HIPAA COVERED ENTITY

HIPAA COVERED ENTITY


HIPAA Covered Entity

Covered entities under HIPAA are individuals or entities that transmit protected health information for transactions for which the Department of Health and Human Services has adopted standards (see 45 CFR 160.103).

Transactions include transmission of healthcare claims, payment and remittance advice, healthcare status, coordination of benefits, enrollment and dis enrollment, eligibility checks, healthcare electronic fund transfers, and referral certification and authorization.

Covered entities under HIPAA include health plans, healthcare providers, and healthcare clearinghouses. Health plans include health insurance companies, health maintenance organizations, government programs that pay for healthcare (Medicare for example), and military and veterans’ health programs.

[1]


[1] https://www.hipaajournal.com/covered-entities-under-hipaa/

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