HIPAA and HITRUST are two frameworks that are commonly compared because they are used in the healthcare industry.
You know all that information you provide to your doctors and health insurance companies? Things like your name, address, social security number, medical history, test results, insurance details—that’s your protected health information or PHI. As a patient, you have certain rights regarding how your PHI is used and shared. Ever wonder what your doctor can and can’t disclose to others about your health? What about to your family or friends? Or for research studies you may want to participate in? We’re here to give you the full rundown on PHI disclosure so you understand your rights and can make the best decisions about who has access to your personal health details.
What Is PHI Disclosure?
When it comes to your health records, privacy is essential. PHI disclosure refers to the sharing of your protected health information with outside parties.
What exactly is protected health information (PHI)?
Protected health information includes any personal details about your health, medical conditions, treatments, payments, and more. This sensitive data is kept private under HIPAA laws, but can be disclosed in certain situations with your consent.
Knowing how your PHI may be used or shared with outside parties gives you more control and helps ensure your health records remain as private as possible. If at any time you have questions about the disclosure of your PHI, don’t hesitate to speak with your healthcare providers.
PHI Disclosure Rules and Regulations
The Health Insurance Portability and Accountability Act (HIPAA) establishes strict rules around disclosing a patient’s protected health information or PHI. As a healthcare provider, you need to understand and follow these regulations to avoid penalties.
PHI refers to any information that could identify a patient – things like their name, address, birth date, and medical records. You can only share PHI for certain reasons, known as “permitted disclosures.” These include:
- Treatment – You can disclose PHI to provide medical care, like sending records to a specialist. You need the patient’s consent for non-emergency treatment.
- Payment – PHI can be shared to bill and collect payment from health plans or patients. For example, sending claims to insurance companies.
- Healthcare operations – Disclosing PHI to improve quality, reduce costs, or manage your practice is allowed. Think reviewing records to monitor treatment effectiveness.
- With patient consent – Patients can sign an authorization form allowing you to disclose their PHI for any purpose. They can revoke consent at any time.
- As required by law – You must disclose PHI when required for public health activities, health oversight, judicial and administrative proceedings, law enforcement, and more.
- To avert a threat – You can disclose PHI to prevent or lessen a serious threat to health or safety in an emergency situation. Notify patients promptly after disclosure.
- For specialized government functions – Disclosing PHI for military and veterans activities, national security and intelligence activities, protective services for officials, medical suitability determinations, and more.
Following these rules helps keep patients’ sensitive health details private while allowing necessary sharing for treatment and other vital purposes. Be transparent in how you handle PHI and get patient consent whenever possible. Patients trust you with their most confidential information, so take that responsibility seriously.
While the rules around sharing patient health information can seem complex, the guiding principles are actually quite straightforward. Only share what’s necessary, get proper consent, and make sure any disclosures are for permitted purposes that improve patient care. If you follow these best practices and check with your organization’s privacy officer whenever you have questions, you’ll be well on your way to handling PHI responsibly and protecting your patients’ trust. Knowledge is power, so keep learning and stay up to date with any changes to the rules.