HIPAA Risk Assessment What is your HIPAA compliance score? You will receive a copy of your results and score via email. "*" indicates required fields Name of Practice PhoneContact Person First Last Email 1. Do you have current HIPAA Privacy AND Security policies along with documentation of annual review?* Don't Know No Yes 2. Have you appointed a Security Officer as well as a Privacy Officer and have job descriptions for both? (Note: this can be the same person)* No Yes Don't Know 3. Has your Privacy/Security Officer(s) received additional training beyond annual training to carry out their role?* Don't Know No Yes 4. Do you have 6-years documentation of staff annual HIPAA training?* (Exception: if your practice has not been open 6-years.)* No Don't Know Yes 5. 6-years training records for new hires before granting computer access to information? (Exception: if your practice has not been open 6-years.)* Don't Know Yes No 6. Has your team been trained what the “minimum necessary” Protected Health Information (PHI) means when carrying out their job functions?* No Don't Know Yes 7. In 2013, did you update all of your HIPAA Business Associate Agreements to include the HITECH Act provisions?* Don't Know No Yes 8. Are your Business Associates and their subcontractors aware of their legal responsibility under the law?* No Don't Know Yes 9. Is your Notice of Privacy Practices (NPP) prominently displayed in your office?* Don't Know Yes No * = required10. Is your Notice of Privacy Practices prominently displayed and easily accessed to anyone visiting your website? (EX: your NPP is not buried in the footer, hidden within your online forms and is not part of the FTC Privacy Policy for cookies?)* Don't Know No Yes 11. Do you conduct the required Security & Risk Assessments to identity potential risks and vulnerabilities to PHI and computer network on an annual basis or more frequently if there are changes?* Yes No Don't Know 12. Do you have the required written risk management, incident response and contingency plans? Do you have documentation that those plans have been updated annually or more frequently as needed?* No Yes Don't Know 13. Do you validate media destruction or sanitization when destroying PHI such as old hard drives, flash drives, memory on copy machines or paper records, etc.?* Yes No Don't Know 14. Do you email PHI to patients or dentists/physicians (specialists or referring doctors)?* No Yes Don't Know 15. Are those emails encrypted or do you have patient permission to send PHI in an unencrypted format?* No Don't Know Yes 16. Would you like take advantage of our complimentary 15-min consult?* Don't Know Yes No PhoneThis field is for validation purposes and should be left unchanged.
