Hipaa For Health Care Professionals

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  • Edition: 1st
  • Format: Paperback
  • Copyright: 2008-02-11
  • Publisher: Cengage Learning
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Supplemental Materials

What is included with this book?


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.

Author Biography

Carl H. Krager is Instructor at Olney College Campus of Illinois Eastern Community College, Olney IL.

Table of Contents

Prefacep. iii
About the Authorsp. v
Acknowledgementsp. vi
Introduction to HIPAAp. 1
Introductionp. 2
How the Rules Came into Existencep. 3
Titles of HIPAA Lawp. 5
Health Insurance Access, Portability, and Renewalp. 5
Preventing Health Care Fraud and Abuse; Administrative Simplification; Medical Liability Reformp. 5
Group Health Plan Requirementsp. 7
Other Titles in HIPAAp. 7
HIPAA: An Organizational and Business Challengep. 8
Who Is a "Covered Entity?"p. 10
The HIPAA Officerp. 11
Summaryp. 12
Review Questionsp. 24
Referencesp. 25
Privacy Issues Explainedp. 26
Introductionp. 27
To Whom Does Title II Apply?p. 27
What Is Protected Health Information?p. 28
Authorization versus Consentp. 30
Concerns about Protected Health Information and Possible Disclosuresp. 32
Required Disclosuresp. 32
Permitted Use and Disclosure without Authorizationp. 33
For Individual Accessp. 33
For Treatment, Payment, and Health Care Operationsp. 34
When Permission to Disclose is Receivedp. 35
When Incidentalp. 36
For Public Interest or to Benefit the Publicp. 36
For Researchp. 38
Permitted Use and Disclosure with Authorizationp. 38
Disclosure of Psychotherapy Notesp. 38
Disclosure for Marketing Purposesp. 39
Disclosure for Directory Purposesp. 40
Limiting Uses and Disclosuresp. 40
Minimum Necessary Usesp. 41
Business Associates under the Privacy Rulep. 42
Training of the Public and Workforcep. 43
Amending Protected Health Informationp. 44
Enforcement Guidelinesp. 45
Civil Penalties under HIPAAp. 46
Criminal Penalties under HIPAAp. 47
What the HIPAA Privacy Rule Coversp. 49
Summaryp. 50
Review Questionsp. 51
Referencesp. 52
Transactions and Code Setsp. 54
Introductionp. 55
Purpose of Transaction Standardsp. 56
Designated Code Setsp. 59
Diagnosis Codesp. 60
Inpatient Procedure Codesp. 61
Outpatient Procedure Codesp. 61
Dental Proceduresp. 62
Drug Codesp. 62
Nonmedical Code Setsp. 63
ASC X12 Nomenclaturep. 64
Data Overviewp. 64
Architecturep. 65
Use of Loopsp. 68
Sample of EDI Claim Data (UB-04, Hospital Billing Form)p. 69
Limitations of Electronic Claimsp. 74
Remittance Advice and Secondary Payerp. 74
Working with Outside Entitiesp. 75
Trading Partner Agreementsp. 76
Business Use and Definitionp. 76
Enforcement of Transactions and Code Setsp. 77
Summaryp. 78
Review Questionsp. 79
Referencesp. 80
Security Rule Explainedp. 82
Introductionp. 83
Core Requirementsp. 84
Administrative Safeguardsp. 85
Security Managementp. 86
Assigned Security Responsibility-Security Officerp. 88
Workforce Securityp. 88
Information Accessp. 89
Security Awareness and Trainingp. 90
Security Incidentsp. 90
Contingency Plansp. 91
Evaluation of Security Effectivenessp. 92
Business Associate Contractsp. 92
Physical Safeguardsp. 92
Facility Access Controlsp. 93
Workstation Usep. 94
Workstation Securityp. 94
Device and Media Controlsp. 95
Technical Safeguardsp. 96
Access Controlp. 96
Audit Controlsp. 98
Integrityp. 98
Person or Entity Authorizationp. 99
Transmission Securityp. 99
Organization Requirementsp. 100
Policies, Procedures, and Documentationp. 101
Impact on Organizationsp. 101
Challenges to Compliance and Enforcementp. 102
Summaryp. 104
Review Questionsp. 106
Referencesp. 107
Unique Health Identifiers and HIPAA Mythsp. 109
Introductionp. 110
Reasons for Identification Numbersp. 111
Employer Identifierp. 111
Health Care Provider Identifierp. 113
Health Plan Identifierp. 115
Personal Identifierp. 115
What Is Important to Know about HIPAA?p. 118
Locating the Latest Title II Rules and Changesp. 119
Legal Ramifications of HIPAAp. 120
Myths about HIPAAp. 123
Summaryp. 128
Review Questionsp. 129
Referencesp. 130
HIPAA for Health Care Professionalsp. 131
Covered Entity Chartsp. 132
CMS Regional Offices and Government Resourcesp. 135
HIPAA Non-Privacy Complaint Formp. 147
Security Standards Matrixp. 150
Resources for HIPAA Informationp. 153
Introduction to HIPAA-Chapter 1p. 153
Privacy Rule Resources-Chapter 2p. 153
Transactions and Code Sets Resources-Chapter 3p. 153
Names and Web Sites of Designated Standards Maintenance Organizations (DSMOs)-Chapter 3p. 154
Security Rule Resources-Chapter 4p. 154
Identifier Rule Resources-Chapter 5p. 155
Glossaryp. 157
Indexp. 166
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