What does HIPPA stand for?
Health Information Portability and Accountability Act
How many PHI Verifiers are required on an Inbound call?
3
In addition to verifying the patient's information what additional information is needed when an insurance company calls in?
•Name of Insurance Company
•Name of Insurance Representative
•Representative telephone number
•Reference number for call
What are the three types of health information that we need to protect on behalf of the patient?
Personal information (PI)
Protected health information (PHI)
Personally, identifying information (PII)
What must always be verified on each call and not considered a verifier?
Patient name and if not patient the caller name/relationship
What are the 2 PHI Identifiers needed on an Outbound call?
• Patients Date Of Birth
•Patients Full Mailing Address
In addition to verifying the patient's information what information is needed when an attorney calls in?
•Name of Attorney Office
•Name of the Representative
•Representative telephone number
How many PHI Verifiers are required on an outbound call?
2
What are some documents that we will need to validate when speaking to family members and other callers?
•Release of Information (ROI)
•HIPAA Release Form
•Power of Attorney (POA)
On an outbound call, If the caller confirms they are the patient/Guarantor, then what can we determine about the phone number on file?
We can determine it is correct.
On an inbound call whose information can be verified in place of the patient's information if PHI is missing or unavailable?
The Guarantor
What must you do if the caller is unable to verify a minimum of 3 PHI identifiers (required or alternate) on an inbound call and 2 PHI identifiers on an outbound call?
We must explain to the caller that "Due to the patient safety and security we can't discuss anything on the patient account".
What information does not need to be verified on an Outbound call?
What are the PHI Identifiers needed on an Inbound call when speaking to the patient?
What are some acceptable alternates that can be used if the caller is not able to verify the required PHI identifiers?