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Privacy Rule for clearinghouses

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Healthcare clearinghouses are entities that process nonstandard information they receive from another entity into a standard (i.e., standard format or data content), or vice versa. In most instances, healthcare clearinghouses will receive individually identifiable health information only when they are providing these processing services to a health plan or healthcare provider as a business associate.

In such instances, only certain provisions of the Privacy Rule apply to the healthcare clearinghouse’s uses and disclosures of protected health information. Healthcare clearinghouses include billing services, repricing companies, community health management information systems, and value-added networks and switches if these entities perform clearinghouse functions.