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2005-030
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2005-030
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Last modified
7/5/2016 2:27:35 PM
Creation date
9/30/2015 7:40:02 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Addendum
Approved Date
01/18/2005
Control Number
2005-030
Agenda Item Number
11.D.1
Entity Name
Blue Cross and Blue Shield of Florida
Symetra :Life Insurance Co.
Subject
HIPAA-AS Addendum to Agreement
Archived Roll/Disk#
4000
Supplemental fields
SmeadsoftID
3862
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then follow the procedure for " Verification of Identity of Those Requesting <br /> Protected Health Information . " <br /> • Once the identity of a parent or personal representative is verified, then follow the <br /> procedure for "Individual ' s Request for Access . " <br /> • All other requests from spouses , family members , and friends must be authorized <br /> by the individual whose PHI is involved . See the procedures for "Disclosures <br /> Pursuant to Individual Authorization. " <br /> 7. Disclosures of De-Identified Information <br /> De-identified information is health information that does not identify an individual and <br /> with respect to which there is no reasonable basis to believe that the information can be <br /> used to identify an individual . There are two ways a covered entity can determine that <br /> information is de-identified : either by professional statistical analysis , or by removing 18 <br /> specific identifiers as outlined in HIPAA regulations . The following identifiers must be <br /> removed to de-identify information : <br /> • names <br /> • all geographic subdivisions smaller than a state (special rules apply) <br /> • all elements of dates ( except year) relating to an individual (special rules <br /> apply) <br /> • telephone numbers <br /> • fax numbers <br /> • electronic mail addresses <br /> • Social Security numbers <br /> • medical record numbers <br /> • health plan beneficiary numbers <br /> • account numbers <br /> • certificate/license numbers <br /> • vehicle identification and serial numbers including license plate numbers <br /> • device identifiers and serial numbers (such as pacemaker number) <br /> • web Universal Resource Locators (URLs) <br /> • Internet Protocol (IP) address numbers <br /> • biometric identifiers including finger and voice prints <br /> • full face photographic images and any comparable images , and <br /> • any other unique identifying number, characteristic or code (special rules <br /> apply) , <br /> Procedure <br /> • Obtain approval from Privacy Official for the disclosure . The Privacy Official will <br /> verify that the information is de-identified. <br /> • The Plan may freely use and disclose de-identified information . De-identified <br /> information is not PHI. <br /> 8 . Verification of Identity of Those Requesting Protected Health Information <br /> 22 <br />
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