Welcome the HIPAA Academy’s Learning Center. We hope these links provide you with a springboard for your HIPAA-related research and compliance activities.
HIPAA Overview
The Health Insurance Portability and Accountability Act (HIPAA) is about insurance portability, fraud, and administrative simplification. It is Title II, the Administrative Simplification section of this legislation that is the driving force behind major changes for health care providers, payers, and clearinghouses. It is within this title that standards for privacy, security, and electronic transactions have been defined.
Useful Links:
HIPAA Privacy
The HIPAA Privacy Rule sets a national foundation for the protection of health information. The standards in this rule apply to covered entities as well as their business associates. Most covered entities were required to comply with the Privacy Rule by April 14, 2003. Small health plans have until April 14, 2004.
Useful Links:
- Summary of the Privacy Rule – Very easy to read. From Office for Civil Rights (OCR) (Adobe Acrobat)
- Final Privacy Rule – This unofficial version has all “comments” removed and is much easier to read than the official version. From Office for Civil Rights (OCR) (Adobe Acrobat)
- Final Privacy Rule – The final rule as published in the Federal Register. 45 CFR Parts 160 and 164 (Adobe Acrobat)
HIPAA Security
The HIPAA Security Rule defines standards and implementation specifications in three sections: Administrative Safeguards, Physical Safeguards, and Technical Safeguards. Compliance is required for most covered entities by April 20, 2005. Small health plans have until April 20, 2006.
Useful Links:
- HIPAA and Role Based Access Control – This HIPAA Academy White Paper is about Role Based Access Control (RBAC) and its application to meet the requirements of the HIPAA Security Rule. (request via e-mail)
- Final Security Rule – The final rule as published in the Federal Register. 45 CFR Parts 160, 162 and 164 (Adobe Acrobat)
HIPAA Transactions, Code Sets and Identifiers
The Standard for Electronic Transactions (also referred to as Transactions and Code Sets) will encourage Electronic Data Interchange (EDI) in the health care industry and ultimately simply the processes involved. The ultimate goal is industry wide savings from the reduction of administrative burdens on health care providers and plans.
Useful Links:
- Final Transactions Rule – The final rule as published in the Federal Register. 45 CFR Parts 160, and 162 (Adobe Acrobat)
- Transactions Implementation Guides – These are the definitive reference for implementing the ANSI X12N transactions specified by HIPAA.
- 270/271 – Health Care Eligibility Benefit Inquiry and Response (Adobe Acrobat)
- 276-277 – Health Care Claim Status Request and Response (Adobe Acrobat)
- 278 – Health Care Services Request for Review and Response (Adobe Acrobat)
- 820 – Group Premium Payment for Insurance Products (Adobe Acrobat)
- 834 – Benefit Enrollment and Maintenance (Adobe Acrobat)
- 835 – Health Care Claim Payment/Advise (Adobe Acrobat)
- 837 – Health Care Claim: Dental (Adobe Acrobat)
- 837 – Health Care Claim: Professional (Adobe Acrobat)
- 837 - health Care Claim: Institutional (Adobe Acrobat)
- ANSI Data Dictionary – This document contains an alphabetical listing of each data element used in the implementation guides. (Adobe Acrobat)
