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A Guide to HIPAA Compliance Audit

Healthcare providers attend various patients during the course of their work. To claim the reimbursement for their services, Healthcare providers must keep records of the treated patients. These records hold information about patients that is sensitive in nature and prone to misuse.  To protect this personal information HIPAA comes into play. All the providers and organizations need to be HIPAA compliant and maintain health information of all the insured patients.

However, recently many healthcare organizations are getting targeted by cyber-attacks. This type of data breach prompts the requirement of a HIPAA compliance audit. This audit is very rigid and can lead to hefty fines in case of failure.

This blog offers extensive information about the HIPAA compliance audit, important aspects related to the audits and how to prepare according to them.

Defining HIPAA Compliance Audit

HIPAA – Health Insurance Portability and Accountability Act is implemented by US federal law. This act is made to protect the valuable information of the patients. It governs the privacy and security of personal health information (PHI).

Whereas HIPAA compliance audit is conducted by the Department of Health and Human Services Office for Civil Rights (OCR). The audit is an assessment of the organization to check if all the required policies and procedures related to HIPAA compliance are met through an examination of the Personal Health Information (PHI) and Electronic Health Information (ePHI).

Even though any organization can conduct internal audits, the HIPAA Audit must be done once a year. It is to forecast and identify the potential risks so that corrective measures can be taken.

Triggers of HIPAA Compliance Audit

The OCR conducts compliance audits as a result of complaints and data breaches. In the matter of big companies and organizations, OCR directs audit randomly anytime.

The two main triggers of an audit are:

  • Complaints:

Complaints are either filed by patients or by employees. The reason for patient complaints can be mismanagement of personal data or refused access to medical records. The complaints made by employees can result in suspected violation of HIPAA by the organization. The employees can summon an audit against mishandled PHI by colleagues or the employer.

2-   Data Breach:

If any breach of data happens, the organizations must report it to the OCR. The OCR will take various factors into consideration before conducting an audit in case of breach reports. The factors range from the intensity of the breach to compliance history and actions taken towards the correction of the breach.

The main causes of data breaches are errors made by employees that can lead to phishing attacks, intentional violation of HIPAA, errors by business associates and faults in the security.

Process of Audit

For a HIPAA compliance audit, any organization must prepare itself to display evidence of compliance. These are the documents, which are considered as the evidence:

  • Documentation of the policies related to privacy, security and breach notification rules.
  • Documentation of the breach incident.
  • List of agreements made with Business Associates regarding PHI.
  • List of procedures to safeguard the administration by managing security of PHI and training the workforce regarding incident response.
  • Proof of workstation security.
  • Proof of technical security to prevent unauthorized access.

Preparation for Audit

There is no special preparation for HIPAA audit. All that needs to be done is compliance with HIPAA regulations. However, the process of compliance must be followed regularly. There is a need for frequent tracking and recording of information related to employee training, risk assessment and incident response.

Following are the steps required for a HIPAA Audit:

  • Appointment of a Security Officer who will ensure that the organization is HIPAA compliant, monitor security practices, train the workforce and document all incidents or breaches.
  • Immediately after any breach, a document of risk assessment is prepared. Usually, the auditor seeks this document to carry forward the process of audit. Risk assessment is a way to expose limitations of a business that can lead to a bigger problem.
  • A well-trained workforce who can handle PHI must also understand the importance of securing the data. Every organization must give training to employees for strong compliance and also keep a record of that training.
  • Organizations must stay consistently updated with the policies and procedures of HIPAA compliance.
  • A regular review of business associates is also a crucial step in the audit.
  • A regular Assessment of HIPAA by conducting internal audits.


HIPAA Audits can be a question of concern for many organizations. Even if an organization is genuinely committed towards ensuring the safety and security of patient information, it can still be unclear about the audit procedures and policies.

If you are an organization looking for a compliance partner, Cyber Cops is here to end your search. Cyber Cops is highly skilled in providing easy HIPAA Training and Compliance. It provides exclusive weekly training that is easy to understand and implement. The exceptional support can help in operating your business faster and better.

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