CH 2 - HIPPA HITEC Flashcards Preview

OST 148 - Medical Insurance and Billing > CH 2 - HIPPA HITEC > Flashcards

Flashcards in CH 2 - HIPPA HITEC Deck (22)
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1

Health system reform legislation signed in 2010 that introduced a number of significant benefits for patients.

Affordable Care Act (ACA)

2

Methodical review; in medical insurance, a formal examination of a physician's accounting or patient medical records

audit

3

Document signed by a patient to permit release of particular medical information under the stated specific conditions.

authorization

4

An impermissible use or disclosure under the Privacy Rule that compromises the security or privacy of PHI and also that should pose significant risk of financial, reputational, or other harm to the affected person.

breach

5

The document notifying an individual of a breach

breach notification

6

A person or organization that performs a function or activity for a covered entity but is not a part of its work force.

business associate (BA)

7

Federal agency within the Department of Health and Human (HHS) that suns Medicare, Medicaid, clinical laboratories, and other government health programs.

Centers for Medicare and Medicaid Services (CMS)

8

A company (billing service, repricing company, or network) that converts nonstandard transactions into standard transactions and transmits data to health plans. Also handles the reverse process, changing standard transactions into non standards.

clearinghouse

9

Alphabetic and/or numeric representations for data. Medical code sets are systems of medical terms that are required for HIPPA transactions.

code sets

10

A medical practices written plan for every operation.

compliance plan

11

Under HIPPA, a health plan, clearinghouse, or provider that transmits any health information in electronic form in connection with a HIPAA transaction.

covered entity (CE)

12

A covered entity's records that contain protected health information (PHI)

designated record set (DRS)

13

The system-to-system exchange of data in a standardized format.

electronic data interchange (EDI)

14

Enacted by US congress in 1996 to protect health coverage and it also requires the establishment of national standards for electronic healthcare transactions and national identifiers for providers, health insurance plans and employers.

Health Insurance Portability and Accountability Act (HIPAA) or 1996

15

Law that guides the use of federal stimulus money to promote the adoption and meaningful use of health information technology, mainly using electronic health records.

Health Information Technology for Economic and Clinical Health (HITECH) Act

16

The HIPAA rule governing the electronic exchange of health information.

HIPAA Electronic Health Care Transaction and Code Sets (TCS)

17

Unique ten-digit identifier assigned to each provider by the National Provider System.

National Provider Identifier (NPI)

18

The part of CMS that enforces the other HIPAA standards.

Office of E-Health Standards and Services (OESS)

19

OCR

Office for Civil Rights

20

NPP

Notice of Privacy Practices

21

Government agency that investigates and prosecutes fraud against government health care programs such as medicare.

Office of the Inspector General (OIG)

22

Under HIPAA, patients protected health information may be shared without authorization for the purpose of treatment, payment and operations.

treatment, payment, and operations (TPO)