What Is HIPAA?


HIPAA, or the Health Insurance Portability and Accountability Act of 1996, are a set of federal rules governing the security and privacy of patient’s health information.

Some parts of the act include the Identifier Standards, the Privacy Rule, the Security Rule, the Enforcement Rule, and Breach Notification Rule. In this post, we will focus on the first two.

The Privacy Rule

The Privacy Rule is specific to how we keep and use patient medical records and individual health information. From the medical office to the clearinghouses to the insurance payors, each party (or “covered entity”) must take the necessary precautions to ensure that patient information is kept private.

Some examples of covered entities include:

  • Doctors, nurses, psychologists, clinics, etc.
  • Insurance companies, company health plans, etc.
  • Billing services (like Americare Network), value-added networks, clearinghouses, etc.

The Act has been modified periodically since it was established. The most recent change was made published on December 10, 2020. It aimed to remove burdens and possible barriers to coordinated care and case management communications.

Meanwhile, The Security Rule aims to protect electronic patient information.

How To Stay HIPAA Compliant?

Compliancy, and especially the Security Rule, has become very relevant and important. With more and more work being done electronically, what can you do to ensure you are being HIPAA compliant?

Regardless of the type of covered entity you are, the first thing you can do is to get a firm understanding of the rules. The United States Department of Health & Human Services has a variety of guidance materials available to help with aspects of HIPAA compliancy. Be familiar with these rules and know when you can or cannot share patient information.

If you are a healthcare provider, ensure appointments (in person or through telehealth) are conducted in a private setting and information is gathered securely. If a private setting is unavailable for telehealth, take measures such as avoiding the use of speakerphones or speaking in a lower voice. Ensure patient information is noted in a private and secure way.

Next, when transferring patient files, ensure the other party is a covered entity. Only share patient information when it is necessary and only share the necessary amount.

When keeping and using medical records, here are some examples of a few other protocols you can put in place:

  • Set guidelines for compliancy at your practice. Ensure those you work with understand these rules.
  • Store patient information in a secure location, electronically or not. Encrypt electronically stored and transmitted files.
  • When working with non-electronic files, keep organized and return files to the secure location after use.
  • When disposing records, take actions such as shred or pulp paper files and purge electronic media. Clean the information completely.

As a medical biller, please understand and follow the HIPAA guidelines, making sure to keep patients’ health information private and secure.

Other HIPAA Considerations

Third party entities, such as organizations helping with claim processing, must also follow regulations when using patient records. For third party coding and billing organizations, this is especially important as you are acting on behalf of a healthcare provider and need to ensure their patient information is protected. When a billing company and a healthcare provider signs a contract, they must clearly state to what extent patient records can be used.

Finally, for any covered entity, if there is a breach, you must also have written policies and procedures in place to deal with them.

How you implement the Privacy Rule is up to your organization. There is flexibility. Depending on the size of your practice, you can do what works best for you. What is the bottom line? Protect patient health information. If you are unsure, you can check online at HHS.gov for more information.


For more, reliable information on HIPAA guidelines, visit the U.S. Department of Health & Human Services website.

Another way to stay HIPAA compliant?

Outsource your medical billing and claim submission services. At Americare Network we ensure compliancy throughout the entire process, protecting your patients and yourself. Our expert team understands the importance of HIPAA compliancy and has ample experience in maintaining privacy and security for different types of practices. We partner with a full spectrum of clinics and practitioners, including, but not limited to, telemed practices, second opinion centers, individual physician practices, etc. Contact us today to find out how we can help you!