Group Insurance Health Care and the HIPAA Privacy Rule

HIPAA stands for Health Insurance Portability and Accountability Act. When I hear people talking about HIPAA, they are usually not talking about the original Act. They are talking about the Privacy Rule that was issued as a result of the HIPAA in the form of a Notice of Health Information Practices.

The United States Department of Health & Human Services official Summary of the HIPAA Privacy Rule is 25 pages long, and that is just a summary of the key elements. So as you can imagine, it covers a lot of ground. What I would like to offer you here is a summary of the basics of the Privacy Rule.

When it was enacted in 1996, the Privacy Rule established guidelines for the protection of individuals’s health information. The guidelines are written such that they make sure that an individual’s health records are protected while at the same time allowing needed information to be released in the course of providing health care and protecting the public’s health and well being. In other words, not just anyone can see a person’s health records. But, if you want someone such as a health provider to see your records, you can sign a release giving them access to your records.

So just what is your health information and where does it come from? Your health information is held or transmitted by health plans, health care clearinghouses, and health care providers. These are called covered entities in the wording of the rule.

These guidelines also apply to what are called business associates of any health plans, health care clearinghouses, and health care providers. Business associates are those entities that offer legal, actuarial, accounting, consulting, data aggregation, management, administrative, accreditation, or financial services.

So, what does a typical Privacy Notice include?

The type of information collected by your health plan.
A description of what your health record/information includes.
A summary of your health information rights.
The responsibilities of the group health plan.

Let’s look at these one at a time:

Information Collected by Your Health Plan:

The group healthcare plan collects the following types of information in order to provide benefits:

Information that you provide to the plan to enroll in the plan, including personal information such as your address, telephone number, date of birth, and Social Security number.

Plan contributions and account balance information.

The fact that you are or have been enrolled in the plans.

Health-related information received from any of your physicians or other healthcare providers.

Information regarding your health status, including diagnosis and claims payment information.

Changes in plan enrollment (e.g., adding a participant or dropping a participant, adding or dropping a benefit.)

Payment of plan benefits.

Claims adjudication.

Case or medical management.

Other information about you that is necessary for us to provide you with health benefits.

Understanding Your Health Record/Information:

Each time you visit a hospital, physician, or other healthcare provider, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment.

This information, often referred to as your health or medical record, serves as a:

Basis for planning your care and treatment.

Means of communication among the many health professionals who contribute to your care.

Legal document describing the care you received.

Means by which you or a third-party payer can verify that services billed were actually provided.

Tool in educating health professionals.

Source of data for medical research.

Source of information for public health officials charged with improving the health of the nation.

Source of data for facility planning and marketing.

Tool with which the plan sponsor can assess and continually work to improve the benefits offered by the group healthcare plan. Understanding what is in your record and how your health information is used helps you to:

Ensure its accuracy.

Better understand who, what, when, where, and why others may access your health information.

Make more informed decisions when authorizing disclosure to others.

Your Health Information Rights:

Although your health record is the physical property of the plan, the healthcare practitioner, or the facility that compiled it, the information belongs to you. You have the right to:

Request a restriction on otherwise permitted uses and disclosures of your information for treatment, payment, and healthcare operations purposes and disclosures to family members for care purposes.

Obtain a paper copy of this notice of information practices upon request, even if you agreed to receive the notice electronically.

Inspect and obtain a copy of your health records by making a written request to the plan privacy officer.

Amend your health record by making a written request to the plan privacy officer that includes a reason to support the request.

Obtain an accounting of disclosures of your health information made during the previous six years by making a written request to the plan privacy officer.

Request communications of your health information by alternative means or at alternative locations.

Revoke your authorization to use or disclose health information except to the extent that action has already been taken.

Group Health Plan Responsibilities:

The group healthcare plan is required to:

Maintain the privacy of your health information.

Provide you with this notice as to the planâEUR(TM)s legal duties and privacy practices with respect to information that is collected and maintained about you.

Abide by the terms of this notice.

Notify you if the plan is unable to agree to a requested restriction.

Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations. The plan will restrict access to personal information about you only to those individuals who need to know that information to manage the plan and its benefits. The plan will maintain physical, electronic, and procedural safeguards that comply with federal regulations to guard your personal information. Under the privacy standards, individuals with access to plan information are required to:

Safeguard and secure the confidential personal financial information and health information as required by law. The plan will only use or disclose your confidential health information without your authorization for purposes of treatment, payment, or healthcare operations. The plan will only disclose your confidential health information to the plan sponsor for plan administration purposes.

Limit the collection, disclosure, and use of participant’s healthcare information to the minimum necessary to administer the plan.

Permit only trained, authorized individuals to have access to confidential information.

Other items that may be addressed include:

Communication with family. Under the plan provisions, the company may disclose to an employee’s family member, guardian, or any other person you identify, health information relevant to that person’s involvement in your obtaining healthcare benefits or payment related to your healthcare benefits.

Notification. The plan may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location, general condition, plan benefits, or plan enrollment.

Business associates. There are some services provided to the plan through business associates. Examples include accountants, attorneys, actuaries, medical consultants, and financial consultants, as well as those who provide managed care, quality assurance, claims processing, claims auditing, claims monitoring, rehabilitation, and copy services. When these services are contracted, it may be necessary to disclose your health information to our business associates in order for them to perform the job we have asked them to do. To protect employee’s health information, however, the company will require the business associate to appropriately safeguard this information.

Benefit coordination. The plan may disclose health information to the extent authorized by and to the extent necessary to comply with plan benefit coordination.

Workers compensation. The plan may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.

Law enforcement. The plan may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.

Sale of business. If the plan sponsor’s business is being sold, then medical information may be disclosed. The plan reserves the right to change its practices and to make the new provisions effective for all protected health information it maintains. Should the company’s information practices change, it will mail a revised notice to the address supplied by each employee.

The plan will not use or disclose employee’s health information without their authorization, except as described in this notice.

In Summary:

As an employee, you should be aware of your rights and feel confident that your employer is abiding by the guidelines of the Privacy Rule.

As an employer offering group insurance health care benefits, you should make your employees aware of their rights and should give them an avenue to obtain more information or to report a problem.

Where Can You Get Affordable Health Insurance?

What is health Insurance

The main reason why you need an affordable health insurance is to help you plan ahead in case of unexpected costly emergencies. The only way you can accomplish this is to compare prices from most leading insurance companies and also choosing a health insurance plan that best suits you. Back in the days, getting a cheap health insurance plan was simply unaffordable. But these days, individuals, small groups, families and students can choose a health insurance plan that is best for them, e.g. like acquiring a help insurance plan that ensures that an individual suffering from any previous medical condition is not excluded.

Private health insurance plan is totally an unrestricted open market, so those who do not yet have a health insurance plan should consider taking out a plan. For those who are seeking good medical health insurance program, having one is possible through the help of specific companies which specializes in providing health care insurance for individuals and also meeting their requirements and also staying within your budget.

Also for individuals who do not want to use a company, then they can use the internet. One major way Americans get health insurance coverage is mostly through their employers. Many employers them receive health insurance coverage for their workers for a limited time thus enabling them receive health insurance coverage. The internet provides an option for a cheaper health insurance. There are lots of companies that provide all types of health insurance plans, making it possible for you and your family to have a specific reasonable and affordable health care insurance plan. Finding out what kind of reputation the company has and how long the company has been in business is a smart idea.

Having a kind of ideal they have for you is advisable also making sure they have been licensed in your state, because it is of no use getting an insurance with a form which has no license and cant get the exact health insurance you want, many agents will help work hard for you, so you could have an affordable health insurance plan which you and your family could live with without great cost. Everyone wants the best health insurance both for themselves and for their families, but only the best health care insurance can do this with low premiums and full coverage.

What are the advantages of health insurance?

Having the right and the best health care insurance is difficult. In order not to get confused, one needs to decide which the best is by doing his or her research thoroughly. The first step to take includes checking out the credentials and also their past performances of the very company you are considering. Just as on insurance outfits does a background check of individuals before accepting proposals, one should also review the financial status including the customer care services of the insurer, by so doing; you stand the chance to know which health insurance company’s best for you. One major way for you to get ratings of these agencies such as A.M best or Moody’s is by using the better business bureau. Many employers use the health insurance scheme to either attract or even retain their quality employers. The health insurance coverage might be a personal scheme or a group scheme organized and sponsored by the employers for employers who work between 20-29 hours per week.

Companies also do not add cost of fringe benefits alongside health insurance, to the price of their product and service. Over the past decades, the cost of health insurance has increased tremendously, surpassing the general rate of inflation in most past years.

The different types of health insurance includes individual health insurance, affordable employee health insurance which is also known as group health insurance, affordable family health insurance, affordable business health insurance etc, your monthly insurance is determined by certain numerous different things. For instance, most premiums based on or according to your age. So your health insurance rates changes accordingly with the type of health policy you have. If your health insurance is basically for yourselves or your entire family, the procedures must surely have an impact on any quote you are young or advanced in age, self employed receiving health insurance companies will adjust your premium based upon your age and this will also affect the cost of your health insurance.

What are the Disadvantages of health insurance?

Since unforeseen occurrences may occur any time, one will never know when an accident is likely to happen, be it the need to be admitted in the hospital for stitches or a broken bone, you may be in the position to receive help quickly without the worry of receiving a huge bill, unlike when you don’t have a health insurance your credit rating beers all the cost. But you can prevent all this problems from happening and also protecting your credits for your future health financially. Increasing the amount of your health insurance deduction is another way in which you can help make sure your insurance rates are lowered. This higher monthly premium is necessary for anyone who has an existing health problem that requires an extensive medical treatment getting variety of quotes from insurance companies which meets for your health and budgets standards, is a wise decision when selection an health insurance. Searching can be done online and this will have saved you money as well.

Many people feel that they are healthy enough, so they don’t need health insurance because they have never had any major medical problems but one thing to note against the possible health insurance is the protection against the possible health problem that may happen in future. It might happen to you in particular or any member of your family, so why not plan on having an affordable health insurance plan today.

Some Easy Steps in Finding the Right Respiratory Masks For the Public Health Medical Emergencies

Since the swine flu spreads all over the world, there are many people protecting themselves by wearing the respiratory masks. But not all the masks are cleared by FDA for the emergencies. Therefore, it is necessary for you in getting the right respiratory mask that will protect your self for the swine flu. Here is information that you can read in order to find the right masks for the public health.

Respiratory masks may all look the same, but you should know that they are quite different each other. Some of these masks like those that are used in the dental offices, are designed to protect you from the splashes. They will not filter out the tiny droplets in the air that may carry viruses. It is important for you in getting the right mask as your needs.

FDA has cleared the two respiratory masks that are made by 3M to be used in the public health emergencies. They are the Particulate respirator 8670F and the Particulate Respirator 8612F. It is the good idea for you in having some of these on your hand in order to protect you and also your family in the event of the global pandemic.

Now you can start purchasing these specific respirators. They are available in any market. You can choose the great model that is suitable with your needs. They are really great in protecting you and your family from any disease that come from the air. It is important for you to be careful in choosing these respirators. These respiratory masks are great for public health medical emergencies. Get them now and you will love the.