Chpt 9 Flashcards
HIPAA Title 1
Protect consumers changing jobs
HIPAA Privacy rule
Protects the type of data that is communicated
HIPAA Security rule
Protects the databases and data for security
HIPAA enforcement rule
Indicates procedures for enforcement and procedures for hearings and penalties
HIPAA Breach notification rule
Requires healthcare providers to notify individuals when there has been a breach of protected information
Preexisting condition
A condition for which a patient received treatment in a certain period before beginning coverage with a new insurance plan
HIPAA preexisting conditions
Limit preexisting condition periods to 12 to 18 months
Clause may be avoided in the new plan for patients who have proof of coverage that was not interrupted by a period of 63 days or more and had a full year of coverage at a previous job
HIPAA Title II
Prevention of healthcare fraud and abuse and simplification of administrative processes in the deliverance of healthcare
PHI
Protected health information
Any patient information that includes identifiers that could be used to identify the patient
Title II privacy rule portion
Regulates how PHI may be transmitted from one place to another
Applies to any healthcare provider who transmits patient information electronically
Entities exempt from complying with HIPAA regulations
Genetic testing companies that consumers contact directly
Mobile apps used for health and fitness
Law enforcement agencies
Schools
Employers
State agencies
Insurance companies
Alternative medicine providers
Disclosure of patient information to the patient upon request
Privacy rule
Within 30 days
Patient disclosure to others
Privacy rule
Patient’s written consent to transfer records from one provider to another
May happen without consent- child abuse must be reported
Minimum necessary rule
Privacy rule
States that only the minimum amount of information necessary is to be shared
Release of all information in a patient’s file is not necessary
Also applies to employees performing their jobs in a medical office
Correction of a health record
If patient disagrees with what is in their health record, they may submit a written statement requesting that information be changed. Becomes a part of the health record but the original information also remains
Not required to change it
Outlining disclosures to a patient
Privacy rule
Upon request, provide a list of occasions that information was shared along with details of the information shared and to whom it was provided
Violation of privacy rule
File complaint with Department of Health and Human Services, Office for Civil Rights
Improper disclosure
Privacy rule
Accidental or unintended
Notify patient of details of information disclosed and to whom, as well as details as to what the privacy officer did to retrieve or destroy the information disclosed
Privacy officer
Privacy rule
An employee in a healthcare facility charged with the duty of educating others on HIPAA compliance
Point person for complaints
Trains staff on HIPAA regulations
Maintains a log of improper disclosures
Discloses to the patient any improper privacy violations
Electronic billing ml
Privacy rule
The process of sending medical claims to insurance carriers electronically
Both claim and payment may be made electronically
HIPAA Security rule
2005
Safekeeping of electronic information within the healthcare facility
3 parts: administrative, physical and technical
Administrative safeguards
Security rule
Written privacy practices and given to patients- signed by each patient
Alerts the patient to the existence of privacy practices and their right to a copy
Access to records
security rule
Which employee type should be permitted access to records
Minimum necessary rule applies
Proper training regarding PHI
Security rule
Written policies on training of personnel on handling of PHI
