ins hand book mod 110 week 3 chapter 2 study guide

26 terms by polsen47 

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CONFIDENTIALITY BETWEEN THE PHYSICIAN AND THE PATIENT IS AUTOMATICALLY WAIVED WHEN THE PATIENT IS BEGING TREATED IN A WORKERS COMPENSATION CASE

true

TO GIVE RELEASE OR TRANSFER INFORMATION TO ANOTHER ENTITY IS CALLED CONSENT.

False

A HIPPA COMPLIANCE EXCEPTION TO THE RIGHT OF PRIVACY AND PRIVILEGED COMMUNICATION IS A PATIENTS RECORDS PERTAINING TO HIS OR HER INDUSTRIAL ACCIDENT CASE.

true

UNDER HIPPA GUIDLINE AN OUTSIDE BILLING COMPANY THE MANAGES CLAIMS AND ACCOUNTS FOR A MEDICAL CLINIC IS KNOWN AS A COVERED ENTITY

false

A PATIENT HAS THE RIGHT TO OBTAIN A COPY OF HIS OR HER CONFIDENTIAL HEALTH INFORMATION

...true

THE CORRECT CODING INITIATIVE (CCI) DEECTS IMPROPERLY CODED CLAIMS THROUGH THE USE OF COMPUTER EDITS

...true

THE GOAL OF THE MEDICARE INTEGRITY PROGRAM (MIP) IS TO IDENTIFY AND REDUCE EXCESSIVE MEDICARE COSTS.

...false

DISCLOING PHI AS AUTHORIZED BY THE LAWS RELATING TO WORKERS COMPENSATION DOES NOT REQUIRE A SIGHED AUTHORIZATION.

...true

WHAT IS THE CORRECT RESPONSE WHEN A RELATIVE CALLS ASKING ABOUT A PATIENT?

Have the physician return the telephone call

EXCEPTIONS TO RIGHT OF PRIVACY RULE INCLUDE .

...gunshot wound cases

CONFIDENTIALITY IS AUTOMATICALLY WAIVED IN CASES OF

...gunshot wounds
Child abuse
Extremely contagious disease
All of the above

WHEN AN INSURANCE BILLING SPECIALIST BILLING FOR A PHYSICIAN AND COMPLETES A MEDCARE CLAIM FORM WITH INFORMATION THAT DOES NOT REFLECT THE TRUE SITUATION

he or she may be subject to fines and imprisonment

TO BILL MEDCARE BENEFICIARIES AT A HIGHER RATE THAN OTHER PATIENTS IS CONSIDERED

abuse

ELECTRONIC MEDIA REFERS TO

...1. leased phone or dial up phone lines
2. The internet
3. transmissions that are physically moved. from one location to another
All of the above

THE OFFICE OF CIVIL RIGHTS ENFORES

...privacy standards

WHAT IS THE BEST RESPONSE WHEN TELEPHONING A PATIENT ABOUT AN INSURANCE MATER AND THE PATIENTS VOICE MAIL IS REACHED?

use care in the choice of words when leaving the message

THE FOCUS ON THE HEALTH CARE PRACTICE SETTING AND REDUCING ADMINISTRATIVE COSTS AND BURDENS ARE THE GOALS OF

...HIPPA Title I insurance reform

A BILLING PRACTICE SUCH AS EXCESSIVE REFERRALS TO OTHER PROVIDERS FOR UNNECSSARY SERICES IS CONSIDERED

...medical billing abuse

STARK LAWS PROHIBIT THE SUBMISSION OF CLAIMS FOR DESIGHATED SERICES IF THE REFERRING PHYSICIAN HAS A WITH THE ENTITY THAT PROVIDES THE SERVICE.

Financial relationships

EMPLOYEES SHOULD BE REQUIRED TO ATTEND A COMPLIANCE TRAING SESSION AT LEAST .

...annually

INDIVIDUAL WHO IS DESIGNATED TO HELP A PROVIDER REMAIN IN COMPLIANCE BT SETTING POLICIES AND PROCEDURES IN PLACE TRAIN STAFF REGARDING HIPPA AND ACT AS THE CONTACT PERSON FOR QUESTIONS AND COMPLAINTS.

...privacy officer
privacy official

A HEALTH CARE COVERAGE CARRIER CLEARING HOUSE OR PHYSICIAN WHO TRANSMITS HEALTH INFORMATION IN ECLTRONIC FORM IN CONNECTION WITH A TRANSACTION COVERED BY HIPPA.

...covered entity

INDIVIDUAL WHO RENDERS MEDICAL SERVICES FURNISHES BILLS OR IS PAID FOR HEALTH CARE IN THE NORMAL COURSE OF BUSINESS.

...health care provider

THIRD-PARTY ADMINISTRATOR WHO RECEIVES INSURANCE CLAIMS FROM THE PHYSICIANS OFFICE PERFORMS EDITS AND REDISTRIBUTES THE CLAIMS ECLECTRONICALLY TO VARIOUS INSURANCE CARRIERS.

...clearinghouse

INDIVIDUAL WHO IS HIRED BY A MEDICAL PRACTICE PROCESS CLAIMS TO A THIRD-PARTY PAYER.

business associate

ivisually identifiable hearth information (IIhi) is any part of a persons health data

...

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