Busy. Please wait.
Log in with Clever

show password
Forgot Password?

Don't have an account?  Sign up 
Sign up using Clever

Username is available taken
show password

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.
Your email address is only used to allow you to reset your password. See 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.
Didn't know it?
click below
Knew it?
click below
Don't Know
Remaining cards (0)
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


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
Popular Medical sets




Use these flashcards to help memorize information. Look at the large card and try to recall what is on the other side. Then click the card to flip it. If you knew the answer, click the green Know box. Otherwise, click the red Don't know box.

When you've placed seven or more cards in the Don't know box, click "retry" to try those cards again.

If you've accidentally put the card in the wrong box, just click on the card to take it out of the box.

You can also use your keyboard to move the cards as follows:

If you are logged in to your account, this website will remember which cards you know and don't know so that they are in the same box the next time you log in.

When you need a break, try one of the other activities listed below the flashcards like Matching, Snowman, or Hungry Bug. Although it may feel like you're playing a game, your brain is still making more connections with the information to help you out.

To see how well you know the information, try the Quiz or Test activity.

Pass complete!
"Know" box contains:
Time elapsed:
restart all cards