Billing / Coding 2 Flashcards
person who makes an accusation of fraud or abuse.
relator
Electronic health records are considered to have significant advantages, including all of the following except
reduced costs.
When protected health information is shared, which of the following should be observed?
minimum necessary standard
Which of the following laws prohibits submitting a fraudulent claim?
FCA
Which of the following is required for releasing protected health information for reasons other than treatment, payment, or health care operations?
patient’s signed authorization
The ACA requires the adoption of __________ for each of the HIPAA Standard transactions.
operating rules
What make(s) it possible for physicians and health plans to exchange electronic data using a standard format.
HIPAA Electronic Transactions and Code Sets
The responsibility of licensed health care professionals to observe state medical standards of care is called
medical professional liability.
The document notifying an individual of a breach is called a
breach notification.
For release of PHI for treatment, payment, and health care operations
no authorization is required from the patient.
For release of PHI for treatment, payment, and health care operations
no authorization is required from the patient.
Which of the following require(s) CEs to establish safeguards to protect PHI?
HIPAA Security Rule
HIPAA identifies three types of covered entities
health plans, clearinghouses, and providers.
NPI is the abbreviation for
National Provider Identifier.
The Health Care Fraud and Abuse Control Program was created by
HIPAA
Which of the following conditions requires a specific authorization from the patient other than for TPO?
alcohol abuse
are numbers of predetermined length and structure, such as people’s Social Security numbers.
Identifiers
E/M is the abbreviation for
evaluation and management.
Which of the following acts contains additional provisions concerning the standards for electronic transmission of health care data?
HITECH
The electronic equivalent of a business document is called a(n)
transaction
CE is the abbreviation for
covered entity
Which of the following are organizations that work for covered entities but are not themselves covered entities?
business associates
How many Americans are currently part of the Medicare and Medicaid programs?
more than 90 million
DRS is the abbreviation for
designated record set.
TPO is an abbreviation for
treatment, payment, and health care operations.
HIPAA is the abbreviation for the
Health Insurance Portability and Accountability Act.
The federal agency that runs Medicare and Medicaid is
CMS
HIPAA contains how many provisions (titles) that focus on various aspects of health care?
5
What group is charged with detecting health care fraud and abuse?
OIG
Which of the following is an action that misuses money that the government has allocated?
abuse
regulate(s) the use and disclosure of patients’ protected health information.
HIPAA Privacy Rule
