Data Security | HIPAA Compliance

Learn how SortSpoke's HIPAA compliance protects your data

Insurance carriers that prioritize HIPAA compliance:

Process medical records and health data with confidence, knowing PHI is protected by law-compliant safeguards
Meet regulatory requirements and eliminate third-party vendor liability exposure
Scale submission processing without risking HIPAA violations or breaches

What is HIPAA Compliance?

DEFINITION

The Health Insurance Portability and Accountability Act (HIPAA) is federal legislation that establishes standards for protecting protected health information (PHI) - any health data that identifies an individual. HIPAA applies to health plans, healthcare providers, healthcare clearinghouses, and their business associates—third parties like SortSpoke that handle PHI on their behalf.

Who Must Comply

Health Plans: Includes health insurance carriers, HMOs, and health maintenance organizationss
Business Associates: Vendors and technology providers (like SortSpoke) that process PHI on behalf of health plans
Subcontractors: Any vendor a business associate engages to handle PHI must also comply

HIPAA Compliant

SortSpoke is HIPPA compliant, demonstrating our commitment to protecting protected health information (PHI) and meeting federal healthcare data security standards for health insurance carriers processing medical records, diagnoses, and sensitive health sdocuments.

Key HIPAA Rules

Privacy Rule: Establishes standards for how PHI can be used and disclosed
Security Rule: Requires technical, administrative, and physical safeguards to protect PHI
Breach Notification Rule: Mandates notification when PHI is accessed or disclosed without authorization

  
What is PHI?
Protected Health Information includes medical records, diagnoses, treatment plans, prescription data, lab results, claims history, and any health information that can identify an individual. When processing health insurance documents, PHI is everywhere—and requires strict protection.

  
Business Associate Requirement (BHA)
As a Business Associate handling PHI on behalf of health insurance carriers, SortSpoke is legally required to maintain HIPAA compliance and sign Business Associate Agreements (BAAs) with our customers. This means HIPAA compliance isn't optional for us—it's a legal obligation backed by federal regulation.

Business Associate Agreements (BAAs)

WHAT IS A BAA?

Under HIPAA, any vendor that handles PHI on behalf of a health insurance carrier must sign a Business Associate Agreement. A BAA defines:

How PHI can be used and disclosed
Required safeguards and security measures
Breach notification responsibilities
Audit and inspection rights
Data destruction procedures upon contract termination

A BAA is legally required before processing any PHI. Without it, both you and your vendor are non-compliant.

  
SortSpoke's BAA Process
Standard template available: SortSpoke provides a HIPAA-compliant BAA template covering all standard requirements
Covers key obligations: Data use limitations, safeguards, breach notification, audit rights, subcontractor management
Executed before onboarding: No PHI processing begins until the BAA is signed
Updated annually: Our BAA is reviewed and updated as regulations and our platform evolve

Learn more about HIPAA at HHS.gov

Why HIPAA Compliance Matters for Insurance Carriers

Health insurance underwriting is built on trust with customers, regulators, and brokers. HIPAA compliance protects all three—and your organization from serious legal and financial consequences.

Legal & Financial Risk

HIPAA violations carry civil penalties up to $1.5M per violation category per year
Criminal violations (willful neglect or intent to sell PHI) carry fines and imprisonment
Regulatory enforcement actions and mandatory audits follow breaches

Reputation & Consumer Trust

PHI breaches erode consumer trust and trigger media coverage
Health insurance subscribers expect their medical data to be protected—breaches damage your market position
Regulatory scrutiny follows breaches, leading to increased oversight and costs

Third-Party Vendor Liability

Health insurance carriers are liable for their business associates' HIPAA violations
If SortSpoke mishandles PHI, you face the penalties and reputational damage
Contractual responsibility (BAA) means you're legally on the hook

Document Processing Complexity

Insurance submissions contain sensitive medical records, diagnoses, lab results, and treatment histories
Manual data extraction from medical records creates high breach risk
Ensuring underwriters access only appropriate PHI while maintaining audit trails is challenging

AI & Automation Risk

Using AI on PHI requires strict safeguards - most AI platforms aren't built for PHI
Black-box AI on medical data creates compliance gaps and audit liability
SortSpoke's approach: Keep a human-in-the-loop and protect PHI with encryption and access controls

  
Compliance Built In, Liability Eliminated
HIPAA compliance gives you concrete assurance that your platform protects PHI, proof you're meeting federal requirements, and confidence your insurance operations are secure and audit-ready.

Why HIPAA Compliance Matters for Insurance Carriers SortSpoke Page (1)

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Here's how SortSpoke implements HIPAA Safeguards

HIPAA compliance requires three layers of protection that SortSpoke operationalizes across your entire platform.

Administrative Safeguards: Policies & Procedures

Regular risk analysis and management assessments identify PHI vulnerabilities and mitigation strategies
All SortSpoke employees handling PHI receive HIPAA training and sign confidentiality agreements
Business Associate Agreements are executed with all customers and subcontractors before processing PHI
Documented incident response procedures for breach detection, investigation, and notification comply with the HIPAA Breach Notification Rule
Authorization policies ensure only authorized personnel can access PHI through role-based permissions

Physical Safeguards: Data Centers & Device Security

SortSpoke uses AWS HIPAA-eligible services with strict physical access controls in secure data centers
Devices accessing PHI are hardened, monitored, and restricted to authorized use only
Data center access is restricted to authorized personnel with comprehensive logging and monitoring

Technical Safeguards: Encryption & Access Controls

All PHI stored in SortSpoke systems is encrypted using AES-256, the strongest encryption standard available
All data moving to and from SortSpoke is protected with TLS 1.2 or higher encryption in transit
Every underwriter and admin has unique credentials; shared accounts are prohibited to ensure accountability
Role-based access controls ensure underwriters see only PHI relevant to their role and submissions
Inactive sessions terminate automatically to prevent unauthorized access
Comprehensive logging captures every access, modification, and export of PHI with timestamps and user IDs
API connections and data transfers use HIPAA-compliant encryption standards for secure transmission

Insurance Submission Specifics: PHI Handling in Underwriting

Our platform automatically identifies PHI in ACORD forms, medical records, and loss runs
AI models are trained on de-identified data only—no live PHI is used in model training
Medical information is displayed to underwriters only when relevant to their underwriting role
Every view, edit, download, or export of PHI is logged with user, timestamp, and action details for complete traceability
Systems alert to unauthorized access attempts or suspicious patterns for proactive breach monitoring

SortSpoke's HIPAA Compliance Journey

SortSpoke is HIPAA Compliant

SortSpoke underwent comprehensive HIPAA compliance assessment, implementing administrative, physical, and technical safeguards across our platform. We created HIPAA-compliant BAA templates for all health insurance customers, trained our workforce on PHI handling, and established ongoing compliance monitoring.

We maintain our compliance through annual reviews, regular risk assessments, and continuous monitoring of controls. This means we're actively protecting PHI year-round—our commitment to HIPAA isn't a one-time certification, it's a continuous operational practice

Learn more

HIPAA is specific to healthcare and protected health information (PHI); SOC 2 is broader data security certification.

SOC 2 addresses security, availability, confidentiality, processing integrity, and privacy—but isn't healthcare-specific.

HIPAA is stricter on healthcare compliance. SortSpoke maintains both certifications.

Learn more about SOC 2.

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SORTSPOKE SECURITY OVERVIEW

Understand exactly how SortSpoke keeps your data secure

Download our Security Overview to see how SortSpoke protects PHI. Get the details on our HIPAA compliance, encryption standards, and healthcare-grade security infrastructure.

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Learn how SortSpoke's HIPAA compliance protects your data

What is HIPAA Compliance?

Who Must Comply

Key HIPAA Rules

Business Associate Agreements (BAAs)

SortSpoke's BAA Process

Why HIPAA Compliance Matters for Insurance Carriers

Featured Resource

What Insurance Carriers Need to Know About HIPAA Compliance

SortSpoke Blog

Here's how SortSpoke implements HIPAA Safeguards

Administrative Safeguards: Policies & Procedures

Physical Safeguards: Data Centers & Device Security

Technical Safeguards: Encryption & Access Controls

Insurance Submission Specifics: PHI Handling in Underwriting

SortSpoke's HIPAA Compliance Journey

SortSpoke is HIPAA Compliant

FAQ

Frequently Asked Questions About SOC Compliance

Understand exactly how SortSpoke keeps your data secure

Featured Security Resources

Read the top security articles from the SortSpoke Blog

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