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nhaBillingandcoding1
| Question | Answer |
|---|---|
| What does HIPAA stand for? | Health insurance portability and Accountability act |
| In what year was HIPPA Implied | 1996 |
| what is the main purpose of HIPAA | To protect privacy and security of patients information and safeguard against fraud and abuse.(protect Medicare and Medicaid from unlawful practices) |
| what does ARRA stands for? | American Recovery and Reinvestment Act |
| Informed consent | providers explain medical or diagnostic procedures, surgical interventions, and the benefits and risk involved, giving patients an opportunity to ask questions before medical intervention is provided |
| Implied Consent | A patient presents for treatment such as arm to allow a venipuncture to be performed |
| what does PHI stand for | Protected Health Information |
| What is an Business Associates | Are individuals, groups,or organization who are not members of the covered entity's workforce that perform functions or activities on behalf of or for a cover entity. |
| Clearinghouse | Agency that converts claims into a standardized electronic format, looks for errors, and formats them according to HIPAA and insurance standards |
| Individually identifiable | Documents that identify the person or provide enough information so that the person could be identified |
| Consent | A patients permission evidenced by signature |
| Authorization | permission granted by the patient or the patients representative to release information for reasons other than treatment, payment, or health care operations |
| Reimbursement | rendered from a third-party payer |
| Auditing | Review of claims for accuracy and completeness |
| Fraud | Making false statements of representation of material facts to obtain some benefits or payment for which no entitlement would otherwise exist |
| Upcoding | Assigning a diagnosis or procedure code at a higher level than the documentation support, such as coding bronchitis as pheumonia |
| Unbundling | Using multiple codes that describe different components of a treatment instead of using a single code that describes all steps of the procedure |
| Abuse | Practices that directly or Indirectly result in unnecessary cost to the medicare program |
| Stark Law | A law that states physicians are not allowed to refer patients to a practitioner with whom they have a financial relationship. |
| What does FDCPA stand for | The fair debt collection practices act |
| What is the Fair debt collection practices act? | Its a law that debt collectors,including collection agencies, or companies who buy unpaid debts, cannot use unfair or abusive practices to collect payment |
| What does OIG stand for? | Office of Inspector General |
| What is the main job of the office of the Inspector general? | protect Medicare and other HHS programs from fraud and abuse by conducting audits,investigations. |
| What does Heat stand for? | Health care fraud prevention enforcement |
| what is medicare | Federally funded health insurance provided to people ages 65 or older than 65 who have certain diseases |
| what does HHS stand for? | Health Human Services |
| What does HCFAC stand for | Health care fraud abuse control |
| what does OCR stand for? | Office of Civil Rights |
| what does HI Tech stand for? | Health information technology for economic and clinical health |
| What does NPBD stand for? | National Practitioner Data Bank |
| What does HIPDB stand for? | Healthcare integrity protection data Bank |
| What does CPT stand for for? | Current procedural |
| What is Deidentified information | information that does not identify an individual because unique and personal characteristics have been removed |
| A government based health insurance option that pays for medical assistance for individuals who have low income and limited financial resources. Funded at the state and national level. Administered at the state level | |
| What is Privacy rule | A HIPAA rule that establish protections for the privacy of the individuals health information |
| What services are not covered under the stark law | Clinical laboratory services Physical therapy Occupational therapy Radiation therapy services/supplies Durable medical equipment/supplies Parental and central nutrients,equipment, supplies Prosthetics,orthotics/prosthetic devices and supplies |
| Mediciad | |
| False claims act | Protects the government from being overcharged for services sold, or substandard goods or services |
Created by:
Naquita02
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