Complying with the Requirement for HIPAA Training in a Dental Office

The requirement for HIPAA training in a dental office is the same as the requirement for any other Covered Entity. However, due to members of a dental office´s workforce often performing multiple roles, complying with the requirement for HIPAA training in a dental office can be challenging.

Most dental offices qualify as HIPAA Covered Entities because they process covered transactions. For this reason, a dental office is required to “train all members of its workforce on the policies and procedures with respect to Protected Health Information […] as necessary and appropriate for the members of the workforce to carry out their functions.” (see 45 CFR § 164.530).

For many dental offices, complying with this requirement can be challenging. Members of the workforce may perform multiple functions; and, in smaller dental offices, an individual employee could be a receptionist, a dental assistant, and a payment processor. Therefore, in addition to HIPAA training, they may also require training on Section 1557 and PCI-DSS regulations.

Having to comply with so many training requirements can stretch the resources of a dental office – notwithstanding that employees have to retain the information and comply with it on a day-to-day basis. Furthermore, HIPAA training in a dental office is likely to differ from HIPAA training in other medical environments due to the volume and nature of interactions with patients.

Why HIPAA Training in a Dental Office is Likely to Differ

The way in which many dental offices operate means there are more occasions when accidental or incidental disclosures of PHI may occur – for example, when calling out names in a busy waiting room. It is also the case that the nature of patient communications can be influenced by emergency patients, nervous patients, and “ill-behaved” patients – particularly ill-behaved child patients.

This implies that the nature of HIPAA training in a dental office should be focused on patient interaction in order to prevent accidental and incidental disclosures as much as possible. Members of the workforce may need a more complete education on the Privacy and Breach Notification Rules as well as more specific instructions on how to comply with the Minimum Necessary Standard.

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The same risks of accidental and incidental disclosures can be present when processing cash or credit card payments – particularly when a partner of parent is paying for a patient´s treatment – and when dealing with Business Associates who may be unfamiliar with the requirements of HIPAA – for example when finance companies are contacted at short notice to fund emergency treatment.

Overcoming the Challenges of HIPAA Training

With so many regulations to comply with – and potentially fewer resources to provide training and monitor compliance – dental offices can find it difficult to overcome the challenges of HIPAA training. However, it is possible to take advantage of off-the-shelf HIPAA training courses that provide members of the workforce with the basics of HIPAA.

The courses cover subjects such as the Privacy Rule, patients´ rights, and the Minimum Necessary Standard so members of the workforce already have an understanding of HIPAA before being provided with policy and procedure training as required by 45 CFR § 164.530. Off-the-shelf training helps trainees put policy and procedure training into context, aids retention, and supports compliance in environments in which multiple regulations have to be complied with.

Dental offices can also take advantage of more advanced training courses that cover the fundamentals of the Security Rule training requirements (see 45 CFR § 164.308) and which can be tailored to account for state laws that pre-empt HIPAA. It is worth noting that both the basic and the advanced training courses are usually provided as online training modules that members of the workforce can take in their free time or that can be used selectively to provide refresher training.

HIPAA Training in a Dental Office: FAQs

What is the difference between an accidental disclosure and an incidental disclosure?

An accidental disclosure is one in which PHI is disclosed by itself, while an incidental disclosure is a secondary disclosure to a permissible disclosure. While in practice there is little difference between the two, an accidental disclosure which impermissibly discloses PHI is a violation of HIPAA, while an incidental disclosure is regarded as a “customary health related communication” that plays a role in ensuring patients receive prompt and effective health care.

Do staff in a dental office also have to undergo security and awareness training?

All members of a covered entity´s or business associate´s workforce have to undergo security and awareness training even if they have no access to systems or databases containing PHI. This is because any member of a workforce can fall victim to a phishing scam that opens the door for a ransomware or other malware attack that could cripple the organization´s computer network.

How do ill-behaved patients impact the nature of patient communications?

Ill-behaved patients can be stressful to deal with and can create delays which may cause waiting patients to become ill-tempered. During times when emotions are running high, it can be difficult to remain compliant with standards relating to patient confidentiality – for example, loudly asking a patient by name to quieten down while a specific treatment is administered.

If a dental office does not process HIPAA-covered transactions, is HIPAA training still necessary?

If a dental office does not process HIPAA-covered transactions (i.e., only bills customers directly), the office does not have to comply with the HIPAA training requirements unless it provides a service for or on behalf of a dental office that is a Covered Entity – in which case it becomes a Business Associate of the Covered Entity and has to comply with the Security Rule training requirements along with any further requirements stipulated in the Business Associate Agreement.

What happens if a dental office fails to provide HIPAA training to staff?

If a dental office fails to provide HIPAA training to staff, an HHS´ Office for Civil Rights conducts a compliance investigation in response to a patient compliant, the dental office will not only be sanctioned for the violation that prompted the complaint, but also for any other compliance failing – including the failure to comply with the HIPAA training requirements.