Chapter 5 Flashcards
Accounting of Disclosures
A listing of all disclosures of protected health information about a patient that were not made as a result of treatment, payment, operations, or upon written authorization of the patient.
Accreditation
Voluntary assessment by an accrediting agency that proves a healthcare facility exceeds the minimum requirements set by licensing agencies.
Business Associate
An individual or organization with which a covered entity contracts to perform functions or duties that involve the use or disclosure of individually identifiable health information.
Clearinghouse
An organization or entity ( public or private ) that processes data into a standardized billing format and checks for inconsistencies or other errors in the claims data.
Compliance
Adherence to rules, for instance, regulations and standards; also refers to the culture of an organization to provide high quality, cost effective efficient healthcare that operates within the requirements of regulatory, accreditation, and other requirements.
Covered Entity
Any healthcare provider or contractor that transmits in electronic form any individually identifiable health information.
Critical Access Hospital
A hospital that has no more than 25 beds; maintains an annual average length of stay of 96 hours or less for acute inpatient care; offers 24 hour, 7 day a week emergency care; and is located in a rural area, at least 35 miles drive away from any other hospital or other critical access hospital; the CoP regulations for CAH’s differ from those for hospitals that are not CAH’s.
Deemed Status
By virtue of acheiving accreditation status, a facility is also in compliance with the CoP.
Health Plan Identifier (HPID)
A unique identifier assigned to every health plan that controls its own business activities, actions, or policies or that is controlled by entities that are not health plans, the effective dates for use of the HPID are November 5, 2014 for large plans, and November 5, 2015 for small plans.
Individually Identifiable Health Information
Data that identify a patient, such as: name, address, date of birth, and gender.
National Provider Identifier Number
A unique 10 digit number that identifies each provider on all administrative or financial transactions, for instance, claim forms.
Notice of Privacy Practices
Written notification, which must be signed by the patient/legal representative, that communicate how PHI is used, disclosures made without the need for authorization, the patient’s rights regarding PHI, the persons to whom PHI may be released, and the covered entity’s legal duties with respect to that information.
Omnibus Final Rule to the HITECH Act
Legislation that updates and clarifies the requirements in the HITECH Act.
Privacy
The right to be left alone, and to expect that one’s health information is available only to those who have a need to access it.
Protected Health Information
Any piece of data that identifies the patient as well as the clinical data tied to the patient.
Security Rule
The HIPAA rule that protects PHI through standard procedures and methods, of storage, access and transmission, as well as through auditing for security breaches.
