HIPPA, Accreditation, Health Insurance Flashcards
Privacy Rule
Policies and procedures that protects a person’s health information
Who must comply with the Privacy Rule?
All healthcare providers, health plans, and health care clearinghouses
What information is protected?
- Anything that can leak the person’s identity (ex: name, health issues, etc)
- How their records are maintained and exchanged
What are the penalties for violating HIPPA?
- fines up to 25k for multiple violations of the same standard in a year
- fines up to 250k or imprisonment for misusing and individual’s identifiable health info
Electronic Health Transactions
health claims, health plan eligibility, (dis)enrollment, payments, first injury reports, benefits, etc
Uniform Identifiers
Used to identify healthcare providers and businesses to send or receive medical claim/payment
Security Rule
Protect all health info that is stored or transmitted, ensures confidentiality, and integrity
Reimbursement (Health plan)
payment for healthcare
Payer
Entity that pays (ex: insurance, patient, government, etc)
Health Insurance
a person that pays a fixed amount every month
Premium
When a person pays a monthly fixed amount, the insurance company will pay for all or some of the costs. haring costs can come in forms of deductibles, copay, or coinsurance
Accreditation
The importance of recognizing someone/something’s status, qualifications, and the activities they can perform
Permit/License
issued to operate facilities, regularly inspects facilities to ensure they comply with the law and meet standards
Why is it important for a facility to be recognized?
Patients will trust their facility and providers, expect quality care, and will be protected
What are some factors that make a facility or provider recognizable?
- Proper education & training
- complying with laws/HIPPA
- maintaining a clean & safe environment
- passing regular inspections
- having permits or licenses
