| Health Insurance Portability and
Accountability Act of 1996 (HIPAA)
National Provider Identifier assignment begins
May 23, 2005 marked the first date that all physicians,
health care professionals and facilities can apply for
their National Provider Identifier (NPI). The NPI will
replace the health care provider identifiers used today
in standard health care transactions. The Health Insurance
Portability and Accountability Act (HIPAA) of 1996 mandates
that all covered entities except small health plans
must begin using the NPI on May 23, 2007; small health
plans have until May 23, 2008.
Regence is working to ensure our systems and procedures
will accept and use NPIs by the compliance date.
Please continue to submit your claims (electronic or
paper) with your Regence BCBSO provider number as you
do today. Currently, if an NPI is submitted, we will
not store it in our systems or use it in claims processing.
We have published articles in our BluePrint®
Newsletter with information about NPI and will
continue to do so throughout the implementation period.
This section of our Provider Information Site
will also be updated as information becomes available.
Articles can be found in these online issues of our
BluePrint Newsletters:
See the CMS Web site at https://nppes.cms.hhs.gov
for additional information related to NPIs.
Table of allowable use or disclosure
of Protected Health Information without authorization
(treatment, payment and health-care operations)
A collaborative effort among several health plans including
Regence BlueCross BlueShield of Oregon, ODS, Providence
Health Plans, Kaiser, PacificSource, LifeWise and Health
Net resulted in a table outlining when protected health
information (PHI) may be exchanged without an authorization
from an individual according to the federal Health Insurance
Portability and Accountability Act of 1996 (HIPAA).
The table includes regulatory cites supporting PHI exchange
without authorization, and has been shared with the
Oregon Medical Association, and the Oregon Association
of Hospitals and Health Systems and HIPAA workgroups.
Click
here to view the table.
If you have any questions regarding this table or your
ability to release PHI without an authorization, please
contact your Medical Association, provider
relations representative, or go to the Health
and Human Services Office for Civil Rights HIPAA site.
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