Breaking down some common health care acronyms.
9/10/2019 9:00
There are few industries with as many acronyms as health care.
It can get confusing. ACA International’s Compliance Education Specialist Angela Czerlanis breaks down some of the fundamental health care collection acronyms and their meanings in the September issue of Collector magazine.
Health Insurance Portability and Accountability Act (HIPAA)
“Health” and “Act” are the easy ones to remember. The “IPA” in the middle might not be what you think. “I” stands for “insurance,” not information. The Health Insurance Portability and Accountability Act of 1996 covers a wide berth of health insurance topics, including patient data and electronic billing processes.
It’s easy to associate the “I” with identity or information because that’s how we remember one of the provisions of HIPAA—it keeps our information private. “P” stands for “portability,” not privacy and/or protection, and refers to protecting health insurance coverage for workers and their families when they change or lose their jobs.
Finally, “A” is for “accountable,” and as collectors, accountability for sensitive data is paramount. Remember, the acronym is HIPAA, not HIPPA—and definitely not HIPPO!
Protected Health Information (PHI)
PHI is anything in a consumer’s file, including demographic information, the health care provider’s name and address, details about procedures or treatment, insurance, medical payments and more.
PHI can exist as physical records, electronic records or spoken information. PHI is protected by HIPAA for 50 years after a person dies.
PHI should only be used for the purpose of TPO: Treatment, Payment or Operations of the facility. When working on an account, only use the PHI you need to get the job done. Do not leave your computer screen visible with PHI displayed and be sure to secure any written documents with PHI to reduce the risk of identity theft.
Personally Identifiable Information (PII)
This is any information that can be used to identify someone. For example, there are thousands of Bob Smiths in the world. Get the right combination of sensitive and nonsensitive PII and you will reach just one person.
Some identifiers are considered nonsensitive, like name, birthdate and address.
These can be found in public records. On their own, they aren’t unique to one person. Sensitive PII includes unique identifiers like a Social Security number, passport number or bank account number. If the information were disclosed or stolen, it could cause harm to the individual. Many items of PII are included on a consumer report.
Non-Public Personal Information (NPI)
The Federal Trade Commission defines NPI as any “personally identifiable financial information” that a financial institution collects about an individual in connection with providing a financial product or service, unless that information is otherwise publicly available. NPI can include names, addresses, telephone numbers, Social Security numbers, PINs, passwords, account numbers, salaries, medical information and account balances.
Check out ACA’s Upcoming Events calendar and join us for a bundle of health care seminars to solidify your knowledge of these and other health care abbreviations. In July, we launched a new version of ACA’s Healthcare Collection Management (HCM) designation course. Campus ACA will also debut a new course in 2019: Essentials for Healthcare Collection, designed for collectors new to health care concepts.
Subscriptions to the Collector magazine digital edition and email notifications for each new issue are available for ACA International members by logging in to ACA International’s website here. Members and nonmembers can also purchase a print subscription. Nonmembers can create a guest profile on ACA’s website to subscribe to available publications.