Wash. Admin. Code § 284-43-0410

Current through Register Vol. 24-21, November 1, 2024

Section 284-43-0410 - Definitions

(1) "Communications subject to confidentiality" means written, verbal, or electronic communication regarding sensitive health care services, and all health care services if a protected individual has requested to limited disclosure including:

(a) Bills and attempts to collect payment, except for premium billing that does not contain any health information;

(b) A notice of adverse benefit determination;

(c) An explanation of benefits notice;

(d) A carrier's request for additional information regarding a claim;

(e) A notice of contested claim;

(f) The name and address of a provider, a description of services provided, and other visit information; and

(g) Any written, oral, or electronic communication from a carrier that contains protected health information.

(2) "Protected individual" has the same meaning as the definition of protected individual in RCW 48.43.005.

(3) "Sensitive health care services" has the same meaning as the definition of sensitive health care services in RCW 48.43.005.

Wash. Admin. Code § 284-43-0410

Amended by WSR 15-24-074, Filed 11/25/2015, effective 7/1/2016

Amended by WSR 20-24-120, Filed 12/2/2020, effective 1/2/2021

Statutory Authority: RCW 48.02.060, 48.43.530, P.L. 111-148 (2010, as amended) and regulations issued on June 24, 2011, amending 45 C.F.R. Part 147 . 11-24-004 (Matter No. R 2011-18), § 284-43-410, filed 11/28/11, effective 12/29/11. Statutory Authority: RCW 48.02.060 and 48.43.520. 10-23-051 (Matter No. R 2009-19), § 284-43-410, filed 11/10/10, effective 12/11/10. Statutory Authority: RCW 48.02.060, 48.18.120, 48.20.450, 48.20.460, 48.30.010, 48.44.050, 48.46.100, 48.46.200, 48.43.505, 48.43.510, 48.43.515, 48.43.520, 48.43.525, 48.43.530, 48.43.535. 01-03-033 (Matter No. R 2000-02), § 284-43-410, filed 1/9/01, effective 7/1/01.