Protected Health Information

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Protected Health Information (PHI) is individually identifiable health information. It is protected by privacy, security, and other rules mandated by HIPAA.

Contents

Definition of PHI

Protected health information means individually identifiable health information that is:

  1. Transmitted by electronic media;
  2. Maintained in electronic media; or
  3. Transmitted or maintained in any other form or medium.

Exclusions

Protected health information excludes individually identifiable health information in:

  • Employment records held by a covered entity in its role as employer.
  • Education records covered by the Family Educational Rights and Privacy Act (20 U.S.C. 1232g) and records described at 20 U.S.C. 1232g(a)(4)(B)(iv).

Individually Identifiable Health Information

Individually identifiable health information is information that is a subset of health information, including demographic information collected from an individual, and:

  1. Is created or received by a health care provider, health plan, employer, or health care clearinghouse; and
  2. Relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual; and
    1. That identifies the individual; or
    2. With respect to which there is a reasonable basis to believe the information can be used to identify the individual.

Health information means any information, whether oral or recorded in any form or medium, that:

  1. Is created or received by a health care provider, health plan, public health authority, employer, life insurer, school or university, or health care clearinghouse; and
  2. Relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual.

Specific Examples

Enrollment Information

Enrollment information generated by a group health plan is PHI.

Guidance

See also HIPAA, HIPAA privacy, and HIPAA security.

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