Evaluation and management of services include

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GuntermanINS Ch 2

HIPAA, HITECH & Medical Records

Question	Answer
Law under the Administrative Simplification Provisions of HIPAA regulating the use and disclosure of pt's protected health information	HIPAA Privacy Rule
Document signed by a patient that permits release of medical information under the specific stated conditions	Authorization
The principle that individually identifiable health information should be disclosed only to the extent needed to support the purpose of the disclosure	Minimum necessary standards
A person or organization that performs a function or activity for a covered entity but is not part of its workforce	Business associate
A company that offers providers, for a fee, the service of receiving electronic or paper claims, checking and preparing them for processing, and transmitting them in proper data format to the correct carriers	Clearinghouse
A HIPAA mandated document that presents a covered entity's principles and procedure related to the protection of pt's protected health information	Notice of Privacy Practices
A coding system used to encode elements of data	Code set
Law under the Administrative Simplification provisions of HIPAA requireing covered entities to establish administrative, physical, and technical safeguards to protect the confidentiality, integreity, adn availability of health information.	HIPAA security rule
Under HIPAA a health plan healthcare clearinghouse or healthcare or healthcare provider who transmits any health information in electronic form in conection with a HIPAA transaction	Covered entity
The systematic, logical, and consistent recording of a patient's health status; history, examinations, tests, results of treatment, and observations-in chronological order in a patient's medical record.	documentation
the expertise reasonably expected of a medical professional	medical standards of care
The provider owns the actual medical records, but the information in the record belongs to	the patient
When a provider injures a patient due to failure to follow medical standards of care it is called	malpractice
Evaluation and management of services include	the patient's chief complaint, the medical history, and the physical exam results
The federal agency that runs Medicare and Medicaid	CMS-Centers for Medicare and Medicaid Services
The laws to tighten the HIPAA Privacy Rule	HITECH Act
HIPAA Law of 1996 was designed to	uncover fraud and abuse, ensure health insurance coverage for workers and their families, protect peoples' PHI
Under HIPAA, if a provider doesn't send claims electronically or employ another firm to do so, they provider may not be a what	covered entity
HIPAA identifies 3 types of covered entities, what are they?	Health plans, clearinghouses, and providers
A vendor that does business with a covered entity is called	business associate
EDI means	electronic data interchange
The HIPAA rules that protect PHI is called the	Privacy Rule
When personal identifiers have been removed, PHI is called	de-identified

Created by: monicagunterman

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