ins hand book mod 110 week 3 chapter 2 study guide
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26 terms
Terms | Definitions |
|---|---|
 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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