HIPAA for Health Plans: Privacy and Security for Payer Staff
45 min
6 sections
12 quiz questions
HIPAA training built specifically for health plan employees. Covers the rules that apply to payers and not to providers: the genetic information underwriting prohibition, the plan sponsor firewall, confidential communication requests, plan-specific Notice of Privacy Practices requirements, and business associate oversight across the vendor chain. For claims, enrollment, underwriting, utilization management, appeals, and compliance staff at Medicare Advantage organizations, Part D sponsors, commercial insurers, TPAs, and Medicaid managed care plans.
Course Content
1
Health Plans Are a Different Kind of Covered Entity
7 min
2
Genetic Information and the Underwriting Prohibition
8 min
3
The Plan Sponsor Firewall
8 min
4
Member Rights and Plan-Specific Notice Requirements
8 min
5
Business Associates and the Vendor Chain
7 min
6
Minimum Necessary, Security, and Everyday Payer Scenarios
7 min
What You'll Learn
Core HIPAA regulations and requirements
Protected Health Information (PHI) handling
Privacy and security best practices
Breach notification procedures
Real-world scenarios and applications
Compliance documentation requirements
Administrative SafeguardsPhysical SafeguardsTechnical SafeguardsAccess ControlsEncryptionMobile DevicesLaptops & WorkstationsEmail SecurityCloud StorageSocial MediaTelehealth PlatformsUSB & Portable MediaRemote Access / VPNPrinters & CopiersPolicies & ProceduresDocumentation RequirementsAudit PreparationIncident ResponseSanctions & DisciplineTraining DocumentationCompliance MonitoringePHI (Electronic)Paper RecordsMinimum NecessaryDe-identificationLimited Data SetsDesignated Record SetPHI in Photos & VideoRight to AccessRight to AmendRight to AccountingRight to RestrictRight to Confidential CommunicationsFront Desk / Check-InPhone ConversationsFamily & VisitorsLaw Enforcement RequestsMedia InquiriesWorkers' CompensationPublic Health ReportingResearch UsesMarketing & FundraisingMinors & GuardiansUnauthorized AccessWaiting RoomBreak RoomParking Lot / Public AreasHome Office / Remote WorkConference RoomsShared Workstations