How To Get A HIPAA Compliance Certification

How To Get A HIPAA Compliance Certification

By: answerout

Patient confidentiality is one of the cornerstones of medical practice. In fact, it’s included in the Hippocratic oath, which implores newly-admitted doctors never to divulge anything that they see or hear in the course of treating patients.      

Unfortunately, the advent of technology has made information sharing easier, threatening the confidentiality of medical records. This paved the way for the creation of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which protects sensitive health information.

First and foremost, healthcare facilities are required to be compliant with HIPAA. This is why they must secure certification to assure patients that the organization is capable of protecting confidential data. 

Important Points About The HIPAA Compliance Certification

Before finding out how to get certified as HIPAA compliant, an organization must understand and take heed of the following points:

  • HIPAA compliance entails implementing policies to safeguard important health information. This is why one of the major steps every organization must take is to provide HIPAA training to its staff.
  • Apart from the HIPAA of 1996, entities should study the HIPAA Privacy Rule and the HIPAA Security Rule (2003), among other related health laws.
  • Compliance requires organizations to study the HIPAA and other related laws thoroughly, as well as apply the salient rules to their respective businesses.  
  • Since compliance isn’t static, facilities are required to revisit and update their internal data protection policies, especially if there are changes in business processes and with the introduction of new technologies.
  • While third-parties offer HIPAA compliance certification to organizations, the Office of Civil Rights under the Department of Health and Human Services (HHS) doesn’t recognize these accreditations.   
  • HIPAA compliance certification is valid only during the time in which the assessment period was done. Having this type of recognition doesn’t mean that the organization can ensure they always abide with the doctor-patient confidentiality, especially if the entity doesn’t review, update, and amend their policies and guidelines.       

Who Should Get HIPAA Compliance?

Apart from healthcare facilities, such as hospitals and clinics, the HIPAA Privacy and Security Rule covers other related organizations. Medical service providers that transmit protected health information in both physical and electronic forms, like health plans and clearinghouses, are included.

Better known as covered entities, these organizations should implement data privacy rules as stated under HIPAA laws. Organizations required to follow the rules include the following:  

     1. Healthcare Providers

Such as: hospitals, medical practitioners, healthcare professionals, nursing or care homes, and clinics.

All healthcare service providers that use and transmit protected health information in electronic format are considered covered entities. These organizations often process medical claims, benefit eligibility applications, and approve referral authorizations, thereby needing to keep the personal information of the patient concerned.    

Healthcare providers need to implement strict measures to ensure that patient information is kept confidential.    

     2. Health plans

Such as: health maintenance organizations, medical insurance providers, and public health organizations. Some employers, universities, medical schools, and other entities collect personal health information for health plans and medical insurance coverage.

Health plans can range from health, dental, vision, and consultation coverages. You can avail of it as an individual or through the company you work for or the school you go to.   

Regardless of the reason why you’re getting the plan, the transaction requires the submission of personal information and patient records. Before the data is shared, these organizations must ask permission from the patient and inform the latter on how the information is utilized.        

     3. Healthcare Clearinghouses

Such as: medical billing services, medical repricing firms, and community health systems.

A medical claims clearinghouse is a third-party company tasked with interpreting, processing, and verifying the data exchanged between insurance providers and payers. These companies check claims for billing and claims discrepancies. Once claims are submitted, clearinghouses check the claims and then either submit the documents to the healthcare service provider for approval or denial.

They may not be considered main care service providers, but the fact that these clearinghouses have access to sensitive medical data makes them a covered entity under HIPAA laws.    

     4. Business Associates (BA)

Such as: private sector vendors, medical app developers, and third-party administrators.

Business associates are individuals and companies outside of the workforce of covered entities who have access to protected health information. These companies perform specific tasks for a covered entity, per HIPAA rules, including data analysis, claims processing, and medical billing.

Similar to clearinghouses, business associates of covered entities will have access to private data, hence they would need to ensure confidentiality of protected health information.    

How To Become HIPAA Compliant And Get A Certificate 

If you operate a business that’s included in the categories mentioned earlier, you can take the following steps in enhancing your existing HIPAA compliance program or getting a certification.     

  • Regular Employee Training

All employees of covered entities and business associates should be well aware of the HIPAA rules and, most importantly, the company guidelines and policies. To ensure HIPAA compliance, companies must subject their workforce to regular HIPAA training for a clear idea of their responsibilities on data security handling. To achieve this, healthcare workers should be trained within two months after they’re hired. Also, they must participate in HIPAA yearly trainings.    

After training completion, a private HIPAA compliance accreditation firm will be giving out a certification form to participants indicating that the student has understood and has committed to uphold information security rules.

Types Of HIPAA Certifications For Individuals

1. Certified HIPAA Professional (CHP) - Employees who have access to protected health information are mandated to attend this type of training. Basic HIPAA compliance serves as the core subject for this training.  


2. Privacy and Administrator Certification - This is required for all workers of the U.S Department of Health and Human Resources, regardless of employment status. This certification offers a more advanced discussion in gathering, handling, storage, and use of protected data.


3. Certified HIPAA Administrator (CHA) - Managers of covered entities are the best candidates for this certification. As an advanced HIPAA-related training, this program discusses HIPAA legislation and data privacy compliance, providing business organizations with better ideas on how to prevent data breaches.   


4. Certified HIPAA Security Specialist - As a more technical certification program, healthcare workers with an information technology background and those who’ve obtained a CHP certificate are the best candidates for this advanced-level certification.     

  • Internal Audits

In relation to HIPAA compliance being dynamic, healthcare organizations and their allied businesses must often review and amend their internal rules, guidelines, and processes as often as possible. Standard requirements for covered entities indicate six annual self-audits in a year, while business associates are obliged to have five self-audit procedures during the same period.

  •  Identification Of Vulnerabilities

Regular self-audits allow companies to review their internal processes and identify data security gaps. These vulnerabilities must be corrected by amending the concerned process or policy. It must then be reported as a remediation effort.

Any remediation report submitted to the HHS bodes well for the company. This is because it allows organizations to keep up with HIPAA standards.         

  • Constant Review Of Policies and Procedures

Since businesses have different processes and procedures in place, their data handling and security procedures must be tailor-made for their own organization. Covered entities must create policies and procedures unique to the business and ensure everything is applicable to their conditions.       

  • Proper Management Of Business Associates

Covered entities must safeguard protected health information at all times. In times where business associates are required to perform specific tasks on their behalf, it’s the organizations’ responsibility to make sure third parties value data security as much as they do. A legally-binding contract–business associate agreement–must be signed with each business associate, containing the terms for data privacy and security.    

Before dealing with the vendor for the first time, consider performing an initial audit by providing the said company with a questionnaire to determine how they’re maintaining their own data security practices. If deficiencies are detected, you can ask the BA to make the necessary remediation measures to address the gaps.            

  • Efficient Incident Response

Policies should also be in place in the event that your company experiences a data breach. Even minor incidents that threaten the integrity and security of protected data should be documented, along with the measures done by the company to mitigate the damages caused by the incident.        

For a minor breach–affecting less than 500 individuals in a specific jurisdiction–the incident must be reported to the affected patients and the HHS within the year. When the security issue impacts more than 500 patients, the persons concerned, the HHS and the media, should be informed within two months following the discovery of the breach.     

  • Third-Party Audits

This requires the participation of expert HIPAA compliance firms to conduct an audit of your company’s policies and processes, including the identification of breaches and remediation procedures in place.  

Most business associates opt for this in order to obtain a HIPAA compliance certificate to show covered entities whom they’re dealing with. In cases companies fall short of the minimum requirements, third parties can draft a plan to improve internal policies and processes to achieve a HIPAA compliant status.


Wrapping Up

HIPAA compliance is every firm’s responsibility. Healthcare organizations that handle protected health information should prioritize secure data handling and establish measures to safeguard patient information. To do this, employees who handle information should be trained about the laws, systems, and policies in place.    

As cyber threats become more sophisticated, organizations shouldn’t keep their guards down. Instead, they must update their policies and processes regularly to keep up with the times. 


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