,Chapter 01 - Legal and Ethical Issues
Chapter 01
Legal and Ethical Issues
Multiple Choice Questions
1. The following individuals are responsible in the health care practice except a(n):
A. physician.
B. transporter.
C. insurance coder and biller.
D. therapist.
A patient's information is easily accessible to those who should have access to it, such as the
physician, insurance coder and biller, and therapist.
ABHES: 4.f. Comply with federal, state, and local health laws and regulations as they relate to healthcare settings
ABHES: 7.c. Comply with federal, state, and local laws relating to exchange of information and describe elements of meaningful use and
reports generated
Accessibility: Keyboard Navigation
Blooms: Understand
CAAHEP: X.C.1. Differentiate between scope of practice and standards of care for medical assistants
CAHIIM: II.B.1. Apply confidentiality, privacy and security measures and policies and procedures for internal and external use and
exchange to protect electronic health information
CAHIIM: V.A.3. Adhere to the legal and regulatory requirements related to the health information management
Difficulty: 2 Medium
Estimated Time: 0-1 minute
Learning Outcome: 01.01
Topic: Health Insurance Portability and Accountability Act
1-1
Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of
McGraw-Hill Education.
,Chapter 01 - Legal and Ethical Issues
2. What are professional coding specialists obligated to do?
A. Comply with the Privacy Rule
B. Work for clearinghouses
C. Release unauthorized private health information
D. Unbundle codes
HIPAA requires that all business-covered entities comply with the terms of the law.
ABHES: 4.f. Comply with federal, state, and local health laws and regulations as they relate to healthcare settings
Accessibility: Keyboard Navigation
Blooms: Remember
CAAHEP: X.C.1. Differentiate between scope of practice and standards of care for medical assistants
CAHIIM: II.A.2. Identify the use of legal documents
Difficulty: 1 Easy
Estimated Time: 0-1 minute
Learning Outcome: 01.01
Topic: Health Insurance Portability and Accountability Act
3. What were the HIPAA Privacy Rules written to protect?
A. Coding professional rights
B. Physician's privacy rights
C. An individual's personal health information
D. A business associate's privacy rights
HIPAA's Privacy Rule was written to protect an individual's privacy with regard to personal
health information.
ABHES: 4.f. Comply with federal, state, and local health laws and regulations as they relate to healthcare settings
Accessibility: Keyboard Navigation
Blooms: Remember
CAAHEP: X.C.1. Differentiate between scope of practice and standards of care for medical assistants
CAHIIM: II.A.2. Identify the use of legal documents
Difficulty: 1 Easy
Estimated Time: 0-1 minute
Learning Outcome: 01.01
Topic: Health Insurance Portability and Accountability Act
1-2
Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of
McGraw-Hill Education.
, Chapter 01 - Legal and Ethical Issues
4. Blue Cross Blue Shield is an example of a:
A. health care provider.
B. health care clearinghouse.
C. health community liaison.
D. health plan.
A health plan is an entity that provides or pays the cost of medical care on behalf of enrolled
individuals; it includes group health plans, health insurance issuers, health maintenance
organizations, and other welfare benefit plans such as Medicare, Medicaid, CHAMPUS, and
Indian Health Services.
ABHES: 4.f. Comply with federal, state, and local health laws and regulations as they relate to healthcare settings
Accessibility: Keyboard Navigation
Blooms: Understand
CAAHEP: VIII.C.1a. Identify types of third party plans.
CAHIIM: None
Difficulty: 2 Medium
Estimated Time: 0-1 minute
Learning Outcome: 01.01
Topic: Health Insurance Portability and Accountability Act
5. Covered entities are defined as businesses that:
A. provide transportation services.
B. have access to the personal health information of patients.
C. create the Health Care Fraud and Abuse Control Program.
D. forbid the submission of health care claims.
Under the Department of Health and Human Services HIPAA regulations, covered entities
are any health plan, healthcare clearinghouse, or healthcare provider that transmits specific
healthcare transactions in electronic form.
ABHES: 4.f. Comply with federal, state, and local health laws and regulations as they relate to healthcare settings
Accessibility: Keyboard Navigation
Blooms: Remember
CAAHEP: VIII.C.1a. Identify types of third party plans.
CAHIIM: II.B.1. Apply confidentiality, privacy and security measures and policies and procedures for internal and external use and
exchange to protect electronic health information
Difficulty: 1 Easy
Estimated Time: 0-1 minute
Learning Outcome: 01.01
Topic: Health Insurance Portability and Accountability Act
1-3
Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of
McGraw-Hill Education.
Chapter 01
Legal and Ethical Issues
Multiple Choice Questions
1. The following individuals are responsible in the health care practice except a(n):
A. physician.
B. transporter.
C. insurance coder and biller.
D. therapist.
A patient's information is easily accessible to those who should have access to it, such as the
physician, insurance coder and biller, and therapist.
ABHES: 4.f. Comply with federal, state, and local health laws and regulations as they relate to healthcare settings
ABHES: 7.c. Comply with federal, state, and local laws relating to exchange of information and describe elements of meaningful use and
reports generated
Accessibility: Keyboard Navigation
Blooms: Understand
CAAHEP: X.C.1. Differentiate between scope of practice and standards of care for medical assistants
CAHIIM: II.B.1. Apply confidentiality, privacy and security measures and policies and procedures for internal and external use and
exchange to protect electronic health information
CAHIIM: V.A.3. Adhere to the legal and regulatory requirements related to the health information management
Difficulty: 2 Medium
Estimated Time: 0-1 minute
Learning Outcome: 01.01
Topic: Health Insurance Portability and Accountability Act
1-1
Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of
McGraw-Hill Education.
,Chapter 01 - Legal and Ethical Issues
2. What are professional coding specialists obligated to do?
A. Comply with the Privacy Rule
B. Work for clearinghouses
C. Release unauthorized private health information
D. Unbundle codes
HIPAA requires that all business-covered entities comply with the terms of the law.
ABHES: 4.f. Comply with federal, state, and local health laws and regulations as they relate to healthcare settings
Accessibility: Keyboard Navigation
Blooms: Remember
CAAHEP: X.C.1. Differentiate between scope of practice and standards of care for medical assistants
CAHIIM: II.A.2. Identify the use of legal documents
Difficulty: 1 Easy
Estimated Time: 0-1 minute
Learning Outcome: 01.01
Topic: Health Insurance Portability and Accountability Act
3. What were the HIPAA Privacy Rules written to protect?
A. Coding professional rights
B. Physician's privacy rights
C. An individual's personal health information
D. A business associate's privacy rights
HIPAA's Privacy Rule was written to protect an individual's privacy with regard to personal
health information.
ABHES: 4.f. Comply with federal, state, and local health laws and regulations as they relate to healthcare settings
Accessibility: Keyboard Navigation
Blooms: Remember
CAAHEP: X.C.1. Differentiate between scope of practice and standards of care for medical assistants
CAHIIM: II.A.2. Identify the use of legal documents
Difficulty: 1 Easy
Estimated Time: 0-1 minute
Learning Outcome: 01.01
Topic: Health Insurance Portability and Accountability Act
1-2
Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of
McGraw-Hill Education.
, Chapter 01 - Legal and Ethical Issues
4. Blue Cross Blue Shield is an example of a:
A. health care provider.
B. health care clearinghouse.
C. health community liaison.
D. health plan.
A health plan is an entity that provides or pays the cost of medical care on behalf of enrolled
individuals; it includes group health plans, health insurance issuers, health maintenance
organizations, and other welfare benefit plans such as Medicare, Medicaid, CHAMPUS, and
Indian Health Services.
ABHES: 4.f. Comply with federal, state, and local health laws and regulations as they relate to healthcare settings
Accessibility: Keyboard Navigation
Blooms: Understand
CAAHEP: VIII.C.1a. Identify types of third party plans.
CAHIIM: None
Difficulty: 2 Medium
Estimated Time: 0-1 minute
Learning Outcome: 01.01
Topic: Health Insurance Portability and Accountability Act
5. Covered entities are defined as businesses that:
A. provide transportation services.
B. have access to the personal health information of patients.
C. create the Health Care Fraud and Abuse Control Program.
D. forbid the submission of health care claims.
Under the Department of Health and Human Services HIPAA regulations, covered entities
are any health plan, healthcare clearinghouse, or healthcare provider that transmits specific
healthcare transactions in electronic form.
ABHES: 4.f. Comply with federal, state, and local health laws and regulations as they relate to healthcare settings
Accessibility: Keyboard Navigation
Blooms: Remember
CAAHEP: VIII.C.1a. Identify types of third party plans.
CAHIIM: II.B.1. Apply confidentiality, privacy and security measures and policies and procedures for internal and external use and
exchange to protect electronic health information
Difficulty: 1 Easy
Estimated Time: 0-1 minute
Learning Outcome: 01.01
Topic: Health Insurance Portability and Accountability Act
1-3
Copyright © 2016 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior written consent of
McGraw-Hill Education.
