Busy. Please wait.
or

show password
Forgot Password?

Don't have an account?  Sign up 
or

Username is available taken
show password

why


Make sure to remember your password. If you forget it there is no way for StudyStack to send you a reset link. You would need to create a new account.
We do not share your email address with others. It is only used to allow you to reset your password. For details read our Privacy Policy and Terms of Service.


Already a StudyStack user? Log In

Reset Password
Enter the associated with your account, and we'll email you a link to reset your password.

Remove Ads
Don't know
Know
remaining cards
Save
0:01
To flip the current card, click it or press the Spacebar key.  To move the current card to one of the three colored boxes, click on the box.  You may also press the UP ARROW key to move the card to the "Know" box, the DOWN ARROW key to move the card to the "Don't know" box, or the RIGHT ARROW key to move the card to the Remaining box.  You may also click on the card displayed in any of the three boxes to bring that card back to the center.

Pass complete!

"Know" box contains:
Time elapsed:
Retries:
restart all cards




share
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.

  Normal Size     Small Size show me how

Regulatory Comp

H.I.T

TermDefinition
The Health Insurance Portability & Accountability Act (HIPAA) of 1996 The first uniform standard that included protections for the privacy & security of patient information
The Health Information Technology for Economic & Clinical Health (HITECH) Act Includes changes to HIPAA that relate to privacy
Documentation Is the record of clinical observations & care for a patient receives at a health facility
Informed Consent Providers are required to explain any medical or diagnostic procedures, as well as surgical interventions, & give patients an opportunity to ask questions before any work is done
Implied Consent If a patient voluntarily undergoes treatment
Protected Health Information (PHI) Individually identifiable health information transmitted by electronic media, maintained in any electronic medium, or maintained in any other form or medium
Clearinghouses Agency that converts claims into standardized electronic format, looks for errors, & formats then according to HIPPA & insurance standards
Individually Identifiable Documents that identify the person or provide enough info so that the person could be identified
Minimum Necessary Standard When disclosing info providers & other covered entities must limit uses, disclosures, & requests to only the amount needed to accomplish a specific purpose
Notice of Privacy Practices The legal obligation of providers to explain to patients how their PHI will be used & disclosed
De-identified Information Does not protect de-identified info which is info that does not identify a individual because unique & personal characteristics have been removed
Authorization Means permission granted by the patient or the patient's representative to release info for reasons other than treatments, payments or health care operations
Consent A patient's permission evidenced by signature
Billing Audits The claim is a record of the medical & surgical services provided to a patient during a episode of care
Reimbursement Payment for services rendered from a third-party payer
Auditing Is the review of claims for accuracy & completeness
Fraud Making false statements of representations of material facts to obtain some benefit or payment for which no entitlement would otherwise exist
Upcoding Assigning a diagnosis or procedure code at a higher level then the documentation supports, such as coding bronchitis as pnumonia
Unbunding Is the practice of using multiple codes that describe different components of a treatment instead of using the correct single code that describe all steps of the procedure
Abuse Practices that directly or indirectly result in unnecessary costs to the Medicare program
HIPAA's Role in Protecting Against Fraud & Abuse Law mandated that info about fraud & abuse be complied into the national Healthcare Integrity & Protection Data Bank (HIPDB)
Final Rule BA's must ensure that PHI remains secure & they are expected to report any breaches in security
Stark Law Law states that physicians are not allowed to refer pts to a practitioner with whom they have a financial relationship
Fair Debt Collection Practices Act (FDCPA) Law says debt collectors, including collection agencies, lawyers, or companies who pay unpaid debts, cannot use unfair or abusive practices to collect payment
Business Associates (BA) Individuals, groups, or organizations who are not members of a covered entity's workforce that perform functions or activities on behalf of or for a covered entity
False Claims Act Protects the Gov. from being overcharged for services provided or sold, or substandard goods or services
Role of the Office of the Inspector General (OIG) Protects Medicare & HHS programs form fraud & abuse by conducting audits, investigations, & inspections to answer formal compliants
Created by: diasiar