HIPAA Flashcards

1
Q

Review of Health Information Portability & Accountability Act (HIPAA) Administrative Simplification

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does the HIPAA Privacy Rule Do?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How does the School of Dentistry do this?

A

Patient Notification of HIPAA Privacy Policy

•Right to request privacy protection
•Access of individual to their own protected health information (PHI)
•Right to request amendment of PHI
•Accounting of disclosures of PHI
•Right to Restriction

The School’s Accountability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Minimum Necessary Rule

A
  • PHI should not be used or disclosed when it is not necessary to satisfy a particular purpose or carry out a function
  • The SOD should take reasonable steps to limit disclosures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Limit Disclosure
Electronic Communication

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The Privacy Rule permits the SOD to use and disclose protected health information

A
  • Treatment
  • Payment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Security

A

Security Rule:
•Builds on effort to comply with Privacy Rule

Privacy Rule:
•Covers:
•PHI in oral, written, & electronic form

Security Rule:
•Covers PHI in ELECTRONIC Form only
•EPR & MIPACS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

State & Federal Regulations

A

•HIPAA is
the minimum standard for privacy

  • Patient privacy compliance requires knowledge of both State and Federal laws
  • The provision that provides the greatest privacy protection will prevail
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Health Information Technology for Economic and Clinical Health Act (HITECH)
& State Attorney Gen

State AG

Authorized to bring civil action on behalf of state residents for HIPAA violations

Obtain damages

HIPAA

violators accountable with civil and criminal penalties

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

HITECH Breach Notification Rule

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

HITECH, Cont.

A

•Definition of Breach

Impermissible use or disclosure under the Privacy Rule that compromises the security or privacy of the protected health information

•Results in a significant risk of

Financial

Reputational

Other harm to the affected individual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q
A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

PHI & Technology

A

•USB Memory Stick & Portable Devices

•De-identify patient PHI or Encrypt before saving

•Lok-IT secure flash drive


How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

PHI & Technology, Cont.

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

SOD and a legally defensible EHR

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Principles of Documentation and Billing

A
  • EHR
  • Document all Clinical Services
  • Follow Established Standard of Care
  • Bill
  • Needed & Documented
  • Necessity for the visit or service
  • Documentation should spell out the specific service provided
17
Q

Billing & Compliance

A
18
Q

Preventing, Detecting, & Reporting

FRAUD

A
19
Q

ABUSE

A

•Any activity that results in excessive or unreasonable cost to the university, or other state or federal agencies

20
Q

Examples of a False Claim

A


•Billing for procedures not performed

•Falsifying information in the patient record

•Duplicate billing

•Falsifying claim forms to receive overpayment for services provided