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HIPAA EXAM

QuestionAnswer
The goal of the Medicare Integrity Program (MIP) is to identify and reduce excessive Medicare costs. False
To give,release, or transfer information to another entity is called consent. False
A patient has the right to obtain a copy of his or her confidential health information. True
The Correct Coding Initiative (CCI) detects improperly coded claims through the use of computer edits. True
Under HIPAA guidelines, an outside billing company that manages claims and accounts for a medical clinic is known as a covered entity. False
Notes, papers, and memos regarding patient information should be disposed of using a shredding device. True
Confidentiality between the physician and the patient is automatically waived when the patient is being treated in a workers' compensation case. True
The process of meeting regulations, recommendations, and expectations of federal and state agencies that pay for health services and regulate the industry is known as eHealth Information Management. False
Baby Baker was born on February 4, 2005 at 9:20 A.M. The proper format for transmission is 200502040920. True
Confidential information includes? Everything that is heard, read or seen regarding a patient.
What is the correct response when a relative calls asking about a patient? Have the physician return the telephone call.
Electronic media refers to what? Leased phone or dial-up phone lines; the Internet; Transmissions that are moved from one location to another.
What action could happen if an employee knowingly submits a fraudulent Medicare or Medicaid claim at the direction of the employer and subsequently the medical office is audited? The employee and employer could be brought into litigation by the state or federal government.
Confidentiality is automatically waived in cases of? Gunshot wounds; child abuse; extremely contagious diseases, etc
Exceptions to the right of privacy rule include? For instance gunshot wounds
What would be an example of NONprivleged information about a patient? City of residence.
What does the Office of Civil Rights enforces? Privacy Standards
A code system used for managing patient electronic health records, information, indexing and billing laboratory problems is called? SNOMED (Systemized nomenclature of Human and Veterinary Medicine)
The focus on the health care practise setting and reducing administrative costs and burdens are the goals of HIPAA Title #? HIPAA Title II (Administrative Simplification)
Nonprivileged information cosnsists of ordinary BLANK unrelated to the treatment of the patient. Facts
Billing for services or supplies not provided is BLANK Fraud
A billing practise such as excessive referrals to other providers for unnecessary services is considered BLANK. Medical billing abuse
Stealing money that has been entrusted to one's care is known as BLANK. Embezzlement
A health care organization must not conduct business with any health care provider who has been listed as an BLANK by OIG. Excluded individual
Stark Laws prohibit the submission of claims for "designated services" if the referring physician has a BLANK with the entity that provides the service. Financial relationship
Telephone conversations by providers in front of patiens should be BLANK. Avoided
What I may see or hear in the course of the treatment or even outside of the treatment in regard to the life of men, which on no account one must spread abroad, I will keep to myself holding such things shameful to be spoken about. Hippocrates
A term coined by AHIMA's eHealth Task Force to describe trnasactions in which health care information is accessed, processed, stored, and transferred using electronic technologies is usually abbreviated as BLANK. eHIM
Employees should be required to attend a compliance training session as least BLANK Annually
Individual who is designated to help a provider remain in compliance by setting policies and procedures in place, train staff regarding HIPAA, and act as the contact person for questions and complaints. Privacy Officer
A health care coverage carrier, clearinghouse, or physician who transmits health information in electronic form in connection with a transaction covered by HIPAA. Covered Entity
Individual who renders medical serivces, furnishes bills, or is paid for health care in the normal course of business. Health care provider
TPA who receives insurance claims from the physician's office, performs edits, and redistributes the claims electornically to various insurance carriers. Clearinghouse
Individual who is hired by a medical practise to process claims to a third party payers Business Associate
A/FCalling patients back for repeated and unnecessary follow-up visits. Abuse
A/FFailure to make required refunds when services are not reasonable and necessary. Abuse
Altering medical records to generate more in payment Fraud
A/FCharging excessively for services and supplies. Abuse
A/FALtering fees on an insurance claim form to obtain higher payment Fraud
A/FForgiving the deductible or copayment for a Medicare patient Fraud
A/FChanging the dates of service Fraud
A/FUnbundling or exploding charges Fraud
A/FFiling insurance claims for serivces not medically necessary Abuse
Billing Medicare beneficiaries at a higher rate than other patients. Abuse
A/FFailure to make a refund when services are not reasonable or necessary. Abuse
Created by: douelt on 2009-09-29



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