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What Dental & Orthodontic Practices Need to Know About HIPAA

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The federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) established national guidelines for the confidentiality of specific health information. HIPAA governs the use, access, and security of protected health information and the rights of patients.

HIPAA compliance for dentists is a severe concern. Even though several dental clinics are self-contained, the HIPAA requirements for dentists extend to every dental office that sends qualification queries, medical clearance requests, or pre-determinations requests digitally. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) remains one of the most misinterpreted federal health regulations in operation, notably in dentistry, more than two decades after it was initially presented. Dental clinics are increasingly appealing prey for cybercriminals as they increase in size and accumulate more patient healthcare and financial data records. Dentists covered by the law must follow HIPAA Privacy and Security Rules.

HIPAA’s application to dentists practicing cosmetic orthodontics is briefly summarized in this piece, emphasizing why HIPAA compliance should be a priority.

HIPAA Rules for Dentists

The Privacy Rule (2003), Security Rule (2005), and Breach Notification Rule are the three parts of the HIPAA Rule for Dentists (2009). Dentists and dental offices should be aware of any changes to these Rules made by the HITECH Act (2009) and the Final Omnibus Rule (2013).

HIPAA Compliance Handbook is an extensive manual about HIPAA laws for dentists. You should know the interpretation of the Breach Notification Rule and the alerts on the HIPAA Privacy and Security Rules enacted in the HITECH Act and Final Omnibus Rule. It also contains information on the aspects of the HIPAA Privacy Rule for Dentists and relevant information about approving Business Associate Agreements with any non-employee who has licensed access to patients’ files.

Does HIPAA Cover a Dentist?

It varies according to the situation. An individual dentist who runs their own dental office will be a “HIPAA Covered Entity.” In case they digitally transmit any patient records for billing, by emailing a compensation claim to a health insurer. The dentist is protected under HIPAA regardless of a third party filing the complaint on their account.

A dentist recruited by a dental firm, on the other hand, is not protected by HIPAA; instead, the dental firm is the HIPAA Covered Entity. In the sense that the dental business will administer HIPAA-compliant laws related to the allowed information disclosed on PHI, they will be obligated to abide by HIPAA. Still, the staff of dental firms is not deemed to be dentists protected under HIPAA.

Small-practice dentists must obtain counsel on whether HIPAA protects them. If this is the case, they must enact laws to ensure HIPAA compliance for dentists. Even if the firm is a Covered Entity, the dentist may be part of completing HIPAA regulatory requirements for dental practices.

Penalties for HIPAA Violations

Dentists are rarely subjected to HIPAA sanctions. Joseph Beck of Comfort Dentists was fined $12,000 in January 2015 for unlawful exposure of patient records, making him the first dentist to be fined under HIPAA. Dr. Andrew Brown, Chairman of the American Dentistry Association’s Council on Dental Practice, released a statement asking medical professionals in the dental industry to treat HIPAA compliance for dentists seriously.

If you’re bound by HIPAA, becoming compliant will require time and resources. Given that HIPAA compliance may necessitate significant time, work, and financial resources, it is required by law. The costs may be insignificant in relation to the fines that OCR may enforce for violations. Dentists are in a modern generation of HIPAA administration. You must be comfortable in your level of HIPAA compliance, be ready for an OCR inspection or complaint inquiry, and be willing to guard your policies, protocols, and practices. Use our dental directory to find out more denTEL.

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