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| Compliance with our state and federal partners is essential
to providing accurate, timely and comprehensive care for
Members. Below is a short list of requirements
(not all-inclusive) that Physicians and Providers should meet. |
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| Protected Health Information (PHI) |
The Privacy Rule provides federal protections for
personal health information held by covered entities
and gives patients an array of rights with
respect to that information. For a complete
descripton of Physician/Provider requirements,
visit the Department of Health& Human Services' website at:
http://www.hhs.gov/ocr/privacy/hipaa/understanding/coveredentities/index.html |
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| Cultural Competence |
The Center for Linguistic and Cultural Competence
in Health Care (CLCCHC) managed by the Office of
Minority Health was established as a vehicle
to address the health needs of populations who
speak limited English. Please visit their
website to access their guides to implementing language
access services in healthcare organizations:
http://www.omhrc.gov/templates/browse.aspx?lvl=1&lvlID=3
Our Provider Manual also covers this topic and describes how to access language related resources
for our Members. |
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| National Provider Identifier (NPI) |
The National Provider Identifier (NPI) is a Health Insurance
Portability and Accountability Act (HIPAA) Administrative
Simplification Standard. An NPI is a unique identification
number for covered health care providers.
Freedom Health requires the use of NPIs for all
claims transactions. For more information about NPI, visit the
website for the Centers for Medicaid and Medicare Services at: http://www.cms.hhs.gov/NationalProvIdentStand/
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For more information on HIPAA requirements, please visit
the regulations and guidance page of Centers for Medicare and
Medicaid website at:
http://www.cms.hhs.gov/home/regsguidance.asp |
Providers 
