Covered Entities

What is a "covered entity" under HIPAA?

Below is a more detailed list of those who fall under the covered entity category under HIPAA.

• Health Plans (licensed insurers, ERISA plans, HMOs, Medicare, etc.)

• Providers (physicians, hospitals, home health, DME, pharmacy, chiropractic, dental, etc.) that conduct one or more of the HIPAA-defined transactions electronically

• Clearinghouses (billing services, value-added networks and switches if these entities perform clearinghouse functions such as claims routing, and cleansing entities)