What are the four parts of the administrative simplification requirements of hipaa

Instructor: Beth Hendricks Show bio

Beth holds a master's degree in integrated marketing communications, and has worked in journalism and marketing throughout her career.

HIPAA Administrative Simplification is designed to maximize the effectiveness of the health care system nationwide. In this lesson, you'll learn more about the components of Administrative Simplification.

Simplifying the Basics

Imagine you've gone to your dentist for a basic procedure and they submit the bill to your insurance for payment. The only problem is, your dentist uses one type of coding and detailing for the procedure and your health insurance uses another. Essentially, your provider and your insurance carrier are not speaking the same language.

This could cause a lot of headaches for you as the patient, right? Luckily, lawmakers foresaw this potential issue and addressed it in the Health Insurance Portability and Accountability Act's (HIPAA) Administrative Simplification.

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Administrative Simplification was created as a part of HIPAA in order to make the healthcare system more efficient (such as allowing your dentist's office and your health insurance to share a common ''language'') for both providers and patients. The technological advancements in the health care industry, particularly the shift from paper records to electronic ones, made it critical for all medical providers to get on the same page. Holding providers to national standards for things like electronic transactions and code sets, unique health identifiers and security and privacy measures has streamlined processes and paperwork for everyone.

Let's take a look at the four parts of HIPAA Administrative Simplification.

Administrative Simplification Components

To create a more efficient health care system, HIPAA requires all medical providers to comply with these four components of administrative simplification.

Electronic Transaction and Code Sets Standards

This part of the rule requires providers that operate electronically to use the same health care transactions, code sets, and identifiers across the health care industry. In essence, this is creating that ''common language'' that was the barrier in the example from our lesson's opening. Standard codes have been developed to describe diseases and other health care diagnoses and issues, simplifying communication between various providers.

Security Measures

Security guidelines give health care providers set minimum rules they must follow regarding storing, accessing and disclosing a patient's electronic records. This standardization makes it possible for providers to all follow the same rules, preventing one from releasing more information about a patient than another.

Appropriate security measures are three-fold:

• Administrative: Policies and procedures put in place at health care organizations to safeguard patient data.
• Physical: Protecting the physical location of patients' records, such as computer systems and buildings.
• Technical: These safeguards have to do with protecting access to patient records through the use of things like passwords and firewalls.

Privacy Standards

Standards regarding the privacy and protection of patients' medical information limit using or sharing data to the minimum necessary standard. What that means is that only the minimum necessary information is shared to accomplish the intended purpose. Privacy requirements also call for patient consent before transmitting his or her medical information and giving the patient access to their medical records.

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