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SESK: Stuff Everyone Should Know · sesk.info/hipaa-ba-billing-company

A clinic hires an outside company to handle its insurance billing using patient records. What is that company under HIPAA?

A business associate.

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  1. A covered entity
  2. Part of the clinic's workforce
  3. A business associate ✔

Why: A business associate handles PHI on a covered entity's behalf, for jobs like billing, claims processing, legal or accounting work, without being on the entity's own staff.

Huh, didn't know that: A business associate may use or disclose PHI only as its business associate contract allows or the law requires.

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References

Answer: A business associate. A business associate handles PHI on a covered entity's behalf, for jobs like billing, claims processing, legal or accounting work, without being on the entity's own staff.

  1. 45 CFR 160.103 (eCFR) www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-160/subpart-A/section-160.103
    creates, receives, maintains, or transmits protected health information
    Checked 2026-10-10.
  2. 45 CFR 160.103 (eCFR) www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-160/subpart-A/section-160.103
    including claims processing or administration, data analysis, processing or administration, utilization review, quality assurance
    Checked 2026-10-10.
  3. 45 CFR 164.502 (eCFR) www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164/subpart-E/section-164.502
    A business associate may use or disclose protected health information only as permitted or required by its business associate contract
    Checked 2026-10-10.

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Work SkillsA clinic sends records to a specialist who will treat the patient. Is the specialist the clinic's business associate?Work SkillsA business associate hires a subcontractor that will handle PHI. Who must get the subcontractor's written assurances?Work SkillsWhen a business associate contract ends, what must happen to the PHI the business associate still holds, if feasible?

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