Health & SafetyAnswer Key

Hipaa Tpo Stands For

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QUESTION 1

Which is necessary and permitted through the HIPAA Privacy Rule for patients' treatment, payment, and health care operations (TPO)?

ANSWER

Both use of PHI and disclosure of PHI

QUESTION 2

What establishes standards for the exchange of financial and asministrative data among covered entities?

ANSWER

Transactions and Code Sets

QUESTION 3

If a practice is being investigated for fraud, what may be the first document to research?

ANSWER

Compliance plan

QUESTION 4

Which code set is used for billing dental procedures?

ANSWER

CDT-4

QUESTION 5

Which complies with the HIPAA Security Rule?

ANSWER

Selecting a mixture of characters for the password

QUESTION 6

Which is a future benefit of the Affordable Care Act?

ANSWER

Preventative services will be completely covered

QUESTION 7

Which federal agency detects health care fraud and abuse?

ANSWER

Office of the Inspector General (OIG)

QUESTION 8

Which federal agency enforces criminal violations under federal law?

ANSWER

Department of Justice (DOJ)

QUESTION 9

Which scenario best describes abuse?

ANSWER

The doctor tells you to bill for an unecessary procedures that was done

QUESTION 10

Which scenario best describes fraud?

ANSWER

The doctor tells you to bill for an undocumented procedure

QUESTION 11

Which of the following will be introduced in the future?

ANSWER

Both patient and health plan identifiers

QUESTION 12

Which measure does NOT enforce the HIPAA Security Rule?

ANSWER

Transmitting unencrypted data

QUESTION 13

Which is also known as the Stimulus Package?

ANSWER

ARRA

QUESTION 14

What is best description of an encounter?

ANSWER

Face-to-face meeting

QUESTION 15

Which is NOT a goal of compliance plans?

ANSWER

Enhance patient education guidelines

QUESTION 16

A social security number is an example of a(n):

ANSWER

Identifier

QUESTION 17

Which act requires covered entities to notify affected individuals following the discovery of a breach of unsecured health information?

ANSWER

HITECH

QUESTION 18

Which law guides the use of federal stimulus money to promote the adoption and meaningful use of health information technology, mainly using electronic health records?

ANSWER

HITECH

QUESTION 19

What are people or organizations that furnish, bill, or are paid for health care in the normal course of business called?

ANSWER

Providers

QUESTION 20

What type of program encrypts data traveling between the office and the internet, such as patients' Social Security numbers, so that the information is secure?

ANSWER

Practice management

QUESTION 21

Who has the aurthority to authorize the release of information on a patient to anyone not directly involved in their care?

ANSWER

Legal representative

QUESTION 22

What are the Centers for Medicare and Medicaid Services (CMS) responsible for?

ANSWER

Impledmenting annual federal budget acts and laws

QUESTION 23

A complaince plan does NOT cover which of the following?

ANSWER

Referrals and authorizations

QUESTION 24

What did the NPI (National Provider Identifier) replace?

ANSWER

Medicare UPIN

QUESTION 25

If a violation is found during a medical practice investigation and a compliance plan is typically followed, what may it indicate to the Office of Inspector General (OIG)?

ANSWER

May be simple errors

QUESTION 26

Which main federal government agency is respnsible for health care?

ANSWER

Centers for Medicare and Medicaid Services (CMS)

QUESTION 27

What is the impermissible use or disclosure of PHI that could pose significant risk to the affected person called?

ANSWER

Breach

QUESTION 28

What is a medical practice's written plan for complying with regulations?

ANSWER

Compliance plan

QUESTION 29

What is the activity of copying files to another media or off site location so that they will be preserved in case the originals are no longer available?

ANSWER

Backup

QUESTION 30

Which is NOT a valid component of a compliance plan?

ANSWER

To have inconsistent policies and prodecures

QUESTION 31

Which is the process of encoding information in such a way that only the person (or computer) with the key can decode it?

ANSWER

Encrypting

QUESTION 32

Which is (are) elements included in a compliance plan according to the Office of the Inspector General?

ANSWER

Both training and ongoing communication

QUESTION 33

Which is vaild aspect of the Affordable Care Act?

ANSWER

Preventive services will be covered by insurance with no copayment required

QUESTION 34

Which standards have been set to govern the electronic exchange of health information?

ANSWER

All of these: Indentifiers, code sets, standard transaction

QUESTION 35

A compliance plan constitutes which of the following?

ANSWER

Both a written document and a committee

QUESTION 36

What is any group of codes used for encoding data elements?

ANSWER

Code set

QUESTION 37

Which is a valid Breach Notification Procedure?

ANSWER

None of these

QUESTION 38

Which code set is for specifying diseases, injuries, impairments, and other health related problems?

ANSWER

ICD

QUESTION 39

Which are covered entites under HIPAA/HITECH that must follow the regulations?

ANSWER

Health Providers

QUESTION 40

A retention schedule:

ANSWER

All of these: explains what records to keep, explains how long records must be saved, covers the method(s) of record storage

QUESTION 41

The standards for wirtten documentation include:

ANSWER

All the above: clarity, legibility, sign and dated entries

QUESTION 42

Which one of these would be the most secure password?

ANSWER

f1H*%4hs

QUESTION 43

What standards are set under the rules of the HIPAA Electronic Health Care Transactions and Code Sets?

ANSWER

All of these: electronic formats, identifiers, codes.

QUESTION 44

In electronic health records, documents may be created in a variety of ways, but they are______

ANSWER

Ultimately viewed on computer screen

QUESTION 45

The provider owns the actual medical records, but the information in a record belongs to _____.

ANSWER

The patient

QUESTION 46

Which of the following is fradulent behavior?

ANSWER

Deception with the intent to benefit

QUESTION 47

The HIPAA Privacy Rule is enforced by the OCR. What does OCR stand for?

ANSWER

Office for Civil Rights

QUESTION 48

Under what conditions should a medical assistant change the facts on an insurance claim?

ANSWER

The facts must never be changed

QUESTION 49

When can information about a patient's drug abuse be disclosed without authorization?

ANSWER

None of these

QUESTION 50

A standard and unique identifier for health care privders to use in filing health care claims is called?

ANSWER

National Provider Identifier (NPI)

QUESTION 51

the HIPAA Privacy Rule is enforced by ______

ANSWER

the OCR

QUESTION 52

Collecting payment in full for a procedure from both the patientand the insurance carrier is an example of ____

ANSWER

Fraud

QUESTION 53

Altering a patients chart to increase the payment the physician recieves is an example of _____

ANSWER

Fraud

QUESTION 54

SOAP is a format for patients' medical _____

ANSWER

Both documentation and records

QUESTION 55

What do patients' medical records contain about their health history?

ANSWER

All of these: facts, observation, findings

QUESTION 56

Entries in patients' medical records should be descending or ascending in what type of order?

ANSWER

Chronological

QUESTION 57

The abbreviation TPO refers to:

ANSWER

Treatment, payment, and health care operations

QUESTION 58

What type of schedule do medical affices use to control how long patient information is stored?

ANSWER

Retention schedule

QUESTION 59

The abbreviation PHI stands for?

ANSWER

Protected health information

QUESTION 60

For up to how long can a medical office's financial records be audited after a patient's last visit (assuming the embezzlement or government funding has not occured)?

ANSWER

7 years

QUESTION 61

A form signed by a patient to permit release of medical information under specific stated conditions is called a(n) _____

ANSWER

Authorization to disclose information

QUESTION 62

A clearinghouse is a company that helps medical offices and health plans exchange ____

ANSWER

Claim data in correct formats

QUESTION 63

Under HIPAA, patients' proctected health information may be shared without authorization for:

ANSWER

All of these: payment, health care operations, treatment

QUESTION 64

______ releasing protected health information for reasons other than treatment, payment, or health care operations requires which type of patient authorization?

ANSWER

Written

QUESTION 65

What is the relationship between documentation and billing?

ANSWER

If a service is not documented, it cannot be billed.

QUESTION 66

Which of these subjects would you not expect to find information about in a patient's medical record?

ANSWER

Employment and salary records

QUESTION 67

A medical office's compliance plan should include ______

ANSWER

Both staff training and internal communications

QUESTION 68

Under what circumstances might a patient's proctected health information be shared without authorization?

ANSWER

Both court orders and workers' compensation cases

QUESTION 69

What is one way that providers can follow the guidelines for the HITECH rule?

ANSWER

All of these: frequently change passwords, access controls, make copies of all data

QUESTION 70

Following OIG's guidance can help in the defense against which of the following?

ANSWER

A false claims accusation

QUESTION 71

If a physician requests that you bill a procedure that is not documented, what would be the best course of action?

ANSWER

Report it to the compliance officer

QUESTION 72

If a pracitce has discovered that the sercurity or of more than 500 people's PHI has been breached, which establishment must be notified (through the HITECH Act)?

ANSWER

Prominent media outlets

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