FINAL Flashcards
breach of data over this number means press release needs to be sent out
500
privacy rule protects any format. true or false?
true
administrative safeguards: name 3
policies procedures security management process risk analyses security officer security awareness & training
locked doors are an example of what type of privacy safeguard?
physical
what are examples of technical safeguards to protect privacy?
passwords and encryption
privacy is
WHAT is protected
security is
HOW info is protected
Why is HIPAA important?
portability
title II fraud and abuse components
- administrative simplification
- transaction and code sets
- national provider identifier (NPI)
- privacy* to protect PHI
- security*
who are covered entities under HIPAA
healthcare providers
healthcare plans
clearinghouses
what do clearinghouses do?
make sure claims are clean
& complete, send bad claims back to provider, send good claims to third party payer
how to protect PHI
consent
authorization
min. necessary info
only ___ should work with blanket authorization
physicians
what are patients’ rights regarding PHI
ask for copy, have corrections made (not omissions), report of when and why info shared
people can charge a reasonable amount to provide records. true or false?
true
data is ___ while ___ is usable & meaningful data
raw
information
4 parts of medicare
A-inpt. hospital care
B-outpt
C-medicare advantage (optional, replaces A, B, and D)
D-Rx
most important function of health record
store patient health information
hospitals have ___ status
deemed
4 entities for rules/reg A B C L
accreditation
bylaws
certification (conditions of participation)
licensure (state/gov’t)
consent is given for
TPO
treatment, payment, operations
authorization is for TPO. T/F?
false, authorization is for anything beyond TPO, like ROI
CAHIIM
accredits colleges
___ registry has people with severe injuries
trauma
physician index
list of pts by ID
authorization has to have ___
expiration date because otherwise ROI would be forever
name some secondary uses of data
- research
- quality, performance, pt. safety
- population health reporting
- administrative
what is HIT’s most important role?
make sure data is complete, accurate, standardized (data dictionary)
people ___ need to give additional consent to be in index/registry
do not, because TPO covers it
indexes are smaller/larger than registries?
smaller, facility-based, examples are MPI or disease registry of a hospital
what is the legal term for no consent for treatment given?
battery
aggregated data is ___
deidentified
what’s the primary data source?
health record
MDS
long term care
HEDIS
insurance plans, administrative claims, health record review data
joint commission’s data set
ORYX
what data set do they use in the ER?
DEEDS
which data set for home health
OASIS
Which data set for inpatient, like hospital
UHDDS
which data set for outpt?
UACDS
Data fields and data definitions are common in ___
data dictionary
what is it called if a facility gets to take medicare patients
deemed status
consent is for ___ while authorization is for ___
TPO;
ROI
What are ICD-10-CM AND ICD-PCS used for?
reimbursement
SNOMED-CT
150,000 TERMS; Language so everyone can speak to one another
CPT
procedures for outpt
what is the formal approval process for academic programs called?
accreditation
what is the formal process for conferring a HIM credential
certification
what is access control?
identifying which data employees should have a right to use
aiding in billing and reimbursement is a ___ fcn of health record
secondary
third-party payers and government policymakers are ___ users of the health record
institutional
___ is a software program that tracks every access to data in the system
audit trail
___ is required of hospitals by states to provide healthcare
licensure
___ is not documented in the acute-care (urgent care) health record
immunizations
when does pt have the opportunity to agree or object?
when court order received
___ is used to describe expected data values
data precision
in long-term care, the care plan is dependent on data from
MDS version 3.0
a consumer interested in comparing performance of health plans should review data from
HEDIS
If you take part of a data set and put it together to form a statistic, the data is
aggregated
what are the four main sources of documentation standards?
Accreditation
Bylaws
Certification
Licensure
