Which of the following is considered a covered entity?

The correct answer identifies private-sector payers processing electronic claims as a covered entity. In the context of health insurance and healthcare transactions, a covered entity is defined by the Health Insurance Portability and Accountability Act (HIPAA) as any organization that processes health information and includes health care providers, health plans, and clearinghouses that transmit any health information in electronic form in connection with a HIPAA transaction.

Private-sector payers are usually health insurance companies or similar organizations that manage health insurance claims and payment processes. Their activities typically involve handling protected health information (PHI) electronically, which directly characterizes them under the HIPAA regulations as covered entities.

In contrast, self-administered health plans that process manual claims do not meet the criteria for covered entities if they do not conduct electronic transactions, as they might operate outside the scope of HIPAA's reach regarding electronic data interchange. Similarly, EHNAC-accrediting clearinghouses provide accreditation services and do not themselves engage in the transaction of healthcare information, thus falling outside the definition of a covered entity. Providers submitting paper-based claims may not engage in electronic transactions, which also disqualifies them from being considered covered entities under HIPAA.