Hipaa Tpo Stands For
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Which is necessary and permitted through the HIPAA Privacy Rule for patients' treatment, payment, and health care operations (TPO)?
Both use of PHI and disclosure of PHI
What establishes standards for the exchange of financial and asministrative data among covered entities?
Transactions and Code Sets
If a practice is being investigated for fraud, what may be the first document to research?
Compliance plan
Which code set is used for billing dental procedures?
CDT-4
Which complies with the HIPAA Security Rule?
Selecting a mixture of characters for the password
Which is a future benefit of the Affordable Care Act?
Preventative services will be completely covered
Which federal agency detects health care fraud and abuse?
Office of the Inspector General (OIG)
Which federal agency enforces criminal violations under federal law?
Department of Justice (DOJ)
Which scenario best describes abuse?
The doctor tells you to bill for an unecessary procedures that was done
Which scenario best describes fraud?
The doctor tells you to bill for an undocumented procedure
Which of the following will be introduced in the future?
Both patient and health plan identifiers
Which measure does NOT enforce the HIPAA Security Rule?
Transmitting unencrypted data
Which is also known as the Stimulus Package?
ARRA
What is best description of an encounter?
Face-to-face meeting
Which is NOT a goal of compliance plans?
Enhance patient education guidelines
A social security number is an example of a(n):
Identifier
Which act requires covered entities to notify affected individuals following the discovery of a breach of unsecured health information?
HITECH
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?
HITECH
What are people or organizations that furnish, bill, or are paid for health care in the normal course of business called?
Providers
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?
Practice management
Who has the aurthority to authorize the release of information on a patient to anyone not directly involved in their care?
Legal representative
What are the Centers for Medicare and Medicaid Services (CMS) responsible for?
Impledmenting annual federal budget acts and laws
A complaince plan does NOT cover which of the following?
Referrals and authorizations
What did the NPI (National Provider Identifier) replace?
Medicare UPIN
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)?
May be simple errors
Which main federal government agency is respnsible for health care?
Centers for Medicare and Medicaid Services (CMS)
What is the impermissible use or disclosure of PHI that could pose significant risk to the affected person called?
Breach
What is a medical practice's written plan for complying with regulations?
Compliance plan
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?
Backup
Which is NOT a valid component of a compliance plan?
To have inconsistent policies and prodecures
Which is the process of encoding information in such a way that only the person (or computer) with the key can decode it?
Encrypting
Which is (are) elements included in a compliance plan according to the Office of the Inspector General?
Both training and ongoing communication
Which is vaild aspect of the Affordable Care Act?
Preventive services will be covered by insurance with no copayment required
Which standards have been set to govern the electronic exchange of health information?
All of these: Indentifiers, code sets, standard transaction
A compliance plan constitutes which of the following?
Both a written document and a committee
What is any group of codes used for encoding data elements?
Code set
Which is a valid Breach Notification Procedure?
None of these
Which code set is for specifying diseases, injuries, impairments, and other health related problems?
ICD
Which are covered entites under HIPAA/HITECH that must follow the regulations?
Health Providers
A retention schedule:
All of these: explains what records to keep, explains how long records must be saved, covers the method(s) of record storage
The standards for wirtten documentation include:
All the above: clarity, legibility, sign and dated entries
Which one of these would be the most secure password?
f1H*%4hs
What standards are set under the rules of the HIPAA Electronic Health Care Transactions and Code Sets?
All of these: electronic formats, identifiers, codes.
In electronic health records, documents may be created in a variety of ways, but they are______
Ultimately viewed on computer screen
The provider owns the actual medical records, but the information in a record belongs to _____.
The patient
Which of the following is fradulent behavior?
Deception with the intent to benefit
The HIPAA Privacy Rule is enforced by the OCR. What does OCR stand for?
Office for Civil Rights
Under what conditions should a medical assistant change the facts on an insurance claim?
The facts must never be changed
When can information about a patient's drug abuse be disclosed without authorization?
None of these
A standard and unique identifier for health care privders to use in filing health care claims is called?
National Provider Identifier (NPI)
the HIPAA Privacy Rule is enforced by ______
the OCR
Collecting payment in full for a procedure from both the patientand the insurance carrier is an example of ____
Fraud
Altering a patients chart to increase the payment the physician recieves is an example of _____
Fraud
SOAP is a format for patients' medical _____
Both documentation and records
What do patients' medical records contain about their health history?
All of these: facts, observation, findings
Entries in patients' medical records should be descending or ascending in what type of order?
Chronological
The abbreviation TPO refers to:
Treatment, payment, and health care operations
What type of schedule do medical affices use to control how long patient information is stored?
Retention schedule
The abbreviation PHI stands for?
Protected health information
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)?
7 years
A form signed by a patient to permit release of medical information under specific stated conditions is called a(n) _____
Authorization to disclose information
A clearinghouse is a company that helps medical offices and health plans exchange ____
Claim data in correct formats
Under HIPAA, patients' proctected health information may be shared without authorization for:
All of these: payment, health care operations, treatment
______ releasing protected health information for reasons other than treatment, payment, or health care operations requires which type of patient authorization?
Written
What is the relationship between documentation and billing?
If a service is not documented, it cannot be billed.
Which of these subjects would you not expect to find information about in a patient's medical record?
Employment and salary records
A medical office's compliance plan should include ______
Both staff training and internal communications
Under what circumstances might a patient's proctected health information be shared without authorization?
Both court orders and workers' compensation cases
What is one way that providers can follow the guidelines for the HITECH rule?
All of these: frequently change passwords, access controls, make copies of all data
Following OIG's guidance can help in the defense against which of the following?
A false claims accusation
If a physician requests that you bill a procedure that is not documented, what would be the best course of action?
Report it to the compliance officer
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)?
Prominent media outlets
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