HIPAA Glossary · Entities & roles
Covered entity
A healthcare provider that transmits standard electronic transactions, a health plan, or a healthcare clearinghouse.
Context
The three covered entity categories at §160.103. Note that "healthcare provider" alone is not sufficient — the provider must also transmit standard electronic transactions (claims, eligibility checks, remittances) to be covered. Many state laws, notably Texas HB 300, define the term far more broadly for state purposes; HIPAA's federal definition is the floor.
Related terms
- Business associate — A person or organisation that creates, receives, maintains, or transmits PHI on behalf of a covered entity.
- Hybrid entity — An organisation with both covered and non-covered functions that formally designates its healthcare components to contain HIPAA's application.
Where this fits
This is one of 50+ terms in the HIPAA Glossary. For how HIPAA is structured end-to-end, see the Security Rule guide and the Privacy Rule guide.