Health Insurance Portability and Accountability Act (HIPPA) Practice Exam

What does Protected Health Information (PHI) require?

1. A diagnosis only

2. An individual association with a diagnosis

3. General health data without personal identifiers

4. Insurance claims data

The correct answer is: An individual association with a diagnosis

Protected Health Information (PHI) is defined as any personal health information that can be used to identify an individual and is related to their health condition, healthcare provision, or payment for healthcare. The key aspect of PHI is that it must be an individual association with a diagnosis, linking personal data directly to a specific person. This means that not only does the information need to pertain to an individual's health, but it must also include a way to identify that individual. For example, health information about an individual’s diagnosis coupled with their name or other identifying information qualifies as PHI. The requirement for individual association ensures that the information is protected under HIPAA regulations, as it has the potential to reveal personal health insights about a specific person. In contrast, other options do not fulfill the criteria for PHI because they either lack the necessary personal identifiers or do not associate specifically with an individual's health condition. General health data without personal identifiers cannot be traced back to a person, thus does not qualify as PHI. Similarly, insurance claims data alone may not provide sufficient linkage to an individual without accompanying identifiers.