What is a Business Associate?

A Business Associate is a person or entity that performs certain functions or activities that involve the use or disclosure of your patient's PHI.  A member of your workforce is not a business associate.  A covered health care provider, health plan, or health care clearinghouse can be a business associate of another covered entity.  The Privacy Rule lists some of the functions or activities, as well as the particular services, that make a person or entity a business associate, if the activity or service involves the use or disclosure of PHI.

Business associate functions and activities include: claims processing or administration, data analysis, processing or administration, utilization review, quality assurance, billing, benefit management, practice management, and repricing. Business associate services are: legal, actuarial, accounting, consulting, data aggregation, management, administrative, accreditation, and financial. See the definition of “business associate” at 45 CFR 160.103.

 

Examples of Business Associates:

• A third-party server and workstation administrator

• A third-party network administrator

• A third-party administrator that assists a health plan with claims processing.

• A CPA firm whose accounting services to a health care provider involve access to PHI.

• An attorney whose legal services to a health plan involve access to PHI.

• A health care clearinghouse that translates a claim from a non-standard format into a standard transaction on behalf of a health care provider and forwards the processed transaction to a payer.

• An independent medical transcriptionist that provides transcription services to a physician.

• A pharmacy benefits manager that manages a health plan’s pharmacist network.

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