Protected Health Information (PHI) is the information about a person’s health including the payments and provisional care. The medical record privacy being mentioned in this article is about the protection of PHI. HIPAA tries to make sure that an individual doesn’t get discriminated against due to their health-related information.
To discuss medical privacy, we must discuss HIPAA first.
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What is HIPAA?
The Health Insurance Portability and Accountability Act (HIPAA) is a law issued by the US Department of Health and Human Services (HHS) that protects the patient’s health information from being disclosed without their permission.
While the patient’s information is protected by law, subject to the privacy rule, there are some individuals or organizations who can access the data. They are called “covered entities”.
Healthcare professionals, health plan providers, healthcare clearinghouses (professionals who organize the data for official use), and business associates (to process, analyze, and bill) come under the umbrella of covered entities.
For you to be HIPAA compliant, read and follow the set guidelines in the HIPAA compliance manual. Make sure that you are able to cover everything before contacting the agencies to appy for the HIPAA certification.
The manual describes the duties of the healthcare providers in the aspect of information protection and sharing. It also states specific HIPAA compliance requirements and the corresponding HIPAA violation fines.
For starters, here are 5 things that need to be comprehended about medical record privacy.
1. Right to Medical Records
Only the patient and their representatives have the right to access the health records. A hospital or healthcare provider may also send, receive, copy, and analyze your data with your permission for your treatment.
You, as an organization, can’t deny access to those records to patients or their representatives even if the services aren’t being paid for. However, you can deny your services the next time. The privacy rules also don’t require you to share the information with healthcare providers or other organizations.
In the case of psychotherapy notes, patients don’t have permission to access it, but the evaluation information should be shared with them. Your HIPAA compliant organization isn’t authorized to disclose psychotherapy notes or evaluation information without the permission of patients.
The patients can request corrections or revisions of their medical records at any time. Even if you don’t agree with them, the details of it should be officially recorded.
2. Health Information in Workplace
HIPAA privacy rules control the information that an employer may ask you about their worker.
While the privacy rules don’t protect the employment record of a worker, they ensure that the medical records are kept private. As the law doesn’t dictate the actions of an employer, they can seek the health information of their employees from the providers. But, it’s your responsibility to inform the individuals and grant permission from them before handing over the records.
3. Right to Representation
HIPAA compliant providers must allow representatives to inspect or receive copies of the patient’s health information subjected to proper authentication.
Usually, children and the patients who can’t operate on their own appoint a person, who they give power of attorney to supervise and take decisions on behalf of them.
In the case of children, usually, their parents or guardians take the responsibility of being their representatives. But, guardianship can vary according to state laws. If a custody decree is issued, the parent, who is responsible for the child, gets to be their representative.
If a patient dies, their representation is done by the administrator of the deceased individual’s estate. This also varies with the state laws that might suggest a different authorization.
You, as the provider, are also entitled by the HIPAA to act upon your analysis of the representative, and you can deny the representation subjected to reasonable doubt of violence, abuse, or neglect.
4. Family and Friends
Unless the individual’s friend or family member is an authorized representative, you are not allowed to share health information with them until the person authorizes you to.
However, exceptions can be made in the case of family and friends.
A healthcare provider can talk to the patient’s family or friends who are present there if they don’t object. Or if the family member is doing the payments and is involved in the care of the patient.
If the patient sends their friends or family members to pick up a report that they personally can’t receive. Some sort of authorization document is required in this case.
Guardians are allowed to know sensitive information if the patient is unconscious or physically unable to grant consent. This is especially common when the patient needs emergency surgeries or other invasive procedures.
However, sharing these information is done with reasonable consideration. Not everything is laid out into the open.
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5. Court Orders and Subpoenas
You may share information about an individual’s health information if a court order was issued. Although you are required to submit the report, only the requested info is to be submitted, not the ones that have no relevance to the case.
A subpoena is different from a court order. Subpoenas are generally issued by a court clerk or attorney. You are not required to hand over the information if you have doubts that the interest parties were not properly notified, or the privacy rules aren’t met.
But, if you are certain that the documentation is proper, and the subject person was notified, you may disclose information to the interested parties after verification of the same.
You may also want to seek a qualified protective order from the court before handing over the information.
6. What is a HIPAA Notice?
A HIPAA notice is a documentation that is issued by the healthcare providers that address the cases where the information may be read, analyzed, or shared. The information may be shared with other parties, including insurance providers and healthcare professionals.
The patients need to sign or decline the agreement in order to be protected under HIPAA. Declining doesn’t mean that the patient won’t be protected by the law. But signing the agreement allows you to share their information with the invoicing department and other healthcare professionals.
The Bottom Line
You should consider HIPAA compliance before starting a business in the healthcare sector. Without a HIPAA compliance certificate, violation fines can be imposed on you. To apply for HIPAA compliance, it’s necessary that you go through the privacy rules regarding medical records, representation, and court orders mentioned in this article.
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