Friday, October 31, 2014
HIPPA Gives was created to offer medical professionals free HIPAA, Health Insurance Portability and Accountability Act information including laws, certification, compliance, violations, rules, standards and implementation guidelines.

HIPAA Rules & Regulations

For medical professionals and providers of health insurance services in the country, one of the important regulations to follow are the HIPAA rules & regulations laid out by Health Insurance Portability and Accountability Act Act of 1996. This act was primarily brought in to effect for streamlining health insurance system and also for protecting the privacy of patient data. The health care providers and organizations and health plan providers that store and use patient information are required to follow the regulations laid down by HIPAA act.

HIPAA Rules & Regulations

HIPAA Rules & Regulations
HIPAA rules & regulations lay out the guidelines that need to be followed while providing health plan coverage and also while providing health services. These guidelines are provided in the form of Administrative requirements and security and privacy requirements that has to be met by the medical care provider and by the health insurance provider.

Administrative HIPAA Rules & Regulations:

Administrative requirements contain many sub parts that establishes the identifiers and code sets needed to be used by the health plan providers and health service providers. The sub parts ranging from Subpart A though Subpart H is available as part of administrative requirements.

Some of the important sub parts are explained below:

Subpart D
This part contains guidelines for Health care providers for implementing Standard Unique health identifier. It contains implementation specifications for Health care provider, Health plans and Health care clearing houses.

Subpart F
This part contains the required guidelines for implementing standard unique employer identifier.

Subpart I
Sub Part I deals with general provisions for arriving at transaction standards. It also talks about the guidelines to be adopted while maintaining the standard and also the rules for making changes to the standard transactions.

Subpart J
Part J deals with the guidelines that need to be followed for framing Medical data code sets.

Subpart L
This part provides information regarding the eligibility criteria that need to be met for considering a transaction as a proper health plan transaction.

Subpart N
This section actually details the different transactions related to Health care claim status. It also provides the standard structure of a health care claim status transaction.

Subpart O
This section talks about the process of enrollment and Disenrollment in a health plan and the standards that need to be adopted while performing enrollment and disenrollment.

Subpart Q
This part talks about the process flow in a Health plan premium payment transaction and the different standards that need to be adopted

HIPAA Rules & Regulations | Security And Privacy:

After the administrative requirements, the next important part of the HIPAA rules & regulations is the Security and Privacy section. This has five subsections ranging from Subpart A through to Subpart E.

HIPAA Rules & Regulations

Subpart A
Subpart A talks about the general provisions such as Definitions, Statutory basis and organizational requirements.

Subpart C
This part contains the security standards that need to be maintained for protecting health information of the patients.

Subpart D
It outlines the process that needs to be followed while notifying the case of breach of unsecured protected health information. This includes Notification to media, Notification to individuals and also notification to secretary.

Subpart E
This part lays out the process to be followed for protecting health information of the individuals.

After going through the details provided here on what are HIPAA rules & regulations, medical service providers and health insurance service providers would get an overall idea about the standards and procedures that need to be followed while working on their related transactions.

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