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26 terms

ins hand book mod 110 week 3 chapter 2 study guide

STUDY
PLAY
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
...