Test 5 Part 13 Flashcards
Fair and Accurate Credit Transactions Act of 2003 (FACTA) prohibits ________ from obtaining and using medical information to decide consumer’s credit eligibility
creditors
Under the Fair and Accurate Credit Transactions Act of 2003 (FACTA), Creditor can obtain and use ____________ related to medical debts, expenses, or income, consumer (a patient) must authorize for consumer reporting agency to share medical information with employers for employment or insurance purposes
financial information
Clinical Laboratory Improvements Amendments (CLIA) protects the information or use of _______________.
Laboratory test results
Laboratories are only used to disclose test results or reports to an “__________” who ordered test, unless state law states otherwise. Individual who is the subject of information is not authorized to immediately and directly receive his or her laboratory test results unless defined by state law
authorized person
Access to the individual’s clinical laboratory information will occur through the ________ who ordered the test(s).
provider
HIPAA Privacy Rule, requests for payment purposes, including utilization review and medical necessity review, do not require authorization if the information is for the payment of a specific episode of care
Other information requests require patient authorization
Insurance companies and government agencies payment requests
Obligation is to treat the patient and provide whatever information is necessary. This usually entails disclosing patient information without authorization
Medical emergencies
_______ organization handles information on behalf of a provider (e.g. ROI vendor, HIE, and EHR vendor)
HIH
Medicare ________ programs are not required to provide authorization for disclosure of PHI (e.g. RAC, MAC, ZPIC, etc.)
Fee-for-Service
_____________ enables review contractors to send their requests for medical documentation electronically, thus eliminating the paper request
Electronic Submission of Medical Documentation (esMD)
