Health Insurance Portability and Accountability Act [HIPAA] - Rights conferred on an individual related to Personal Health Information

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Rights conferred on an individual related to Personal Health Information

Health Insurance Companies and Healthcare Service Providers that are covered entities must comply with an individualís right to:

► Ask for viewing and acquiring a copy of personal health records.

► Initiating and implementing corrections incorporated to health information pertaining to an individual.

► Receive a notice as to how personal health data may be used and shared.

► An individual is the ultimate sole-deciding authority as to whether accessibility and permission to view his/her personal health records can be granted or not, before sharing personal health information can be used or shared for certain purposes such as marketing, clinical and market research etc.

► Obtain a report seeking to clarify the reasons for sharing personal health information with others and the dates on which the data was shared.

► In case, if an individual feels that his/her rights related to healthcare data are being denied or feels that personal health information is not being adequately protected, he/she has the liberty to:

► File a complaint with Healthcare provider or health insurer

► File a complaint with the U.S. Government

Accessibility, Viewing and Receiving of Personal Health Records

The HIPAA law has framed rules and regulations regarding who can access and receive an individualís health information.

To make sure that an individualís health information is adequately protected in a manner that does not interfere with his/her health status, this information or data can be used and shared:

► For an individualís treatment and better coordination in healthcare

► For paying the doctors and hospitals pertaining to an individualís health care and provide adequate support to run their businesses

► With help of the individualís family members, relatives, friends, or others, an individual can identify as to who are involved with his/her healthcare or medical bills, unless the individual has certain objections or reservations

► To verify whether the concerned medical practitioners are providing adequate healthcare services and whether the nursing homes are sterile, clean and safe

► For protecting public health, for example, by reporting of influenza or gastro-enteritis in a particular area

► Preparation and submission of medico-legal reports such as gunshot wounds to the police.

An individualís health information cannot be viewed, used or shared without your written consent, unless allowed under the amendments made to HIPAA. For example, without an individualís authorization, it becomes impossible for the concerned healthcare provider:

► To give or share an individualís personal healthcare data with your employer

► Usage or sharing of health information for marketing or advertising purposes

► Sharing or accessibility of private notes pertaining to his/her healthcare

Personal Medical Records

The Privacy Rule under HIPAA confers on an individual, the right to access, inspect, review and receive a copy of his/her medical records and billing records except for a few exceptions that are held by healthcare insurance companies and healthcare service providers.


Only an individual or his/her authorized personal representative has the right to access personal health records. A healthcare service provider or healthcare insurance organization may deliver copies of personal health records to another service provider or healthcare insurance organization as required for carrying out further course of treatment or payment of medical bills or as authorized by the particular individual. However, the Privacy Rule does not require the healthcare service provider or health insurance companies to share personal health data with other providers or plans with whom the individual is not associated in any manner.

Incurred Expenses/Charges

An individual cannot be denied by a healthcare service provider a copy of his/her personal health records on grounds that he/she has not paid for the services that have been provided. A healthcare service provider may charge a reasonable amount for copying and mailing the records. The provider is not authorized to charge an individual feesí for searching or retrieving personal medical records.

Correction of personal data in Health Records

If an individual feels that the data in medical bills or health records is misrepresented or is factually incorrect, he/she has the right to request the healthcare service provider or health insurance organization to make suitable amendments to the existing records which should be accompanied with relevant proof to qualify for the same. It becomes mandatory for the concerned healthcare service provider or health insurance company to respond to an individualís request and initiate necessary amendments to the shortfall in the data. At the same time, it becomes the responsibility of the concerned healthcare service provider or health insurance organization to verify the data in case it is inaccurate or incomplete. In case, if the service provider or health insurance organization does not heed to his/her request, then such an individual has the right to submit a statement of disagreement pertaining to that healthcare service provider or Health Insurance Company and the same must be incorporated to an individualís health records.

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