http://www.cms.hhs.gov/hipaa/hipaa1/content/modcert3.asp <---- more info at this link
The concept of creditable coverage is that individuals should be given
credit for previous health coverage when moving from one employer group
health plan to another, from an employer group health plan to an
individual policy, or from certain kinds of individual coverage to an
employer group health plan.
Most health coverage is creditable coverage, including prior coverage
under a group health plan (including a governmental or church plan),
health coverage (either group or individual), Medicare, Medicaid, a
military-sponsored health care program such as CHAMPUS, a program of the
Indian Health Service, a State high risk pool, the Federal Employees
Health Benefit Program, a public health plan, and a health benefit plan
provided for Peace Corps members.
What is a certificate of creditable coverage?
The certificate of creditable coverage is intended to establish an
individual's prior creditable coverage for purposes of reducing the extent
to which a plan or issuer offering health coverage in the group market can
apply a preexisting condition exclusion. The certificate of creditable
coverage is a written document that reflects certain details about an
individual's creditable health coverage.
Teri MacGill, CPA, CISSP, CIA, CISA
The Regence Group
Security Staff Consultant/Security Architect
(503) 553-1406
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[EMAIL PROTECTED]
To: "WEDI SNIP Security Workgroup
List" <[EMAIL PROTECTED]>
09/11/2003 12:49 PM cc: "WEDI SNIP Privacy Workgroup
List" <[EMAIL PROTECTED]>
Please respond to Subject: Terminology question
josmith
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I'm sending this to all three lists as I don't
know which group may have the answer. We recieved
a question from a client containing a reference
that I'm not familiar with. The question was
"Do you have the ability to suppress the HIPAA
certificates of creditable coverage if requested"
I've yet to see any reference to a HIPAA certificate
of creditable coverage. Can anyone help me with a
definition for this?
Thanks,
Joe Smith
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