Therefore, a dentist communicating exclusively by phone and fax does not qualify as a HIPAA-covered healthcare provider and does not have to follow the HIPAA Rules for dentists.Īn exception to the criteria exists if a dentist engages a third-party administrator or Dental Support Organization on their behalf to perform eligibility checks, obtain authorizations, and transmit claims information. To further confuse the issue of does HIPAA apply to dentists, voice communications by telephone and paper communications by non-digital fax are not considered “electronic” transactions. The adopted standards include eligibility checks, authorizations, and claims information. However, there are many dentists who do not qualify as HIPAA-covered healthcare providers because they do not “transmit information in an electric form in connection with a transaction for which the Department of Health and Human Services has adopted a standard”. While not all the complaints are attributable to dentist HIPAA violations, the high percentage of dismissed cases implies the public also finds HIPAA in dentistry complex. 65% of complaints from members of the public relating to HIPAA violations are dismissed after review due to not having an eligible case for action. It is not only dentists that find the HIPAA Rules for dentists challenging. It can also be the case that state licensing laws dictate how the HIPAA Rules are applied in dental practices. This can because some dentists do not fulfil the criteria to be Covered Entities, others may have hybrid roles, and a number work in states with more stringent privacy laws than HIPAA. The issue of HIPAA in dentistry is a complex one. However, not all dentists qualify as a Covered Entity, and the HIPAA regulations for dental offices may not apply in every state if the state has passed a privacy law with more stringent data protection or increased patient rights. The HIPPA Rules for dentists are the same as for any other healthcare provider that qualifies as a HIPAA Covered Entity.
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