifier | |
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| Health Care Provider Identifier | |
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| Health Plan Identifier | |
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| Personal Identifier | |
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| What is Important to Know About HIPAA? | |
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| Misconceptions About HIPAA | |
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| Summary | |
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| End of Chapter Questions | |
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| Scenarios | |
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| References | |
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| Resources for Further Information | |
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| Required and Addressable Security Standards | |
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| Further Scenarios and Questions for Consideration | |
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| Glossary | |
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| Index | |