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MedLaw&Ethics HIPAA

HIPAA terms

QuestionAnswer
A private or public healthcare entity that processes nonstandard electronic transactions into HIPAA transactions (billing co.) Clearinghouse
Healthcare organizations covered under HIPAA that handle electronic PHI Covered Entities
Providers, clearinghouses, billing companies Examples of covered entities
A number assigned to an employer for purposes of identification (tax purposes) Employer Identification Number (EIN)
A national data bank that collects and reports disclosures of actions taken against healthcare practitioners, providers and vendors for noncompliance and fraudulent activities Healthcare Integrity and Protection Data Bank (HIPDB)
Regulates the privacy and security of patients health information, sets standards for transactions, and allows easier transfer of insurance for patients Health Insurance Portability and Accountability Act (HIPAA)
Permission to use information based on the reason for knowing, or use of, the information HIPAA-defined permissions
the application of communication and information to medical practice, research, and education medical informatics
the provider must make a reasonable effort to limit the disclosure of patient information to only the minimum amount necessary to accomplish the purpose of the request minimum necessary standard
a written statement the details the providers privacy practices Notice of Privacy Practices (NPP)
the federal office that investigates violations of HIPAA Office of Civil Rights
Title II of the HIPAA Privacy Rule
individually identifiable information that relates to the physical or mental condition or the provision of health care to an individual protected health information
occurs when the state privacy laws are stricter than the privacy standards established by HIPAA State's pre-emption
the use of communications and information technologies to provide healthcare services to people at a distance telemedicine
what the covered entity may use PHI for without the patient's authorization TPO
a wireless system that is used by physicians and nurses to access patient information Wireless Local Area Network (WLAN)
Stays within the covered entity and is used for purposes of the entity Use of PHI
the covered entity releases PHI to a third party outside of the entity Disclosure of PHI
Needed for TPO and does not need to be written Consent
gives permission for release of PHI for reasons other than TPO, has to be written, signed and dated Authorization
Reasons for disclosure of PHI that are a threat to public health, law enforcement, organ donations and workers compensation Public interest
the removal of all individually identifiable information form a medical record de-identify
allows a covered entity to disclose PHI without authorization subpoena or court order
HIPAA approved code set for diagnoses and inpatient procedures ICD-9-CM
HIPAA approved code set for outpatient procedures CPT-4
Created by: Kirkster