UHIPAA Ukuqeqesha Ukuhambisana Nonyaka

Umthetho wokuThengiswa komshuwalense wezeMpilo nokuPhathwa kweMpilo wenziwa ngo-1996. Uphoqelelwa yiHhovisi LamaLungelo Emisebenzi KaHulumeni wase-United States. Kuyisethi yemihlahlandlela kahulumeni eyenziwe ukuvumela abasebenzi ukuba bathathe umshuwalense wabo wezokwelapha uma behamba nomqashi, bavumele abantu ukuba bathole umshuwalense wezokwelapha naphezu kwezimo zangaphambili (ngaphansi kwemibandela ethile), nokubeka izindinganiso zobumfihlo zempilo yesiguli ulwazi.

• Umthetho Wobumfihlo we-HIPAA uvikela ubumfihlo bomuntu ngamunye ulwazi olubonakalayo lwezempilo.
• Umthetho wezokuphepha we-HIPAA ubeka amazinga kazwelonke wokuphepha kolwazi lwezempilo lwe-elekthronikhi.

Kudingeka ngumthetho ukuhlinzeka ngezemfundo nokuqeqeshwa kwe-HIPAA kubantu abasebenza embonini yezokunakekela impilo ukuqinisekisa ukuphendula ngokuyimfihlo nokuphepha kolwazi lwezempilo oluvikelwe. Izinhlangano ezihlanganisiwe kumele ziqeqe wonke amalungu abasebenzi emsebenzini wezinqubomgomo nezinqubo ze-HIPAA.

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I-HIPAA Umthetho Wobumfihlo

Amazinga Wokungasese Okwaziswa Ngokwempilo Ngokwemfihlo (Private Rule) yakhelwe ukubhekana ngokuqondile nokuvikelwa kolwazi lomuntu siqu lwezempilo. Kubalulekile ukuba ubukhulu behhovisi lakho lezokwelapha ligcine ukuhambisana kwe-HIPAA.

Ubani Obhalwe Ngomthetho Wobumfihlo?

• Izinhlelo Zempilo
• Abanikezeli Ukunakekelwa Kwezempilo
• Ukunakekelwa Kwezempilo

Inhlangano ehlanganisiwe, njengoba ichaziwe ku-HIPAA, ingaba uhlelo lwe-inshuwalense yezempilo, indlu yokuhlanza impilo noma umhlinzeki wezempilo odlulisela ulwazi lwezempilo oluvikelwe ngekhompyutha futhi kungaba izinhlangano, izikhungo noma abantu.

Odokotela kanye nabanye ochwepheshe bezempilo abasebenza neziguli kanye namarekhodi abo ezokwelapha okuyimfihlo kufanele balandele izinqubomgomo, izinqubo, nemithetho eyenzelwe ukuvikela ubumfihlo begciwane kanye nemfihlo. Bonke abahlinzeki bezempilo banomthwalo wemfanelo wokugcina abasebenzi babo baqeqeshiwe futhi banolwazi mayelana nokuhambisana kwe-HIPAA . Kungakhathaliseki ukuthi ukudalula okungenakugunyazwa noma okungekho emthethweni kwe-PHI kuthathwa njengokuphulwa kwe-HIPAA.

• Ama-Business Associates

Umlingani webhizinisi, njengoba kuchaziwe yi-HIPAA, noma yimuphi umuntu noma inhlangano eqhuba ibhizinisi elibandakanya ukusetshenziswa noma ukudalulwa kolwazi lwezempilo oluvikelwe egameni lenkampani ehlanganisiwe futhi akuyona isisebenzi sehlangano ehlanganisiwe.

Ngolwazi Luni Oluvikelwe?

I-PHI noma Ulwazi Lwezempilo Oluvikelwe libhekisela kunoma yiluphi ulwazi lokukhomba olulodwa olufakwe kwirekhodi lezokwelapha lesiguli elidluliselwa noma elondolozwe nganoma yiluphi uhlobo.

Ukusetshenziswa Nokudalulwa

Inhlangano ehlanganisiwe ingasebenzisa noma idalule ulwazi lwezempilo oluvikelwe (i-PHI) ngaphandle kokugunyazwa ngaphansi kwezimo ezithile.

1. Kulowo nalowo
2. Ukwelashwa, Ukukhokha, Nemisebenzi Yokunakekelwa Kwezempilo
3. Ukusetshenziswa Nokudalulwa Ngethuba Lokuvumelana noma Okwenziwe
4. Ukusetshenziswa okungajwayelekile nokudalula.
5. Imisebenzi Yomphakathi Nenzuzo
6. Ukufakwa Kwemininingwane Elinganiselwe ngenhloso yocwaningo, imisebenzi yezempilo yomphakathi noma yokunakekelwa kwezempilo

Isaziso Sobumfihlo

Abahlinzeki bokunakekelwa kwezempilo banesibopho sokunikeza iziguli zabo isaziso sezenzo zobumfihlo. Lesi saziso, njengoba kudingwa yi-HIPAA Private Rule, sinika iziguli ilungelo lokukwaziswa ngamalungelo abo okuyimfihlo njengoba zihlobene nolwazi lwabo lwezempilo oluvikelwe (i-PHI).

Isaziso kufanele sichaze ulwazi oluthile kalula ukuqonda imigomo:

• Indlela umhlinzeki azosebenzisa ngayo futhi adalule i-PHI yabo
• Amagciwane amalungelo aqondene ne-PHI yawo
• Isitatimende esitshela isiguli semithetho efuna umhlinzeki ukuthi alondoloze ubumfihlo be-PHI yabo
• Iziguli ezingathintana nazo ukuze uthole olunye ulwazi mayelana nezinqubomgomo zobumfihlo zomhlinzeki

Ukuphoqelelwa Nezigwegwe Zokungavumelani

Izigwegwe zemali zomphakathi

• U- $ 100 ukwehluleka ukuhambisana
• Amaphesenti angu- $ 25,000 ngonyaka ngokuhlukumeza okuningi kwemfuneko efanayo

Izinhlawulo zobugebengu (ngokuthola ngokuthola noma ukudalula i-PHI ngokwephula i-HIPAA)

• U-$ 50,000 uhle futhi uphinde uboshwe unyaka owodwa
• I-$ 100,000 ihlelekile kuze kube yiminyaka emihlanu ejele (uma ukwephulwa kuhilela ukungabi namanga)
• U-$ 250,000 uhamba kahle kuze kube yiminyaka eyishumi ejele (uma ukwephula kuhilela ukuthengisa, ukudlulisa, noma ukusebenzisa i-PHI)

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Umthetho wokuphepha we-HIPAA

Amazinga Wokuphepha Wokuvikelwa kolwazi lwezempilo oluvikelwe nge-Electronic (uMthetho Wokuphepha)

Ukuphepha kwe-HIPA kubhekisela ekusunguleni izivikelo ze- PHI kunoma yikuphi uhlobo lwe-elekthronikhi. Lokhu kufaka phakathi noma yiluphi ulwazi olusetshenzisiwe, olugcinwe noma oludluliselwa ngekhompyutha. Noma iyiphi indawo echazwe yi-HIPAA njengenhlangano ehlanganisiwe inesibopho sokuqinisekisa ubumfihlo nokuphepha kolwazi lwesiguli sayo kanye nokugcina imfihlo ye-PHI yabo.

Ubani Ohlanganiswa Ngomthetho Wokuphepha?

• Izinhlelo Zempilo
• Abanikezeli Ukunakekelwa Kwezempilo
• Ukunakekelwa Kwezempilo

Inhlangano ehlanganisiwe, njengoba ichaziwe ku-HIPAA, ingaba uhlelo lwe-inshuwalense yezempilo, indlu yokuhlanza impilo noma umhlinzeki wezempilo odlulisela ulwazi lwezempilo oluvikelwe ngekhompyutha futhi kungaba izinhlangano, izikhungo noma abantu.

• Ama-Business Associates

Umlingani webhizinisi, njengoba kuchaziwe yi-HIPAA, noma yimuphi umuntu noma inhlangano eqhuba ibhizinisi elibandakanya ukusetshenziswa noma ukudalulwa kolwazi lwezempilo oluvikelwe egameni lenkampani ehlanganisiwe futhi akuyona isisebenzi sehlangano ehlanganisiwe.

Ngolwazi Luni Oluvikelwe?

I-PHI ye-elekthronikhi noma Ulwazi lwezempilo oluvikelwe libhekisela kunoma yiluphi ulwazi lokukhomba olulodwa olufakwe kwirekhodi lezempilo lesiguli elidluliselwa noma elondolozwe nganoma yiluphi uhlobo. Umthetho wokuphepha awufaki i-PHI idluliselwe ngomlomo noma ngokubhala.

Ukucaciswa kokuphatha

Izinhlinzeko zokwenza lula zokuphatha ze-HIPAA zisungula amazinga kazwelonke wokuphepha kolwazi lwezempilo oluvikelwe nge-elektroniki. Lokhu kufaka imithetho nemigomo yokuthengiselana kanye nezinethi zekhodi kanye nezihlonzi zabaqashi nabahlinzeki.

Ukuthengiselana namazinga wokubeka ikhodi

Ukuthengiselana okujwayelekile kwe-Electronic Data Interchange (EDI) yedatha yokunakekelwa kwezempilo kuhlanganisa izimangalo futhi kuhlangene nokwaziswa, ukukhokha kanye nokukhishwa kwezimali, isimo sezimangalo, ukufaneleka, ukubhaliswa nokusabalalisa, ukudluliselwa nokugunyazwa, ukuhlanganiswa kwezinzuzo kanye nokukhokhwa kwe-premium.

Ikhodi ejwayelekile yokubeka ukuxilongwa, inqubo, kanye namakhodi wezidakamizwa zihlanganisa i- HCPCS (Izinsiza Zomsebenzi / Izinqubo), i- CPT-4 (Physicians Procedures), i-CDT (I-Dental Terminology), i- ICD-9 (Ukuxilongwa kanye Nezinqubo Zokugula Iziguli), ICD-10 ( Kusukela ngo-Okthoba 1, 2015) kanye namakhodi we-NDC (National Drug Codes).

Amazinga Wokukhomba Abaqashi nabanikezeli

Izihlonzi ezijwayelekile zifaka phakathi Inombolo Yokuqashwa Kwamaqashi (EIN) kanye neNational Identier Identifier (NPI). I-EIN isetshenziselwa ukukhomba abaqashi ekuthengiseni okujwayelekile. Ukuqokwa koMhlinzeki kaZwelonke noma i-NPI yinombolo enezinombolo ezingu-10, eyingqayizivele yokuhlonza esetshenziselwa ukuthatha indawo yezihlonzi zomhlinzeki njengeNombolo Yokukhomba Yomhlinzeki Wodwa (UPIN) ku-HIPAA ukuthengiselana okujwayelekile. Abahlinzeki bempilo bayadingeka ngokumiswa kwe-HIPAA ukuthola i-NPI.

Imithetho yokugcina ukuphepha kwe-HIPAA ihlanganisa izivikelo zezindawo ezintathu eziyinhloko.

Izivikelo Zokuphatha

1. Ukuthuthukisa inqubo yokulawulwa kokuphepha okubandakanya ukuthuthukiswa kwezinqubomgomo nezinqubo, ukuhlolwa kwangaphakathi, uhlelo lokubhekana nokuphepha kanye nezinye izivikelo ukuqinisekisa ukulandelwa kwabasebenzi behhovisi lezokwelapha.
2. Nika umthwalo wokuphepha kumuntu oqokiwe ukuze aphathe futhi ahlole ukusetshenziswa kwezinyathelo zokuphepha nokuziphatha kwabasebenzi.
3. Qalisa izici eziqinisekisa ukuthi abasebenzi banokuqeqeshwa okufanele nokugunyazwa okufanele ukufinyelela ku-PHI.
4. Chaza amazinga okufinyelela kubo bonke abasebenzi nokuthi anikezwa kanjani
5. Kudinga ukuthi bonke abasebenzi basehhovisi lezokwelapha kuhlanganise nokuphathwa baqeqeshe ukuphepha futhi babe nezikhumbuzo ngezikhathi kanye nemfundo yomsebenzisi.

Ukuvikelwa okungokwenyama

1. Faka ifayela le-PHI endaweni ephephile kanye nendawo yokusebenzela yabasebenzi (lokhu kuhlanganisa ukusetshenziswa kwamalokhikhi, okhiye, namabheji avule izivalo) ezivimbela ukufinyelela kubantu abangagunyaziwe nabangenayo.
2. Thuthukisa izinqubomgomo zokuqinisekisa ukugunyazwa kokufinyelela, ukulawula imishini nokuphatha izivakashi. Thuthukisa futhi unikeze amadokhumenti kuhlanganise nemiyalelo yokuthi ihhovisi lakho lezokwelapha lingakusiza kanjani ukuvikela i-PHI (isibonelo, ukuvala ikhompyutha ngaphambi kokushiya ngaphandle kokulindelwe)
3. Nikeza ukuvikelwa komlilo nezinye izingozi

Izivikelo zobuchwepheshe

1. Qalisa ukuhlonza komsebenzisi okuyingqayizivele kuhlanganise amaphasiwedi nezinombolo zephini
2. Yamukela ukulawula okuzenzakalelayo kwe-logoff
3. Qopha futhi uhlole umsebenzi wesistimu ngezinhloso zokucwaninga
4. Sebenzisa izilawuli zokubethela ukuvikela idatha edluliselwe phezu kwenethiwekhi

Ukuphoqelelwa Nezigwegwe Zokungavumelani

Izigwegwe zemali zomphakathi

• U- $ 100 ukwehluleka ukuhambisana
• Amaphesenti angu- $ 25,000 ngonyaka ngokuhlukumeza okuningi kwemfuneko efanayo

Izinhlawulo zobugebengu (ngokuthola ngokuthola noma ukudalula i-PHI ngokwephula i-HIPAA)

• U-$ 50,000 uhle futhi unyaka owodwa ejele
• I-$ 100,000 ihlelekile kuze kube yiminyaka emihlanu ejele (uma ukwephulwa kuhilela ukungabi namanga)
• U-$ 250,000 uhamba kahle kuze kube yiminyaka eyishumi ejele (uma ukwephula kuhilela ukuthengisa, ukudlulisa, noma ukusebenzisa i-PHI)

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Amathiphu Okugwema Ukuhlukumeza i-HIPAA

1. Thatha izinyathelo ezidingekayo zokuzigcina ekudaluleni ulwazi ngokusebenzisa ingxoxo evamile. Gwema ukudalulwa kolwazi ngokusebenzisa ingxoxo evamile; ukuxoxa ngolwazi ngesineke ezindaweni zokulinda, emigwaqeni noma ezikhungweni; ukulahlwa okufanele kwe-PHI; futhi ukufinyelela kolwazi kunqunyelwe kuphela kwabasebenzi abanemisebenzi efuna ukuthi ulwazi. Ukwaziswa okuyisisekelo kungabonakala kungabalulekile kakhulu ukuthi kungakhulunywa kalula engxoxweni evamile kodwa kufanele kwabiwe kuphela ngesidingo sokwazi.
2. Gwema ukuxoxa ngolwazi ngesineke ezindaweni zokulinda, imigwaqo noma izakhiwo. Ulwazi oluzwelayo lungase luzwwe izivakashi noma ezinye iziguli. Futhi qiniseka ukuthi ugcina amarekhodi weziguli ezindaweni ezifinyeleleka emphakathini. Njengoba iziteshi zamahhala kanye nezihlengikazi zingena evulekile, hamba i-kilometer eyengeziwe ukuqinisekisa ukuthi amakhompiyutha agcinwa ngaso sonke isikhathi. Abanikazi bamashadi kufanele bahanjiswe futhi iphaneli langaphambili limbozwe ngokwezindinganiso ze-HIPAA.
3. I-PHI akukaze ilahlwe kumathrekhi okudoti. Noma iyiphi idokhumenti ephonswe kudoti ivulekile emphakathini ngakho-ke ukwephulwa kolwazi. Kunezindlela eziningi zokulahla i-PHI. Ukulahla kahle kwephepha PHI kuhlanganisa ukushisa noma ukushisa. I-PHI ye-elekthronikhi ingasuswa ngokusula, ukusula, ukuguqula kabusha, ukukhipha, ukuqhaqhaza noma ukukhipha.
4. Kunezinhlobo zobuchwepheshe obukhona ezenzelwe ukuvikela idatha yesiguli. Khetha ngokukhetha amadivaysi nesofthiwe egcina idatha phezu kokuxhumeka okungenantambo okufaka umlilo, anti-virus, anti-spyware, kanye nobuchwepheshe bokutholakala kwe-intrusion. Sebenzisa ukuqapha okukhulu lapho ufinyelela idatha ngaphezu kokuxhumeka okude. Ochwepheshe be-IT basikisela ukusebenzisa uhlelo lokuqinisekiswa kwezinhlangothi ezimbili ngamathokheni wokuphepha namaphasiwedi.