Who Needs HIPAA Training and Certification?

HIPAA stands for the Health Insurance Portability and Accountability Act of 1996.  Its goals are to protect health insurance for workers and their families when they lose their job or change employers; to protect the privacy of patients' health information; to simplify and standardize the electronic communication of patient information and administrative processes; and finally to prevent fraud and insurance abuse.  Basically, anyone involved in any fashion with medical or health insurance information needs to understand and implement the policies and procedures in this act by law.

Health Care Providers

The first obvious group that needs proper HIPAA training and certification is the health care providers.  Everyone who works in a hospital, clinic or doctor's office must clearly understand and implement HIPAA practices on a daily basis.  Understanding the importance of keeping patient records private helps to understand why records are handled in a particular fashion and makes doing the job right easier in the long run.  Doctors, receptionists, office managers, nurses, medical billers, clinicians and aides all need proper HIPAA training and certification and should be kept abreast of any updates or changes to the law.  The Privacy Rule is something that everyone in the office must be aware of since this information must be given to each patient and documented.

Health Plans

Everyone working in a health insurance office should also receive the proper HIPAA certification and training.  They must know who should be eligible for coverage and make sure that patients get the coverage they are entitled to.  They must also understand what constitutes insurance fraud or abuse so they can be aware of the signs to look for when processing and paying claims.  Since everyone in the health insurance company is also involved with health insurance information, they must also understand the laws regarding transmitting and receiving this vital information.

Clearing Houses and Human Resources

Companies that perform electronic billing and claims re-pricing are also required to complete the HIPAA training and certification process.  Managed care vendors, consultants and support contractors are also included in this group and need the proper training as well as personnel in the human resources departments of any business that offers health insurance to its employees.  Failing to get the proper training and certification could result in a lack of compliance that could potentially result in large fines or other penalties for these professionals.

Training and certification for HIPAA is vital for anyone involved in the collection or transmission of health insurance or medical information.  This training and certification is fairly easy and inexpensive to receive and can even be done over the internet.