HIPPA

[Guest SaraR]

We have a self insured health plan. I have been told that if we include in our HIPPA policy that assisting employees with health insurance claims is a routine and recurring task, that we are not required to have an employee sign an authorization form before we can assist them. Can anyone verify that this is correct for me? Thank you.

[Steve72]

This is a somewhat complicated question. Your post is basically correct, but will depend on what assistance activities are actually being performed, what information is being shared and what kind of arrangement you have with your TPA regrding communication with plan personnel.

If you classify assistance activities as a plan function, and bring all employees who perform this task within the HIPAA "firewall", the general consensus is that those employees can continue performing these functions without specific authorization. However, if you have individuals performing this action, why not have them obtain an authorization at the outset of the assistance? It's a relatively painless process, and most employees will understand the need and be willing to execute the authorization to get assistance with their claims.

[Guest cherryred]

The health plan is the covered entity and may use or dislcose information for treatment, payment or health care operations to other covered entities or business associates without obtaining specific authorization from the individual. If the people handling the information (assiting the employees) are doing so on behalf of the health plan and are doing so for treatment, payment or health care operations purposes, then you do not need to obtain an authorization.