AhaBulb: Stuff Everyone Should Know · ahabulb.com/hipaa-ba-billing-company
A clinic hires an outside company to handle its insurance billing using patient records. What is that company under HIPAA?
A business associate.
- A covered entity
- Part of the clinic's workforce
- A business associate ✔
Why: A business associate handles PHI on a covered entity's behalf, for jobs like billing, claims processing, legal or accounting work, without being on the entity's own staff.
Huh, didn't know that: A business associate may use or disclose PHI only as its business associate contract allows or the law requires.
Why did the clinic's outside biller bring a briefcase? It was a business associate.
Like this card?
References
Answer: A business associate. A business associate handles PHI on a covered entity's behalf, for jobs like billing, claims processing, legal or accounting work, without being on the entity's own staff.
- 45 CFR 160.103 (eCFR) www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-160/subpart-A/section-160.103
creates, receives, maintains, or transmits protected health information
Checked 2026-10-10. - 45 CFR 160.103 (eCFR) www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-160/subpart-A/section-160.103
including claims processing or administration, data analysis, processing or administration, utilization review, quality assurance
Checked 2026-10-10. - 45 CFR 164.502 (eCFR) www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164/subpart-E/section-164.502
A business associate may use or disclose protected health information only as permitted or required by its business associate contract
Checked 2026-10-10.
Think this answer is wrong? Tap "Challenge this answer" on the card in the game and tell us why.
More stuff everyone should know
Healthcare Privacy (HIPAA)What must a clinic have before letting a cloud company store its patient records?Healthcare Privacy (HIPAA)A billing clerk needs a patient's insurance ID. How much of the patient's chart should the clerk look at?Healthcare Privacy (HIPAA)Does HIPAA protect patient information that is spoken out loud, or only paper and computer records?
That's stuff everyone should know.