The Health Insurance Portability and Accountability Act (HIPAA) is one of the most important mandatory regulations for healthcare providers. HIPAA consists of many components, establishing and enforcing a range of protocols that aim to protect patients and their personal protected health information (PHI).
HIPAA’s Privacy Rule protects all forms of PHI and establishes regulations relating to accessibility. Within the Privacy Rule is the Right of Access Initiative—a protocol determining regulatory compliance for patient access to copies of their PHI. Discover what the HIPAA Right of Access Initiative entails and enhance how your medical office handles sensitive patient data.
Included and Excluded Accesses
According to HIPAA, patients can access any protected information in a designated record set, which includes the following:
- Medical records
- Billing records
- Insurance information
- Member onboarding records
- Clinical lab tests
- Wellness and disease management programs
- Medical images
- Clinical case notes
Medical providers cannot create additional information upon PHI access requests. Whatever is already recorded gets transferred to the appropriate patients.
Information excluded from access requests includes any information not directly related to the patients, such as a patient’s performance review on past services and any data collected not being used to make patient decisions. Psychotherapy notes that analyze and document counseling sessions and information compiled for legal actions and proceedings are also excluded from access.
Access Requests
Patients can request access verbally, in writing, or online and receive access in any reasonable format of choice, from online portals to emails. Upon request, medical providers and covered entities are in charge of making sure patients undergo thorough verification to confirm their identities.
Providers have approximately 30 days to deliver PHI after receiving and approving access. Medical providers and covered entities can also choose to charge a reasonable fee for PHI copies if patients request PHI summaries with their access records.
Access Denials
Patient PHI access offers many benefits and is a patient’s right. However, in certain circumstances, medical providers can deny access. A medical provider can deny the request if the requester wants:
- Information not included in the designated record set
- Psychotherapy notes
- Records of a research study in progress
- Records included in a court case or legal procedure
- A delivery method that increases security risks
Any requests that insinuate causing someone harm can also result in a denial.
Personal Representative Access
In scenarios where patients can’t make their own executive decisions, a legal representative can request PHI access. The same exemptions and rules that apply to patients’ PHI access also apply to proxies. They can only request information included in the designated record set, and medical providers can deny them access depending on certain circumstances.
Compliance Penalties
Failure to comply with appropriate protocols regarding the Right of Access Initiative leads to repercussions. Compliance penalties include fines and tickets. Staying well-informed on all things HIPAA with HIPAA training for medical office staff reduces your facility’s risk of compliance breaches and ensures you safely and successfully administer patient access. Gamma Compliance provides HIPAA training programs that cover all the essential topics of HIPAA, including the Right of Access Initiative. Our sessions are easy-to-follow, informative, and HIPAA-compliant. Check out our HIPAA training and stay compliant with ease.
Access to PHI is tricky because the wrong access can lead to potential safety breaches and can cause issues like fraud and identity theft. However, giving access to the right people offers many benefits that enhance your medical office and clients’ experiences. With the right training, you can successfully grant PHI access without causing any security breaches. Knowing about the HIPAA right of access initiative is essential for understanding and complying with HIPAA.