This document provides an overview of HIPAA privacy rules regarding the use of protected health information (PHI). PHI includes individually identifiable health information such as medical history, health status, and identification details. Providers may use PHI without specific patient permission for treatment, payment, and healthcare operations. Treatment refers to discussing a patient's case with other providers, payment covers submitting insurance claims, and operations includes staff training. Anyone with access to PHI is liable if confidentiality is breached, and penalties for breaches include large fines, jail time, and loss of medical privileges.

1. Confidentiality Training
MHA690
Kelly Fields
May 23, 2013

2. HIPPA Privacy Rule
• Providers may only use patients’ Protected
Health Information (PHI) without specific
permission for:
– Treatment
– Payment
– Operations
(National health career association billing and
coding exam, 2013)

3. Treatment
Primarily for the purpose of discussion of the
patient’s case with other providers involved
with the patient’s care

4. Payment
Claims submitted on behalf of patients

5. Operations
For purposes such as staff training and
improvement.

6. Protected Health Information
Individually identifiable health information
such as:
– past mental and physical health status
– present mental and physical health status
– identification information such as name, social
security number, birth date, etc.
("What is protected health information (PHI) and "electronic
protected health information" (ePHI)?)

7. Who is Liable?
Anyone who has access to Personal Health
Information.
Note: Employers may be liable for illegal acts
committed by employees.

8. Penalties for a Breech of
Confidentiality
Huge fines
Jail time
Suspension of practicing privileges
(HIPAA security: Harsh fines, penalties are a
wake-up call to us all, 2013)

9. References
"What is protected health information (PHI) and "electronic protected
health information” (ePHI)? (n.d.). Retrieved from Health Resources and
Services Administration:
http://www.hrsa.gov/healthit/toolbox/HealthITAdoptiontoolbox/
PrivacyandSecurity/underhippa.html.
HIPAA security: Harsh fines, penalties are a wake-up call to us all. (2013).
Retrieved from NYU Langone Medical Center:
http://compliance.med.nyu.edu/news/documenting_inpatient_admissions
National health career association billing and coding study guide. (2013).
Retrieved from National Health Career Association:
http://schoolsformedicalbillingandcoding.com/study-guide-for-medical-billing-and-
coding-exam/