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How do Employer Identification Numbers apply to HIPAA transactions?

Written by Kirsten Peremore | September 08, 2023

EINs are an integral part of electronic transactions governed by HIPAA. They are used to identify covered entities and other relevant parties involved in the electronic exchange of healthcare information.

 

What is the Employer Identification Number?

The Employer Identification Number (EIN) is a unique nine-digit number assigned by the Internal Revenue Service (IRS) to businesses, non-profit organizations, government agencies, and other entities. EINs are assigned by the Internal Revenue Service (IRS). Its primary purpose is to identify these entities for tax purposes, similar to how Social Security Numbers (SSNs) are used to identify individuals.

See also: HIPAA's Transaction and Code Sets Rule

 

How does EIN apply to HIPAA transactions?

The EIN is required on certain electronic transactions by HIPAA for covered entities and other entities involved in electronic healthcare transactions.

When conducting electronic transactions under HIPAA, covered entities, health plans, and healthcare clearinghouses are identified by their EIN. The EIN serves as an identifier for these entities within the electronic data interchange (EDI) systems used for HIPAA transactions. It helps ensure the accurate and secure processing of electronic healthcare information.

Business associates who handle electronic healthcare transactions on behalf of covered entities may also use their EIN when conducting such transactions. Business associates play a significant role in the secure exchange of healthcare information. They must adhere to HIPAA regulations, including the proper use and safeguarding of EINs and other identifiers.

See also: Do you need consent to text patients?

 

When is an EIN necessary?

An Employer Identification Number (EIN) is necessary for various business and non-profit entities in the United States. Here are the situations when obtaining an EIN is required:

  1. Hiring employees: If your business plans to hire employees, you must have an EIN. This number is used for tax reporting, payroll processing, and other employment-related matters.
  2. Operating as a corporation or partnership: Any business entity operating as a corporation or partnership, including Limited Liability Companies (LLCs) taxed as corporations, must have an EIN.
  3. Withholding taxes: If your business is required to withhold taxes on income (such as dividends, interest, or non-resident alien withholding), you need an EIN.
  4. Filing employment tax returns: Businesses that are required to file employment tax returns, such as Form 941 (Employer's Quarterly Federal Tax Return) or Form 944 (Employer's Annual Federal Tax Return), must have an EIN.
  5. Opening a business bank account: Most financial institutions require an EIN to open a business bank account.
  6. Applying for business licenses or permits: Many states and local authorities may require an EIN when applying for business licenses or permits.
  7. Operating as a trust, estate, non-profit, or farmers' cooperative: Entities such as trusts, estates, non-profit organizations, and farmers' cooperatives must obtain an EIN.
  8. Administering Keogh plans: Self-employed individuals who have Keogh retirement plans need an EIN to administer these plans.
  9. Dealing with certain types of taxes: If your business is involved in certain types of taxes, such as excise taxes, alcohol, tobacco, or firearms taxes, you will need an EIN.
  10. Changing business type: If your business structure changes, such as from a sole proprietorship to a corporation or partnership, you may need to obtain a new EIN.

See also: HIPAA Compliant Email: The Definitive Guide