What Information Can a Home Care Agency Disclose to Health Plans for HIPAA?
According to the Health Insurance Portability and Accountability Act (HIPAA), a covered entity must comply with the privacy rule. A covered entity is a health care provider, health plan and a health care clearinghouse. HIPAA states the privacy rule protects all individually identifiable health information (PHI) held or transmitted by a covered entity in electronic, paper or oral form. The information can only be released to obtain payment, treatment or for its own healthcare operation activities.
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Condition
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The past, present, future mental or physical condition information of a patient can be released by a Home Care Agency to that individual's health carrier. This also includes identifiable information such as name, address and social security number.
Treatment
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A patient's treatment and demographic information can be released to the individual's health carrier in order to receive additional treatment or consultation from the health carrier.
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Payment
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A Home Care Agency can release protected health information to obtain payments, benefits and premiums as it relates to the health care supplied to the patient.
De-Identified Information
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Information that is not identifiable through a name, address, social security or other demographic information can be released.
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References
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