CPB HIPAA Exam Study Guide with Complete Solutions

CPB HIPAA Exam Study Guide with Complete Solutions Healthcare Regulations - Answer️️ -These are not always definitive and may vary by payer, geographic area, and the setting in which patient care is provided. Health Insurance Portability and Accountability Act (HIPAA) - Answer️️ -Provides rights and protections for participants and beneficiaries of health plans. Healthcare Fraud and Abuse Control Program (HCFAC) - Answer️️ - Established under HIPAA, to combat fraud and abuse in healthcare. Designed to coordinate federal,state, and local law enforcement. Annual reports are made by the US Department of Health and Human Services (HHS) and Department of Justice (DOJ). Privacy Rule - Answer️️ -A national standard to secure a patient's protected health information (PHI), which is "individually identifiable health information". Covered entities are defined as health plans, healthcare clearinghouses, and any healthcare provider who transmits health information. ©SOPHIABENNET@ Thursday, August 22, 2024 10:21 AM Certified Professional Biller By: American Academy of Professional Coders(AAPC) 2 A covered entity may not use or disclose PHI unless the Privacy Rule permits it, or as the individual authorizes it in writing. Health Information Technology for Economic and Clinical Health (HITECH) - Answer️️ -Specifies that an organization that provides data transmission of PHI (protected health information) to a covered entity and that require access to PHI routinely will be treated as a business associate that must follow the privacy rule. De-Identification - Answer️️ -The process of removing identifying information from data sets in order to assure the anonymity of individuals. Uses and Disclosures of PHI - Answer️️ -1. Release of records to the individual who is the subject of the information. 2. By a covered entity for treatment, payment, and healthcare operation activities. 3. The individual may grant informal permission by being asked outright, giving them the opportunity to agree or object in circumstances the individual is not capable of providing his or her signature. ©SOPHIABENNET@ Thursday, August 22, 2024 10:21 AM Certified Professional Biller By: American Academy of Professional Coders(AAPC) 3 4. Incidental use and disclosure is permitted if the covered entity has reasonable safeguards in place to ensure that the information being shared is limited to the "minimum necessary". Minimum Necessary Standard - Answer️️ -Principle that individually identifiable health information should be disclosed only to the extent needed to support the purpose of the disclosure. 12 National Priority Purposes (instances that don't require the individual's authorization to be released) - Answer️️ -1. Required by Law - Includes by statute, regulation, or court orders. 2. Public Health Activities - Release to public health authorities who are legally authorized to receive reports to prevent and control disease, injury, or di