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New Certification Process Protects Anthem Member Privacy

Aug 05, 2015

Safeguarding their members’ privacy is a high priority for Anthem. They want your clients and their workers to feel safe and know that Anthem treats their health care claims as confidential. That’s why Anthem makes sure the health reports they share with their fully insured groups are handled the right way. If their groups ask for certain reports, Anthem will ask them to sign a new De-Identified and Summary Health Information Certification form.

What is De-Identified and Summary Health Information?
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) gives fully insured groups a choice:

Only groups that choose not to get member PHI, but ask for de-identified information or summary health reports must sign the new form. Employers need sign it only once, not each time a report is requested. The form does not apply to ASO (Administrative Services Only) groups.

De-Identified Information leaves out facts that directly identify a person. Summary Health Information may include claims history and combined costs. But details that could identify members have been removed. Here are some examples:

Signing the certification confirms that no attempts will be made to re-identify member data from the health reports, either by the employer or by any outside vendors they use. Protecting member privacy this way helps protect your clients and their business.

How the form helps protect your clients' business
Summary Health Information can be viewed as PHI, even though Anthem removes identifying factors. De-Identified information can be put with other facts employers have about their employees to re-identify the ones with health expenses. This becomes PHI. Without steps to ensure proper handling, your client's business could be forced to:

For questions, please ​contact a member of your b&p Sales Team - 888.722.3373.

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