What term describes a health plan, a health care clearinghouse, or a health care provider that transmits any health information in electronic form in connection with a HIPAA transaction?

What term describes a health plan, a health care clearinghouse, or a health care provider that transmits any health information in electronic form in connection with a HIPAA transaction?

• A. Drug Formulary
• B. Covered Entity
• C. Balance Billing
• D. Doctor Shopping

Answer: (B)

Covered Entity describes a health plan, a health care clearinghouse, or a health care provider that transmits any health information electronically in connection with a HIPAA transaction. This term identifies groups that must comply with HIPAA privacy and security rules when they engage in standard electronic exchanges of PHI, such as claims submissions or eligibility verifications. A separate concept is a business associate, which refers to entities that handle PHI on behalf of a covered entity under a contract. The other options refer to different, non-entity concepts and do not define who must follow HIPAA rules in electronic transactions.

Covered Entity describes a health plan, a health care clearinghouse, or a health care provider that transmits any health information electronically in connection with a HIPAA transaction. This term identifies groups that must comply with HIPAA privacy and security rules when they engage in standard electronic exchanges of PHI, such as claims submissions or eligibility verifications. A separate concept is a business associate, which refers to entities that handle PHI on behalf of a covered entity under a contract. The other options refer to different, non-entity concepts and do not define who must follow HIPAA rules in electronic transactions.