HIPAA Compliance for Ophthalmology: What You Need to Know

HIPAA Compliance for Ophthalmology

Are you an Ophthalmologist? Did you know that you need to be HIPAA compliant? As an Ophthalmologist treating patients, you are considered a covered entity under HIPAA, with specific responsibilities. Find out how to become a HIPAA compliant Ophthalmologist.

What is Required for a HIPAA Compliant Ophthalmology Practice?

As a HIPAA covered entity, it is essential for Ophthalmology practices to be HIPAA compliant. To be HIPAA compliant, you must follow the rules and regulations outlined in the HIPAA Privacy, Security, and Breach Notification Rules. 

Each of these Rules comes with a specific set of standards to ensure protected health information (PHI) use and disclosure is limited to only authorized parties. 

HIPAA Privacy Rule

The HIPAA Privacy Rule regulates the use and disclosure of PHI. To comply with the Privacy Rule, HIPAA compliant Ophthalmologists must limit PHI use and disclosure, provide patients with a Notice of Privacy Practices, and grant patients access to their medical records.

Minimum Necessary Standard

The HIPAA minimum necessary standard requires healthcare providers to limit the use and disclosure of PHI to the minimum needed to perform specific job functions. In other words, all employees do not need the same level of access to information to perform their assigned jobs. 

For example, an Ophthalmologist likely needs access to a patient’s entire medical history to perform their job successfully. A Physician Assistant or Optometrist in the same practice may not need the same level of access to the chart. 

An Office Manager would also require different access levels to a patient’s chart, limited to the information they need to book patient appointments, accept payment for the visit, and submit claims to their health insurance provider.

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HIPAA Seal of Compliance

HIPAA Notice of Privacy Practices

A HIPAA Notice of Privacy Practices (NPP) provides patients with an explanation of how their PHI will be used and disclosed by their healthcare provider. An NPP must be provided to the patient upon intake before receiving treatment.

An NPP must include:

  • The following statement, as a header, or otherwise prominently displayed: “THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.”
  • A description of how PHI can be used for treatment, payment, and health care operations.
  • A description of the types of PHI uses and disclosures requiring patient authorization.
  • A description of the circumstances in which the covered entity may use or disclose PHI without written authorization.
    • A covered entity may use or disclose PHI without authorization for specific, limited purposes. Examples include public health and health oversight activities, and judicial proceedings.
  • The name, title, and phone number of a person or office to contact for further information or questions about the notice.
  • The date on which the notice is first in effect.
  • A statement that an individual may revoke an authorization.

Right of Access

The HIP