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