HIPAA Frequently Asked Questions

1. What is HIPAA ... ?
2. What Is "Protected Health Information" ... ?
3. What Kind of Information has to be Protected ... ?
4. Why are People Worried About Privacy ... ?
5. What Other Rights do I have under HIPAA ... ?
6. What is The Notice of Privacy Practices ... ?

7. What if I think there is a mistake in my chart or other medical record ...?

8. Will HIPPA allow anyone else have to look at my medical records ...?

9. What happens if you want to release my personal health information for a reason not listed above ...?

10. What Happens when I sign a Release of Information ...?

What is HIPAA ... ?

·       HIPAA is a federal law. In 1996 congress passed a law called the Healthcare Insurance Portability and Accountability Act  (HIPAA). The main goal of the law is to help employees take their health benefits with them when they move from one employer to another. This law also covers many other topics that have to do with your healthcare. Although you already have many of these rights under Colorado law, HIPAA further protects the privacy and safety of your personal healthcare information, including information about your mental health care. This personal health care information is referred to as “Protected Health Information” or PHI.

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What Is "Protected Health Information" ...?

HIPAA defines "protected health information" (PHI) as information that relates to:

·       Your past, present or future physical or mental health condition.

·       The fact that you have received treatment for a physical or mental health condition.

·       Any past, present or future payment information for your health care through Medicaid, Medicare or other insurance companies.  

More and more, a person’s healthcare information is kept on computers.  The law is designed to ensure that all of the information about you that is stored on computers or in any other form, such as in a chart, is kept safe and confidential.  The information that is protected by HIPAA includes information that you provide and information that is received or written by a health care professional, health plan or employer.

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What Kind of Information has to be Protected ... ?

Many kinds of information is considered personal, so is considered Protected Health Information. This includes:

·       the fact that someone received treatment

·       Claims information (information that has to do with an insurance company paying for your health care).

·       Information about your treatment

·       Demographic information (other personal information such as race, gender, employment status, where you live, etc.) that is obtained while you are receiving health care.

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Why are People Worried About Privacy ... ?

Because so much personal information, including health care information, is stored on computers, many people are concerned about privacy. The protections provided in the Privacy Rule of HIPAA have three goals:

·       to give people more control over their personal health information

·       to limit what others can do with protected health information

·       to safeguard health information that relates to a specific person (also referred to as individually identifiable health information).

 When a person knows that their personal health information is protected, this may increase the trust between them and the people who provide and pay for their care.

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What Other Rights do I have under HIPAA ... ?

The law also wants to make sure that you, as a consumer, have rights when you want access to your own healthcare information. Although you already have many of these rights under Colorado Law, HIPAA gives you the following rights:

·       You can inspect or copy information that health plans (including Medicaid) and providers use when they make decisions about your care;

·       You can know who has seen your health information for reasons that are not directly related to your medical care, or paying for your medical care.

·       You can ask to talk to someone confidentially about your health care records.

·       You can ask that changes or corrections be made to your health information.

·       You must give permission for anyone to use information about your health care for purposes other than treatment, payment or health care operations.

You will receive a Notice of Privacy Practices by April 14, 2003. This letter explains HIPAA and your rights in more detail.

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What is The Notice of Privacy Practices ...?

By April 14, 2003, everyone who is Medicaid eligible in the SyCare Options or West Slope Options service area was sent a Notice of Privacy Practices.  This letter explains to our covered members what kinds of information ValueOptions and Colorado Health Networks collects about them and how we use that information. 

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What if I think there is a mistake in my chart or other medical record ...?

If you believe there is a mistake in your record, or if you would like to add more information, you have the right to ask that we make corrections or include more information.  If we agree to make the change you requested, we will notify everyone who might need to know about it. This may include other insurance companies or providers that treat you. At times, other organizations may let us know that they have agreed to make changes to your health information; and we will make those changes in our records as well.

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Will HIPPA allow anyone else have to look at my medical records ...?

No. 

Although we maintain health information about our members, we are not free to use it for any purposes we choose. We can only use that information to carry out the routine activities necessary to provide you with good care, and activities of payment.  These include:

·       For treatment. We may share your health information with caregivers who are involved in providing your health care.

·       Coordinating your care between providers or between a provider and an insurance company.

·       Submitting or paying claims. We may use and share your health information to pay claims from the health professionals who have provided services to you. We may also use and share your PHI to receive payment for our services.

·       reviewing utilization patterns (understanding how our members use services to that we can provide better and more efficient care)

·       credentialing (ensuring that our providers have the proper credentials)

·       improving the services you receive.

·       When required by law. We will share PHI about you when required by federal, state or local law, or by court order, or if your records are subpoenaed.

·    We may share PHI when we are required to collect information about disease or injury, or to report information to a public health authority.

·    In order to avoid a serious threat to health or safety, we may share PHI with law enforcement or other persons who might prevent or reduce the threat of harm.

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What happens if you want to release my personal health information for a reason not listed above ...?

By law, we must have your written permission (an “authorization”) to use or give out your health for any purpose that is not described above. You may take back (“revoke”) your written permission at any time, unless we have already released the information based on your permission.

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What Happens when I sign a Release of Information ...?

Unless we use information for routine purposes, we will need to obtain a Release of Information Authorization from you. This Release of Information Authorization will include:

·       a description of the information that will be used or shared

·       who the information with be shared with

·       the reason why we feel we need to share the information

·       when or why the release will expire

You also have the right to revoke the release at any time and your care will not be denied if you refuse to sign a release. When releasing information, we will only use the “minimum amount of information necessary to do our job.

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