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Health, Vision and Dental Insurance
Health Insurance Portability And Accountability Act (HIPAA)
Compliance Procedures and Authorization Forms
Portability
On August 21, 1996, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) was signed into law. A federal act that protects people who change jobs, are self-employed, or who have pre-existing medical conditions. This Act places limitations on a group health plan's ability to impose pre-existing condition exclusions, provides special enrollment rights for certain individuals, and prohibits discrimination in group health plans based on health status. For more information visit the Department of Labor's web site at www.dol.gov
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Accountability
Effective April 14th, 2003, law requires compliance with HIPAA regulations. The Privacy Rule of HIPAA regulations governs the use and disclosure of Protected Health Information (PHI), that is, medical information that contains any of a number of patient identifiers including name, social security number, telephone number, medical record number or zip code. Any information that can reasonably be used to identify you and that relates to your past, present or future physical or mental health or condition, the provision of health care to you or the payment for that care is protected information under the HIPAA Privacy Rule. The regulations protect all individually identifiable health information in any form (electronic, paper-based, oral) that is stored or transmitted by a covered entity.
To fulfill our obligations under the HIPAA regulations and protect your privacy, new procedures are taking place at USI Colburn effective April 14th, 2003. The following is a brief summary of these new procedures:
- To properly identify you, USI Colburn representatives will ask for your name, address and last four digits of your social security number when you contact us by phone.
- Calls received by USI Colburn representatives from you regarding specific service(s) performed may be handled several ways:
- You may call USI Colburn. Our representative will in turn contact your health insurance carrier on your behalf regarding the issue(s). A representative from your health insurance carrier will respond directly to you to follow-up, not an USI Colburn representative.
- You may sign an authorization form allowing USI Colburn representatives to speak with the carrier on your behalf until the claim issue is resolved.
- In some cases, we may be able to initiate a three-way call with your carrier while you are on the phone line. Your health insurance carrier will accept a verbal authorization from you in most cases.
- In the event USI Colburn receives calls from someone other than you regarding a claim/service issue, two authorization forms may be required. One form will authorize the carrier to release information to USI Colburn and another will authorize USI Colburn to release the information to the individual making the phone call. An example of this would be a dependent spouse calling on behalf of the subscriber.
Authorization Forms
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Professional
Liability