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Accounting of PHI Disclosures: Difference between revisions
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Accounting of PHI Disclosures (view source)
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Policy No.: '''6061'''<br /> | Policy No.: '''6061'''<br /> | ||
Effective Date: '''03/17/03'''<br /> | Effective Date: '''03/17/03'''<br /> | ||
Revised Date: '''draft | Revised Date: '''draft 10/28/22''' <br /> | ||
Revised Date: ''' ''' <br /><br /> | Revised Date: ''' ''' <br /><br /> | ||
<big>'''Accounting of Protected Health Information Disclosures Policy'''</big> | <big>'''Accounting of Protected Health Information Disclosures Policy'''</big> | ||
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== Definitions == | == Definitions == | ||
===Affiliated Covered Entity (ACE)=== | ===Affiliated Covered Entity (ACE)=== | ||
Legally separate covered entities that designate themselves as a single covered entity for the purpose of HIPAA Compliance. Current ACE members are: The Nebraska Medical Center, UNMC Physicians, UNMC, University Dental Associates, Bellevue Medical Center and Nebraska Pediatric Practice, Inc. d/b/a Children’s Specialty Physicians. ACE membership may change from time to time. The Notice of Privacy Practices lists current ACE members. Access and amendment rights apply to designated record sets throughout the ACE. | Legally separate covered entities that are affiliated and designate themselves as a single covered entity for the purpose of HIPAA Compliance. Current ACE members are: The Nebraska Medical Center, UNMC Physicians, UNMC, University Dental Associates, Bellevue Medical Center and Nebraska Pediatric Practice, Inc. d/b/a Children’s Specialty Physicians. ACE membership may change from time to time. The Notice of Privacy Practices lists current ACE members. Access and amendment rights apply to designated record sets throughout the ACE. | ||
===Health Care Operations=== | ===Health Care Operations=== | ||
The following activities related to the Organization's functions as a health care provider and sponsor of a self-insured health plan: | The following activities related to the Organization's functions as a health care provider and sponsor of a self-insured health plan: | ||
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#General administrative and business functions; | #General administrative and business functions; | ||
#Insurance activities relating to the renewal of a contract of health insurance; | #Insurance activities relating to the renewal of a contract of health insurance; | ||
#Evaluating | #Evaluating health care provider and plan performance; | ||
#Resolution of internal grievances; and | #Resolution of internal grievances; and | ||
#Fundraising. | #Fundraising (see [https://wiki.unmc.edu/index.php?title=Use_and_Disclosure_of_Protected_Health_Information&action=edit#Use.2FDisclosure_of_PHI_for_Marketing Use/Disclosure of PHI for Marketing]). | ||
===Payment=== | ===Payment=== | ||
Activities undertaken by a health care provider or health plan to obtain premiums, to determine or fulfill its responsibility for coverage and provision of benefits under the health plan or to obtain or provide reimbursement for the provision of health care. Some of these types of activities include determinations of eligibility or coverage (including coordination of benefits or the determination of cost sharing amounts), billing, collection activities, claims management, medical necessity determinations, utilization review activities including pre-certification and pre-authorization of services, disclosure to consumer reporting agencies related to collection of premiums or reimbursement and health care data processing related to the above-listed activities. | Activities undertaken by a health care provider or health plan to obtain premiums, to determine or fulfill its responsibility for coverage and provision of benefits under the health plan or to obtain or provide reimbursement for the provision of health care. Some of these types of activities include determinations of eligibility or coverage (including coordination of benefits or the determination of cost sharing amounts), billing, collection activities, claims management, medical necessity determinations, utilization review activities including pre-certification and pre-authorization of services, disclosure to consumer reporting agencies related to collection of premiums or reimbursement and health care data processing related to the above-listed activities. | ||