One of the things we love most about this great country is our freedom. At times, we take advantage of the amount of freedom we are given and occasionally underestimate the kind of power having freedom holds. Needless to say, because of that freedom, we are also subjected to rules and regulation, as well as laws and ordinances. We are the very reason for stipulations and statues and for the most part, we can agree they are created for the equal protection of all. The medical industry sees no reason to dispute or disregard these rights. In fact, it supports your privilege to never be denied medical attention, to always seek a second opinion, and most importantly your right to discretion. They also understand the importance of privacy when it comes to submitting claims to medical insurance providers, so they developed the use of ICD codes to differentiate all diagnosis and CPT codes to vaguely report the findings. Amazingly, this is only the beginning. Realistically, science and technology has advanced at a rate that supersedes the speed of light, so it was certainly necessary to get all of these rules and provisions in place, in order to ensure that they are strictly met and enforced under any and all medical circumstances.
On August 21, 1996, the U.S. Congress made history when it proposed and passed the Health Insurance Portability and Accountability Act, also known as HIPAA. It was created to provide coverage for American workers and their families in the event of a job change, layoff, or job loss. This coverage prevents there from being a gap in insurance so that workers and their families will continue to have insurance until their temporary employment status is lifted.
Some of the primary benefits of HIPAA is it minimizes health insurance and health care fraud. It provides a universal system of identifying medical diagnoses and determines how they will be coded for billing purposes. Lastly, HIPAA provides the insured with protection of confidentiality to ensure their personal information is not compromised within the health care industry.
According to the United States Department of Labor (DOL) Employee Benefits Security Administration (2016), HIPAA extends workers and families with health insurance coverage when life changes and/or events take place. Some examples include when a worker loses his job, gets married, or has a child. It ensures workers and their families will have the necessary coverage without concern of being denied.
One of the unique things about HIPAA is that it does not discriminate against the insured because of health conditions. It cannot deny coverage to individuals and their families or charge premiums outside of the standard levels of care (dol.gov, 2016). HIPAA also works with individual states to provide coverage to individuals that supersedes that of federal mandates. This includes overseeing regulations of health insurance premiums and guidelines for patient care to ensure workers and their families receive the best course of treatments available (dol.gov, 2016).
The Department of Health and Human Services (HHS) (n.d.), provides a myriad of educational information for workers and consumers, including what rights patients have, how personal information is protected, and information pertaining to individuals’ rights in the workplace. Perhaps one of the most compelling, critical pieces of information provided pertains to patient rights. It clears up common misperceptions of consumers as to what their rights are. One in particular is the misconception that patients do not have the right to their medical information. In fact, 27% of patients held this misperception (hhs.gov, n.d.). Not only are patients’ privy to their medical information, but also can obtain a copy of their electronic medical records. Patients can send their medical records to another medical provider themselves or request to have them sent. This compelling information has enabled patients to be more actively involved in their own medical treatment by devising course of treatment in conjunction with their physicians for optimal health outcomes.
Since the inception of HIPAA, the healthcare industry has continually worked to provide a system of treatment and coverage to consumers that ensures the best optimal outcomes. One of the ways in which this is achieved is through proper and accurate documentation of medical records. Various medical software have been developed to help medical coders and administrators protect and preserve patient data to ensure privacy. Interestingly, with the advances in medical technology, the United States ranks well below other countries in terms of quality healthcare provided to patients and spends more on patients than other countries by comparison (Sanderson, 2011).
Through efforts to protect the freedoms that Americans have, the healthcare industry has done its fair share of ensuring consumers have freedoms protected when it comes to receiving patient care. As part of the freedoms that Americans have been afforded in this way is the right to seek the best optimal healthcare and course of treatments offered. Additionally, consumers are entitled to full access to their patient records to aid them in decision-making pertaining to their health and well-being. HIPAA provides added layers of protection for consumers on a variety of levels from protecting patient data to ensuring workers and their families will not have gaps in coverage should there be a loss of employment or other unexpected life changes that warrant changes to health insurance. This also includes how medical diagnoses are coded through medical billing in a universal system that ensures health insurers are held to a higher standard in providing the benefits to patients they have elected and pay for. It is through a combination of factors that provide consumers with the necessary protections to ensure optimal healthcare experiences and outcomes.
