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Electronic Data Interchange: Impact On The Field Of Health Information

442 Words2 Pages

Electronic Data Interchange (EDI) is used in healthcare to standardize electronic transactions so that electronic information being sent from one computer system to another will be the same. EDI is comprised of eight transactions, each of which are mandated by the Health Insurance Portability and Accountability Act, or HIPAA. Electronic data interchange continues to prove its major business value by lowering costs, improving speed and business efficiency. Exchanging documents electronically improves transaction speed and visibility while decreasing the amount of money a vendor spends on the process. Electronic Data Interchange provides the ability to quickly and efficiently exchange healthcare information in a safe and cost effective way. …show more content…

HIPPA has had a great impact on the field of health information and the health information management professional. HIPAA covers entities such as health plans, clearinghouses and healthcare providers. It is designed to protect the patient’s identifiable health information from any unauthorized use in any form. The Administrative Simplification Subsection of HIPPA is what covers the privacy and security of patient’s information along with uniform identifiers, transactions and code sets. The Rule also gives patients’ rights over their health information, including rights to examine and obtain a copy of their health records, and to request corrections and also ensures equal access to certain health and human services and protects the privacy and security of health information. There are hefty fines that are given out if someone is found guilty when violating the HIPAA law. The mandatory penalties are up to $1,500,000.00 plus civil and criminal penalties extended to the business associates and entities. The offense allows the state attorney to bring action on behalf of the patient whose information was stolen. Conducting HIPPA Risk Assessments can foresee problems before they occur and take steps to fix issues within

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St. David’s South Austin Medical Center (the “Hospital”) has received a letter from John Craven, an attorney representing former Hospital patient Ramona Reeves. Mr. Craven states that the Hospital’s entering into a Settlement Agreement with GEICO Insurance Company after the Hospital’s receipt of Ms. Reeves’ “HIPPA (sic) Revocation/Cancellation of Prior Authorization” constituted a wrongful disclosure of her individually identifiable health information (“PHI”). You have asked us to evaluate whether the provision of billing information and/or entering into the settlement agreement with GEICO violated HIPAA. The answer is no.

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HIPAA has changed Healthcare Information in so many ways when it comes down to EDI. The system is designed to simplify electronic transactions and codes sets. The simplification of HIPAA was designed to show a consistency and operational improvements within the payer and the provider. In order to transfer healthcare information, it has to comply with the standards of HIPAA for that transaction.

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The federal Health Insurance Portability and Accountability Act also known as HIPAA has set a national standard for the handling of electronically stored medical records. Medical confidentiality protects conversations between a patient and his or her doctor from being used against the patient in court. It is a part of the rules of evidence in many common law jurisdictions. The penalties for violating HIPPA are based on the level of negligence and can range from $100 to $50,000 per violation or per record, with a maximum of $1.5 million per year. Violations can also carry criminal charges that can result in jail time.

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1795 Words | 8 Pages

The walls in the office of healthcare providers are made sound proof by the Health Insurance Portability and Accountability Act (HIPPA). Sound proof meaning that each patient’s healthcare information can only be shared between the provider and the patient; their information is required to remain confidential by law. In 1996, HIPPA was passed by congress; the act included regulations that would help to protect patient privacy and health information (Petersen, 2001). After reading the novel, “The Immortal Life of Henrietta Lacks” by Rebecca Skloot one may be appalled and think that what occurs in the novel is a complete violation of HIPPA. But, the time frame needs to be taken into consideration.

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The purpose of the HIPAA transactions and code set standards is to simplify the processes and decrease the costs associated with payment for health care services. The transactions and code set standards apply to patient-identifiable health information transmitted electronically. Physician practices will continue to be able to submit paper claims. When the regulations take effect in October 2002, standard formats and code sets will take the place of any payer-specific or location-specific formats or requirements. ICD-9-CM Volume 1 and 2: Diagnosis Coding - ICD-9-CM is used to code and classify morbidity data from the inpatient and outpatient records, physician offices, and most National Center for Health Statistics (NCHS) surveys.

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HIPAA is the acronym for the Health Insurance Portability and Accountability Act that was passed by Congress in 1996. the portion of HIPAA addressing the ability to retain health coverage is actually overseen by the California Department of Insurance and the California Department of Managed Health Care. The initial two titles of HIPPA are: Title I secures medical coverage scope for laborers and their families when they change or lose their employments. Second Title II known as the Administrative Simplification arrangements, requires the foundation of national measures for electronic human services exchanges and national identifiers for suppliers, medical coverage arrangements, and managers. HIPAA 's underlying object was to guarantee and enhance the coherence of medical coverage scope for laborers evolving employments.

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The article stated that business associates can offer DDE as an option to health plans and also DDE can be customized as well. Since DDE is an option, health plans can offer DDE to certain providers but DDE system must meet the requirements of HIPAA because of the information that is transmitted via electronic. However, some critical issues involved were sending as a transaction which is not DDE and health care plans are not to offer incentives to use the DDE system. Also, electronic data interchange (EDI) could not replace DDE because it is an option to providers but EDI has to used (Nachimsom,

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The HIPAA privacy rule establishes national standards to protect individuals’ medical records and other personal health information and applies to health plans, health care clearinghouses, and those health care providers that conduct certain health care transactions electronically. HIPAA security rule deals with, electronic Protected Health Information (ePHI), which is essentially a subset of what the HIPAA Privacy Rule encompasses. HIPAA Administrative Simplification provisions, covered entities, defined as health plans, health care clearinghouses, and health care providers, who transmit health information electronically, are expected to comply with the final

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