HELP FILE

HIPAA Section A – Background information on HIPAA Rules

    What entities are covered by HIPAA?
    All healthcare clearinghouses, health plans, and healthcare providers that conduct certain transactions in electronic form. This includes entities that use a billing service to conduct transactions on their behalf.
    What is considered "electronic" under the terms of HIPAA?
    The term “electronic” is used to describe, but is not limited to, the transmitting of healthcare information via the Internet, an extranet, leased lines, dial-up lines, etc.
    What are HIPAA transactions?
    • Healthcare claims or their equivalent
    • Healthcare payment and remittance advice
    • Healthcare claims status
    • Eligibility inquiries
    • Referral certifications and authorizations
    • Claims attachments
    • First reports of injury