HIPAA Frequently Asked Questions
General HIPAA Questions:
What is HIPAA?
The Health Insurance Portability and Accountability Act (HIPAA) is the most significant piece of federal legislation affecting the health care industry since the inception of Medicare and Medicaid programs. HIPAA improves the portability and continuity of health insurance coverage for millions of Americans. HIPAA mandates rules to maintain the privacy of protected health information, to establish security requirements to protect that information and to develop standard identifiers.
Who Must Comply?
- Health Plans - This category includes individual or group plans that provide or pay the cost of medical care and includes both the Medicare and Medicaid programs.
- Health Care Providers - This includes physicians, hospitals, physical therapists, pharmacists, dentists, providers of home medical equipment, etc.
- Health Care Clearinghouses - This includes entities that process or facilitate the processing of health information received from other entities. It includes groups such as physicians and hospital billing services.
HIPAA 2013 Update Questions:
What about school absence forms for kids? If you did a surgery and they are out for a day, is it OK to list the treatment and just the time off needed?
- Keep the note general. For example, “Due to treatment in our office, Johnny was unable to return to school.”
- Give the note to the parent. What they do with it in terms of distributing it is not the dentist’s responsibility.
What if the patient moves out of state and calls to request their records be sent to another dentist?
Tell the patient to have the new dentist fax a request to you. Dentist to dentist is a permissible disclosure. To add additional protection the patient can be told to give a release to the dentist to send along with the fax. Depending on urgency, postal mail can be used.
What if there is a conflict where patient says “I'll pay out of pocket, don't bill my insurance for this procedure” (example transitional partial where insurance will then NOT pay for final procedure based on 1/5 yr rule) but your PPO contract with the insurance company requires you to bill for ALL procedures done for a patient?
HIPAA as a federal law trumps the insurance contract. Yes, under some circumstance there are entities more powerful than the insurance industry.
Can I fax school notes directly to the school?
Use minimum necessary standards as a guide and send only that information that is necessary, for example, “Johnny has an appointment.”
Are employees of a practice considered business associates?
No
Often, dental software does not allow for electronic transfer of dental records, only printouts -- how is this covered by new rules?
You do not have to buy new software or equipment in order to comply with a patient’s request. If your system does not allow the transfer you can supply a hard copy with an explanation of the reason you cannot send it electronically.
How often do patients need to sign a new “notice of privacy practices” form? Since the notice has just been updated, does the updated notice only need to be signed by new patients or all existing patients?
Patients do not need to sign the Notice of Privacy Practice forms itself, but instead merely an acknowledgement “I, ______________, have received/reviewed a copy of this office’s Notice of Privacy Practices.” If a patient refuses to sign which is their right the office is to document what steps they took to get the authorization. The updated notice has to only be given to new patients. It should also be posted on the website and in the office.
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