	Health Insurance Portability and Accountability Act of 1996 Tool Kit \| Links \| Contact Info Tool Kit The Health Insurance Portability and Accountability Act, known as HIPAA , was passed into law in August of 1996. HIPAA was created to help citizens meet the challenge of getting and maintaining health care, especially those who are self-employed, change jobs from one company to another, or have pre-existing health conditions. Initial HIPAA legislation was aimed at insurance reform and health insurance portability. This legislation, known as HIPAA Title I, is only one aspect of HIPAA Like many other organizations in our health care industry, HealthSCOPE Benefits has been diligently working for months to meet the requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). HealthSCOPE Benefits is committed to facilitating our customers’ efforts to comply with the HIPAA regulations. To help our clients meet their HIPAA needs, HealthSCOPE Benefits has created a Tool Kit that contains templates of many of the most common forms needed to comply with the HIPAA regulations. This tool kit contains sample forms such as a Privacy Notice, a sample Business Associate Agreement, and several key Patient Rights forms. Disclaimer Listed below are form templates that have been developed to assist with a group health plan's efforts to comply with the HIPAA Privacy Regulations. If you are not a group health plan, these forms may not be accurate for your organization. These forms may not meet all of an organizations requirements of the privacy regulations and you are encouraged to seek advice from your individual legal counsel for any specific questions or concerns. These forms are to be used as a template only and should not be considered legal advice on how to comply with the HIPAA Privacy Regulations. Since all organizations have differing polices on handling an individual's protected health information, these templates should be customized to your organization's policies and subject to your independent legal review. Click on the desired link below to view the template. You can also right-click the link and select "Save Target As..." to download the form: Sample Privacy Notice Sample Business Associate Agreement Authorization Form Access Request Form Amendment Request Form Confidential Communication Request Form Disclosure Accounting Request Form Plan Certification Restriction Request Form Revocation of Authorization Form Personal Representative All of these documents are in PDF format which requires the Adobe Acrobat Reader. If you do not have an Acrobat Reader, you can download it from Adobe's site by clicking on the icon below. Back To Top HIPAA Links The following are additional reference links that are presented as a convenience from HealthSCOPE Benefits' website. The existence of a link should not be assumed as an endorsement by HealthSCOPE Benefits. HealthSCOPE Benefits is not responsible for the contents of any such resources. DHHS - Administrative Simplification DHHS – HIPAA Privacy and Security DHHS – Office for Civil Rights CMS - Centers for Medicare and Medicaid Services NCVHS - National Committee on Vital and Health Statistics HIPAA Implementation Guides Healthcare Provider Taxonomy Workgroup for Electronic Data Interchange (WEDi) Data Interchange Standards Association AFEHCT - American Association of Health Care Transactions Health Privacy Project MIS Training Institute Audit and Security Training HIPAA.ORG Back To Top HIPAA Contact Information HealthSCOPE Benefits Privacy Official HealthSCOPE Benefits Attn: Ed Grooms Privacy Official P.O. Box 1224 Little Rock, AR 72203 Back To Top

Health Insurance Portability and Accountability Act of 1996

Tool Kit | Links | Contact Info

Tool Kit
The Health Insurance Portability and Accountability Act, known as HIPAA , was passed into law in August of 1996. HIPAA was created to help citizens meet the challenge of getting and maintaining health care, especially those who are self-employed, change jobs from one company to another, or have pre-existing health conditions. Initial HIPAA legislation was aimed at insurance reform and health insurance portability. This legislation, known as HIPAA Title I, is only one aspect of HIPAA

Like many other organizations in our health care industry, HealthSCOPE Benefits has been diligently working for months to meet the requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). HealthSCOPE Benefits is committed to facilitating our customers’ efforts to comply with the HIPAA regulations.

To help our clients meet their HIPAA needs, HealthSCOPE Benefits has created a Tool Kit that contains templates of many of the most common forms needed to comply with the HIPAA regulations. This tool kit contains sample forms such as a Privacy Notice, a sample Business Associate Agreement, and several key Patient Rights forms.

Disclaimer
Listed below are form templates that have been developed to assist with a group health plan's efforts to comply with the HIPAA Privacy Regulations. If you are not a group health plan, these forms may not be accurate for your organization.

These forms may not meet all of an organizations requirements of the privacy regulations and you are encouraged to seek advice from your individual legal counsel for any specific questions or concerns.

These forms are to be used as a template only and should not be considered legal advice on how to comply with the HIPAA Privacy Regulations. Since all organizations have differing polices on handling an individual's protected health information, these templates should be customized to your organization's policies and subject to your independent legal review.

Click on the desired link below to view the template. You can also right-click the link and select "Save Target As..." to download the form:

Sample Privacy Notice
Sample Business Associate
Agreement Authorization Form
Access Request Form
Amendment Request Form
Confidential Communication Request Form
Disclosure Accounting Request Form
Plan Certification
Restriction Request Form
Revocation of Authorization Form
Personal Representative

All of these documents are in PDF format which requires the Adobe Acrobat Reader. If you do not have an Acrobat Reader, you can download it from Adobe's site by clicking on the icon below.

HIPAA Links
The following are additional reference links that are presented as a convenience from HealthSCOPE Benefits' website.

The existence of a link should not be assumed as an endorsement by HealthSCOPE Benefits. HealthSCOPE Benefits is not responsible for the contents of any such resources.

DHHS - Administrative Simplification
DHHS – HIPAA Privacy and Security
DHHS – Office for Civil Rights
CMS - Centers for Medicare and Medicaid Services
NCVHS - National Committee on Vital and Health Statistics
HIPAA Implementation Guides
Healthcare Provider Taxonomy
Workgroup for Electronic Data Interchange (WEDi)
Data Interchange Standards Association
AFEHCT - American Association of Health Care Transactions
Health Privacy Project
MIS Training Institute Audit and Security Training
HIPAA.ORG

HIPAA Contact Information
HealthSCOPE Benefits Privacy Official
HealthSCOPE Benefits
Attn: Ed Grooms
Privacy Official
P.O. Box 1224
Little Rock, AR 72203