How Does HIPAA Apply to Your Dentist?

You’ve likely heard about HIPAA. If you’re wondering what those letters stand for it’s Health Insurance Portability and Accountability Act of 1996.

You might also be curious about how HIPAA applies to your dentist and/or your dental health information.

It’s perhaps safe to assume that your dentist is current with both HIPAA compliance and regulations. Even so, it’s useful to understand what exactly HIPAA involves and why you should be aware.

What about HIPAA?

The acronym describes the broader issue of privacy and security surrounding your personal healthcare information. The law was passed to protect your health information and to help assure that your related personal data is securely stored and private.

Fraud and abuse associated with your protected health information (PHI) is the primary concern. Thus, HIPAA rules require providers and healthcare entities to provide certain administrative, physical, and technology protections that meet established criteria.

Who is required to follow HIPAA rules?

An organization or entity “covered” by HIPAA includes:

• A health plan
• A healthcare clearinghouse
• A healthcare provider that has the capability to transmit any health information electronically or in printed format.

Dentists are covered under HIPAA rules since they are considered a healthcare provider. That being true, dentists have access to your PHI (more on this in a moment), they provide online communication access, and they obtain and store your provided information for scheduling/appointment purposes.

What is HIPAA compliance for a dentist?

The basic rules of HIPAA for dentists and healthcare providers in general applies to your PHI.

Think of your protected health information as:

• Your name
• Your addresses
• Your social security number
• Your insurance information
• Your medical records

And basically any other information relative to your health.

Following are the HIPAA compliance requirements you can expect your dentist to follow:

• Provide protection for your PHI from unauthorized access, usage, or disclosure.
• Implement a response plan should a data breach occur such as communication with you (their patient) via what’s known as the Breach Notification Rule.

Be assured that HIPAA rules for your dentist align with those of general healthcare providers. They are required to comply with rules relative to patient privacy, security, and information access.

What’s common with a HIPAA rules violation?

A typical violation of HIPAA is the sharing of your PHI without your consent. That could include unauthorized communication with insurance companies and/or other healthcare providers.

Privacy is fundamental. That being the case, your written consent (noted in your patient file) is required before your PHI can be shared with third parties.

Consent also applies to:

• Disclosure of a mental illness or substance abuse.

And…

• Disclosing your PHI to third parties, insurance providers, family members, or friends.

Keep in mind that HIPAA violations can bring a hefty fine up to $50,000 per violation via the U.S. Department of Health and Human Services.

What actions can you expect your dentist to take regarding HIPAA compliance?

The rules around HIPAA are typically understood by most healthcare providers and dentists. Their actions relative to compliance should create a trusted relationship between you and your provider.

Common actions around HIPAA compliance include:

• Staff training and ongoing communication about HIPAA privacy and security.
• A security plan that assures your data is protected, such as digital firewalls and encryption technology.
• A routine review of HIPAA rules updates and policies.

Your relationship with a dentist is no doubt personal. You should expect the assurance that any and all information shared is respected and kept private according to HIPAA protections.

Virtual dental care would fall under HIPAA protections.

That would equally apply to Dental.com and their “second opinion” solutions alongside any personal health information you provide.

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