HIPAA Agent Training PowerPoint 12/11/2013 Sheets... · HIPAA Agent Training PowerPoint 12/11/2013 Much of our Company and Agent activity is directly or indirectly related to the

Welcome to Online Training! Today you’re going to learn about HIPAA.

12/11/2013 HIPAA Agent Training PowerPoint

This Agent Training PowerPoint provides information about HIPAA. Remember, this material is for training and has not been filed or approved as advertising. It should not be used as a sales tool.

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HIPAA stands for the Health Insurance Portability & Accountability Act and was enacted by the United States’ Congress in 1996. Additional enhancements were added to the Act in 2003.

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HIPAA was created to protect and preserve health insurance for workers and families if they change or lose jobs. It regulates the availability and scope of group health plans and certain individual plans. It also regulates the time-frame restrictions a group plan can place on benefits for preexisting conditions if the insured had health insurance prior to enrolling in the new plan.

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But HIPAA does more. One of its most important contributions is the regulations it has to increase the efficiency of the healthcare system by standardizing and encouraging the electronic exchange of health information. It also has programs in place to control fraud and abuse within the healthcare system and regulations to maintain the privacy and security of health data for individuals and organizations like ours which must receive and use that health data.

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As an insurer that sells health plans, we continuously transmit, receive, or maintain health information in some form or another. We receive and retain personal health information daily from applicants and customers. We receive information from healthcare providers electronically or in some other form.

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Much of our Company and Agent activity is directly or indirectly related to the issues for which HIPAA was created, such as maintaining the privacy and security of our applicants’ and policyholders’ information.

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Consequently, maintaining compliance with HIPAA regulations is important to both the Company and to you as a representative of the Company – especially as it relates to receiving and maintaining information from applicants and customers and to privacy and security issues.

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In the course of normal Agent activity, you are exposed to certain applicant/policyholder information. This can include your customer’s name, address, date of birth, and Social Security number. It may also include private financial information concerning debts, assets, and account numbers, as well as health information and family matters.

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According to HIPAA privacy and security laws, you must keep all this personal applicant/policyholder information confidential.

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In addition, you may be exposed to certain protected health information as it relates to a policyholder such as:

• Dates of Service for health providers

• Claims data

• Underwriting details

• Responses to health questions

• Premium billing or payment data

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This Protected Health Information is considered to be Individually Identifiable Health Information. Under HIPAA rules, you may not disclose this Protected Health Information to anyone, other than information that is required in the normal course of business. We are permitted to use or disclose Protected Health Information for payment of health claims.

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Violation of HIPAA privacy and security rules can result in loss of policyholder trust, Company credibility, and Company revenue.

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Violations can also result in civil or criminal penalties for individuals and companies, and Company sanctions for Agents, up to and including termination of Agent appointments with the Company.

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The Company takes the following steps to ensure compliance with HIPAA rules:

• Mails HIPAA Privacy and Security Notices to customers so they know their rights.

• Studies HIPAA rules and alters Company processes as needed.

• Conducts Company training sessions.

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Congratulations! You have completed the HIPAA Agent Training PowerPoint.


Documents

HIPAA Agent Training PowerPoint 12/11/2013 Sheets... · HIPAA Agent Training PowerPoint 12/11/2013 Much of our Company and Agent activity is directly or indirectly related to the