chapter 8

Question 0

health insurance portability and accountability act (HIPAA)

Answer 0

a federal law passed in 1996 to protect privacy and other health care rights for patients. the act helps workers keep continuous health insurance coverage for themselves and their dependents when they change jobs, and protects confidential medical information from unauthorized disclosure and/or use. it was also intended to help curb the rising cost of health care fraud and abuse

Question 1

privacy

Answer 1

freedom from unauthorized intrusion

Question 2

covered entities

Answer 2

health care providers and clearing houses that transmit HIPAA transactions electronically, and must comply with HIPAA standards and rules

Question 3

covered transactions

Answer 3

electronic exchanges of information between two covered- entity business partners using HIPAA- mandated transaction standards

Question 4

designated record set

Answer 4

records maintained by or for a HIPAA- covered entity

Question 5

notice of privacy practices (NPP)

Answer 5

a written document detailing a health care provider’s privacy practices

Question 6

protected health information (PHI)

Answer 6

information that contains one or more patient identifiers

Question 7

de- identity

Answer 7

to remove from health care transactions all information that identifies patients

Question 8

state preemption

Answer 8

if a state’s privacy laws are stricter then HIPAA privacy standards, the state laws take precedence

Question 9

treatment, payment, and health care operations (TPO)

Answer 9

a HIPAA term for qualified providers, disclosure of PHI to obtain reimbursement, and activities and transactions among entities. treatment means that a health care provider can provide care; payment means that a provider can disclose PHI to be reimbursed; health care operations refers to HIPAA- approved activities and transactions

Question 10

standard

Answer 10

a general requirement under HIPAA

Question 11

rule

Answer 11

a document that includes the HIPAA standards or requirements

Question 12

transaction

Answer 12

transmission of information between two parties for financial or administrative activities

Question 13

code set

Answer 13

under HIPAA, terms that provide for uniformity and simplification of health care billing and record keeping

Question 14

electronic transmission

Answer 14

the sending of information from one network- connected computer to another

Question 15

electronic data interchange (EDI)

Answer 15

the use of uniform electronic network protocols to transfer business information between organizations via computer networks

Question 16

permission

Answer 16

a reason under HIPAA for disclosing patient information

Question 17

limited data set

Answer 17

protected health information from which certain patient identifiers have been removed

Question 18

security

Answer 18

policies and procedures that protect PHI from unauthorized access

Question 19

firewalls

Answer 19

hardware, software, or both designed to prevent unauthorized persons from accessing electronic information

Question 20

encryption

Answer 20

the scrambling or encoding of information before sending it electronically

Question 21

verification

Answer 21

the requirement under HIPAA to verify any request as legitimate before protected health information is released

Question 22

minimum necessary

Answer 22

term referring to the limited mount of patient information that may be disclosed, depending on circumstances