Who is a “covered entity” under the EDIregulations?
You are covered under the EDIregulations if you are a health plan, a health care clearinghouse, or a health provider who conducts business using electronic transactions. Q: I am a health care provider, but I don’t do any electronic transactions now, everything I do is done by paper. Does HIPAA require me to use the standard formats in my paper transactions, or even worse, does it require me to do all of my transactions electronically? (March 2002) A: Under HIPAA, health care providers are not required to do transactions electronically. However, if they do, they must use the standards. If you do not engage in any electronic transactions, you are not covered by HIPAA and are not bound to use the electronic data exchange standards. However, whether or not it is otherwise to your advantage or disadvantage to remain a paper based system is a determination you will need to make. Comments or questions about the information on this page can be directed to the Office of the Counsel.
