CH 2 - HIPPA HITEC

Question 1

Health system reform legislation signed in 2010 that introduced a number of significant benefits for patients.

Answer 1

Affordable Care Act (ACA)

Question 2

Methodical review; in medical insurance, a formal examination of a physician’s accounting or patient medical records

Answer 2

audit

Question 3

Document signed by a patient to permit release of particular medical information under the stated specific conditions.

Answer 3

authorization

Question 4

An impermissible use or disclosure under the Privacy Rule that compromises the security or privacy of PHI and also that should pose significant risk of financial, reputational, or other harm to the affected person.

Answer 4

breach

Question 5

The document notifying an individual of a breach

Answer 5

breach notification

Question 6

A person or organization that performs a function or activity for a covered entity but is not a part of its work force.

Answer 6

business associate (BA)

Question 7

Federal agency within the Department of Health and Human (HHS) that suns Medicare, Medicaid, clinical laboratories, and other government health programs.

Answer 7

Centers for Medicare and Medicaid Services (CMS)

Question 8

A company (billing service, repricing company, or network) that converts nonstandard transactions into standard transactions and transmits data to health plans. Also handles the reverse process, changing standard transactions into non standards.

Answer 8

clearinghouse

Question 9

Alphabetic and/or numeric representations for data. Medical code sets are systems of medical terms that are required for HIPPA transactions.

Answer 9

code sets

Question 10

A medical practices written plan for every operation.

Answer 10

compliance plan

Question 11

Under HIPPA, a health plan, clearinghouse, or provider that transmits any health information in electronic form in connection with a HIPAA transaction.

Answer 11

covered entity (CE)

Question 12

A covered entity’s records that contain protected health information (PHI)

Answer 12

designated record set (DRS)

Question 13

The system-to-system exchange of data in a standardized format.

Answer 13

electronic data interchange (EDI)

Question 14

Enacted by US congress in 1996 to protect health coverage and it also requires the establishment of national standards for electronic healthcare transactions and national identifiers for providers, health insurance plans and employers.

Answer 14

Health Insurance Portability and Accountability Act (HIPAA) or 1996

Question 15

Law that guides the use of federal stimulus money to promote the adoption and meaningful use of health information technology, mainly using electronic health records.

Answer 15

Health Information Technology for Economic and Clinical Health (HITECH) Act

Question 16

The HIPAA rule governing the electronic exchange of health information.

Answer 16

HIPAA Electronic Health Care Transaction and Code Sets (TCS)

Question 17

Unique ten-digit identifier assigned to each provider by the National Provider System.

Answer 17

National Provider Identifier (NPI)

Question 18

The part of CMS that enforces the other HIPAA standards.

Answer 18

Office of E-Health Standards and Services (OESS)

Question 19

OCR

Answer 19

Office for Civil Rights

Question 20

NPP

Answer 20

Notice of Privacy Practices

Question 21

Government agency that investigates and prosecutes fraud against government health care programs such as medicare.

Answer 21

Office of the Inspector General (OIG)

Question 22

Under HIPAA, patients protected health information may be shared without authorization for the purpose of treatment, payment and operations.

Answer 22

treatment, payment, and operations (TPO)