HIPAA compliance checklist for private practitioners

By Jamie Frew on Feb 29, 2024.

Fact Checked by Ericka Pingol.

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Introduction to HIPAA compliance

The Health Insurance Portability and Accountability Act of 1996 refers to a federal law that regulates how confidential patient information can be created, stored, and shared between healthcare practitioners. Working in the healthcare field requires an in-depth understanding of how HIPAA functions - not only is this important to protect the privacy of patients, but it can also protect your practice. Breaching HIPAA compliance has significant consequences; including costly fines, losing your medical license and even jail time. Although it can be hard to keep up to date with all of the guidelines that come under HIPAA, particularly given how frequently these change, you nevertheless need to make a continued effort to stay informed. Within this guide, we’ll outline some of the main regulations and how your practice can stay compliant, helping you to minimize any risk of breaching HIPAA and compromising the privacy of your patients.

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What are the four basic guidelines of HIPAA?

HIPAA is essentially separated into four different guidelines that provide specific regulations for certain areas within healthcare. These are:

Privacy rules

Privacy rules dictate when PHI (protected health information) can be accessed and shared by healthcare practitioners. These regulations are in place before, during, and after you see or treat a patient, which includes the appointment scheduling process, check-in, and follow-up care. 

Enforcement rules

The enforcement rules provide information regarding how your practice should respond to any breaches, investigations, or concerns. This can help you identify any areas that are at risk of breaching compliance and work quickly to amend these.

Security rules

Security rules detail the specific measures you need to have in place to maintain HIPAA compliance, including encryption, physical safeguards, risk management, and steps taken to ensure a compliant workplace.

Breach notification rules

These rules require you to inform the necessary parties if a breach has occurred.

Tips to become HIPAA compliant

Although there are a lot of different factors to be aware of regarding compliance, we’ve collated some helpful tips to make this process as simple as possible. 

Develop & implement strong cybersecurity policies

As sophisticated technology continues to be developed and implemented in healthcare businesses, it has become increasingly important to establish cybersecurity policies. Whilst hacking and unauthorized breaches will always pose a threat to the online storage of healthcare data, implementing strong encryption and other online safeguards will help to protect your patients and guarantee your compliance.

Have strong PHI safeguards

When you are looking into an EHR evaluation checklist, you need to determine that the PHI is protected using a range of physical and virtual safeguards. This includes only granting access to authorized users, using frequently changing passwords, and implementing physical security measures at the site of data storage.  

Investigate violations in case of non-compliance

Whilst trying to maintain compliance at all times should be your number one priority, there will likely be times when breaches occur. If this happens, you need to have a procedure in place that allows you to investigate violations and work to amend them quickly.

Conduct regular risk assessments

The best way to determine whether or not your business operations are compliant is to conduct regular risk assessments. These help identify any areas that may require improvement and help you ensure you are maintaining HIPAA compliance.

HIPAA compliance checklist for private practitioners

One of the best ways to analyze the compliance within your business is to run through a checklist and identify the specific areas that you need to either reinforce or implement security measures. 

Have a good understanding of HIPAA privacy & security rules

Before you even begin to implement security measures, you need to have a good understanding of the specific rules that HIPAA dictates. Just like when you learn insurance coverage and develop your understanding of healthcare terminologies, this can take a bit of time but it is well worth the effort. Only when you are equipped with the right knowledge will you be capable of implementing suitable security measures within your business operations and ensuring your patient information is protected at all times - both virtually and physically.

Protect patient data

The next step on your HIPAA compliance checklist is determining what specific types of patient data you need to protect. This varies depending on what field of healthcare you work in and the type of patients you see, but often includes patient identifying information (name, age, address, date of birth), medical record, contact information, and social security number.

Avoid any potential HIPAA violations

Unsurprisingly, you also need to have protocols in place that prevent you from committing any potential HIPAA violations. This requires you to understand exactly what can lead to a breach, the most common types of violations, and how to respond if a violation does occur.

Encourage proper documentation within your private practice

One of the easiest preventative measures for violations is to enforce proper documentation at all times. We understand that documentation can be a time-consuming and tedious aspect of working as a practitioner, but when done well, it can not only protect your patients but also your business. Every interaction with a patient needs to be recorded adequately so you can justify your decisions or actions in the case of a HIPAA violation.

Stay updated on any HIPAA changes

HIPAA guidelines change frequently, and it is your responsibility to stay informed about these changes. It is a good idea to conduct regular training sessions that outline recent changes in the regulations so that all staff members are knowledgeable and capable of protecting PHI.

Growing a private practice

Changes to HIPAA compliance checklists due to the COVID-19 pandemic

Following the COVID-19 pandemic, there was a massive increase in the number of healthcare businesses using telehealth technology to conduct their services. Whilst this was a positive change as it allowed more patients to be treated and cared for, it has significantly impacted how HIPAA compliance works. In addition to the above items on a HIPAA compliance checklist, you also need to do your research into a software vendor’s security protocols and enter into a BAA (business associate agreement). These are regulations that come under HIPAA, and they allow you to use software to create, store and share clinical documentation whilst still ensuring the protection of your patients’ privacy. Although COVID-19 was unprecedented and couldn’t have been planned for, any changes in how healthcare is conducted must always be compliant with HIPAA. As a healthcare practitioner, it is your responsibility to ensure this is the case. However, although the pandemic has had significant impacts on the healthcare industry, these aren’t all bad. The increased use of healthcare technology has correlated with improvements in clinical outcomes, as well as being an effective strategy to improve the finances of practices.

Take home message

We understand that HIPAA compliance is stressful, particularly given the significant consequences that can occur if a practitioner or business is found to be in breach of regulations. Nevertheless, for the sake of both your practice and your patients, you must invest time and effort into maintaining compliance. When it comes time to manage the budget for your private practice, you should consider allocating some resources and funding to improving compliance - this may be in the form of compliance software, regular training programs, or effective risk assessments. Hopefully, this guide has shown you some of the most important compliance features to look out for within your healthcare business, and you feel prepared and ready to protect yourself and your patients!

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