Sample Checklist – Documentation of Staff Training

LETTERHEAD

This is to confirm that _______________________________________, an employee [staff member/volunteer/clinical student/etc.] in this office, has completed training in the following areas, including those required by the U. S. Department of Human Services under the Health Insurance Portability & Accountability Act (HIPAA) :

___ Protecting Patient Privacy & Confidentiality
	___ A. Understanding The Ethical & Legal Standards
		1. Ethical Rules About Confidentiality & Informed Consent 2. Legal Rules About Confidentiality & Informed Consent 3. Consequences of Unethical &/or Illegal Disclosures
	___ B. Following Office Policies About Privacy & Confidentiality
		1. Protecting Patient’s Right to Privacy While In Our Office 2. Protecting Patient’s Right to Confidentiality (Non-Disclosure) 3. Signing the Employee Confidentiality Contract
	___ C. HIPAA Privacy, Security, & Transmission Rules (if applicable)
___ Billing Patients and/or Third Parties for Reimbursement
	___ A. Ethical & Legal Requirements/Limitations
		1. Accuracy of Information Provided (Avoiding Insurance Fraud) 2. Care in Transmission (HIPAA re FAXing, etc.). 3. Limitations Imposed by Provider Contracts
	___ B. Policies re: Electronic Transmission of Claims & Treatment Plans
___ Other Policies & Procedures
	___ A. Maintaining Boundaries & Avoiding Dual Relationships ___ B. Operating Within Specified Job Description ___ C. Monitoring

___ [if appropriate] The training completed on __________________ (date) included a test on the HIPAA-required training about confidentiality and privacy issues. This person passed that test. Training will be updated as appropriate.
Signed:______________________________________________________ Date:

*Note: This documents the broad ethics-based training that combines the HIPAA-required topics of privacy and confidentiality with other ethical topics, as summarized in our ethics-based staff training manuals