Transferring personal health information

Under HIPAA, a transaction of information between two parties for the purpose of carrying out financial or administrative activities related to health care can include the following types of transmission:

  • health care claims or equivalent encounter information;
  • health care payment and remittance advice;
  • coordination of benefits;
  • health care claim status;
  • enrollment and disenrollment in a health plan;
  • eligibility for a health plan;
  • health plan premium payments;
  • referral certification and authorization;
  • first report of injury;*
  • health claims attachments;*
  • other transactions that may be prescribed by regulation.

*Currently, HIPAA has stayed, or delayed implementation of, first reports of injury and health care claim attachments as covered HIPAA transactions. Note: Although an occupational health nurse may fax or electronically transmit a first report of injury, doing so does not make him or her a "covered entity" under HIPAA. This transmission generally is related to the physician’s first report of injury for which the physician will receive payment for services rendered.