CDEO ASSESSMENT GUIDE 2025
|MOST COMMON QUESTIONS WITH CORRECTLY
VERIFIED ANSWERS (the recent quizes)|ALREADY
A+ GRADED|GUARANTEED PASS
Health Insurance Portability and Accountability Act of 1996 - (HIPAA)
August 21, 1996 - HIPAA was enacted on _________.
Kennedy-Kassebaum - HIPAA aka as ______ bill, was originally enacted to provide rights
and protections for participants and beneficiaries of group health plans. Under this law,
exclusions for preexisting conditions were limited, and discrimination against employees and
dependents based on their health status were prohibited.
Fraud, Abuse - HIPAA also established the Healthcare _____ and _____ Control Program,
a far-reaching program in healthcare, including both public and private health plans to combat
both
Administrative Simplification - HIPAA _______ provisions required that sections of the
law be publicized to explain the standards for the electronic exchange, privacy, and security of
health information.
August 14, 2002 - Congress did not enact privacy legislation within the specified time
governed by HIPAA. The U.S. Department of Health and Human Services (HHS) developed a
proposed rule, which was released for comment on November 3, 1999. Many comments were
received, and modifications were made to the rule. The modifications were published and
released in final form on ______.
HHS - _____ issued a privacy rule to set a national standard for the protection of certain
health information.
Privacy Rule - The _______ standards address how an individual's protected health
information (PHI) may be used. Its purpose is to protect individual
privacy, while promoting high-quality healthcare and public health and well-being. -
flexible, comprehensive - The Privacy Rule was designed to be ______ and ______, to
allow for the various uses and disclosures the healthcare community must address.
,All - ____ covered entities are required to follow the Privacy Rule.
plans, clearinghouses, provider - Covered entities are defined as health _____, healthcare
________, and any healthcare _________ who transmits health
information in an electronic format. -
plan - Health ______ covered entities are organizations that pay providers on behalf of an
individual receiving medical care. These plans include health, dental, vision, and prescription
drug insurers. Some examples include health maintenance organizations (HMOs), Medicare,
Medicaid,
and Medicare supplement insurers, as well as employer, government, and church-sponsored
group health plans. There are exceptions: An employer who solely establishes and maintains the
plan with fewer than 50 participants is exempt. Two types of government-funded programs -
are not health plans: food stamps and community health centers. Insurers providing only
worker's compensation, automobile insurance, and property and casualty insurance are not
considered to be health plans. -
providers - All healthcare ________ who electronically transmit health information
through certain transactions are covered entities. Some examples of transactions that may be
submitted electronically are claim forms, inquiries about the eligibility of benefits, and requests
for authorization of referrals. Simply using electronic technology, such as sending emails, does
not mean a healthcare provider is a covered entity; the transmission must be in connection with
a standard transaction. The rule applies to all, regardless of whether they transmit the
transactions directly, or use a billing service or other third party to transmit on their behalf.
They are defined as providers of services, such as hospitals, and providers of medical or health
services, such as physicians, dentists, and other practitioners who furnish, bill, or receive
payment for healthcare.
clearinghouses - Healthcare ________ include billing services, repricing companies, and
community health management information systems that process nonstandard information,
received from another entity, into a standard (ie, standard format or data content) or vice versa.
In most instances, healthcare clearinghouses receive individually identifiable information for
processing services to a health plan or healthcare provider as a business associate. In these
cases, only certain provisions are applicable to the clearinghouses' uses and disclosures of
protected health information.
, Transactions - _______ occur through electronic exchanges, which allow information to
be transferred between two parties for specific purposes.
plan - A healthcare provider will send a claim to a health _____ to request payment for
the medical services he or she provides.
HIPAA - _____ regulations standardized transactions for Electronic Data Interchange (EDI)
of healthcare data. These transactions are: claims and encounter information, payment and
remittance advice, claims status, eligibility, enrollment and disenrollment, referrals and
authorizations, coordination of benefits, and premium payment.
HIPAA - Under _______, electronic transactions must use the adopted standard and
adhere to the content and format requirements of ASC X12N or NCPDP (used for certain
pharmacy transactions) for each transaction. An additional rule was adopted to standardize the
code sets for diagnoses and procedures. These code sets include: HCPCS (Healthcare Common
Procedure Coding System—ancillary services and procedures); CPT® (Current Procedural
Terminology—physician's procedures); CDT® (Current Dental Terminology—dental procedures);
ICD-9 (International Classification of Diseases-9th revision— diagnosis and inpatient hospital
procedures); ICD-10 (International Classification of Diseases-10th Revision, which replaced ICD-
9 on October 1, 2015); and NDC (National Drug Codes).
unique identifier - In addition to the standardization of the codes used to request
payment for medical services, a _______ for employers and providers must be used on all
transactions.
Business associates - _______ perform certain functions or activities, which involve the
use or disclosure of individually identifiable health information, on behalf of another person or
organization, without being a member of the entity's workforce. These services include claims
processing or administration, data analysis, utilization review, billing, benefit management, and
re-pricing.
Business - _______ associate services to a covered entity are limited to legal, actuarial,
accounting, consulting, data aggregation, management, administrative, accreditation, or
financial services.
protected health information - To be considered a business associate, the persons or
organizations would involve the use or disclosure of ________ between the two parties.
can - A covered entity ____ be a business associate of another covered entity.
Health Information Technology for Economic and Clinical Health Act - HITECH
|MOST COMMON QUESTIONS WITH CORRECTLY
VERIFIED ANSWERS (the recent quizes)|ALREADY
A+ GRADED|GUARANTEED PASS
Health Insurance Portability and Accountability Act of 1996 - (HIPAA)
August 21, 1996 - HIPAA was enacted on _________.
Kennedy-Kassebaum - HIPAA aka as ______ bill, was originally enacted to provide rights
and protections for participants and beneficiaries of group health plans. Under this law,
exclusions for preexisting conditions were limited, and discrimination against employees and
dependents based on their health status were prohibited.
Fraud, Abuse - HIPAA also established the Healthcare _____ and _____ Control Program,
a far-reaching program in healthcare, including both public and private health plans to combat
both
Administrative Simplification - HIPAA _______ provisions required that sections of the
law be publicized to explain the standards for the electronic exchange, privacy, and security of
health information.
August 14, 2002 - Congress did not enact privacy legislation within the specified time
governed by HIPAA. The U.S. Department of Health and Human Services (HHS) developed a
proposed rule, which was released for comment on November 3, 1999. Many comments were
received, and modifications were made to the rule. The modifications were published and
released in final form on ______.
HHS - _____ issued a privacy rule to set a national standard for the protection of certain
health information.
Privacy Rule - The _______ standards address how an individual's protected health
information (PHI) may be used. Its purpose is to protect individual
privacy, while promoting high-quality healthcare and public health and well-being. -
flexible, comprehensive - The Privacy Rule was designed to be ______ and ______, to
allow for the various uses and disclosures the healthcare community must address.
,All - ____ covered entities are required to follow the Privacy Rule.
plans, clearinghouses, provider - Covered entities are defined as health _____, healthcare
________, and any healthcare _________ who transmits health
information in an electronic format. -
plan - Health ______ covered entities are organizations that pay providers on behalf of an
individual receiving medical care. These plans include health, dental, vision, and prescription
drug insurers. Some examples include health maintenance organizations (HMOs), Medicare,
Medicaid,
and Medicare supplement insurers, as well as employer, government, and church-sponsored
group health plans. There are exceptions: An employer who solely establishes and maintains the
plan with fewer than 50 participants is exempt. Two types of government-funded programs -
are not health plans: food stamps and community health centers. Insurers providing only
worker's compensation, automobile insurance, and property and casualty insurance are not
considered to be health plans. -
providers - All healthcare ________ who electronically transmit health information
through certain transactions are covered entities. Some examples of transactions that may be
submitted electronically are claim forms, inquiries about the eligibility of benefits, and requests
for authorization of referrals. Simply using electronic technology, such as sending emails, does
not mean a healthcare provider is a covered entity; the transmission must be in connection with
a standard transaction. The rule applies to all, regardless of whether they transmit the
transactions directly, or use a billing service or other third party to transmit on their behalf.
They are defined as providers of services, such as hospitals, and providers of medical or health
services, such as physicians, dentists, and other practitioners who furnish, bill, or receive
payment for healthcare.
clearinghouses - Healthcare ________ include billing services, repricing companies, and
community health management information systems that process nonstandard information,
received from another entity, into a standard (ie, standard format or data content) or vice versa.
In most instances, healthcare clearinghouses receive individually identifiable information for
processing services to a health plan or healthcare provider as a business associate. In these
cases, only certain provisions are applicable to the clearinghouses' uses and disclosures of
protected health information.
, Transactions - _______ occur through electronic exchanges, which allow information to
be transferred between two parties for specific purposes.
plan - A healthcare provider will send a claim to a health _____ to request payment for
the medical services he or she provides.
HIPAA - _____ regulations standardized transactions for Electronic Data Interchange (EDI)
of healthcare data. These transactions are: claims and encounter information, payment and
remittance advice, claims status, eligibility, enrollment and disenrollment, referrals and
authorizations, coordination of benefits, and premium payment.
HIPAA - Under _______, electronic transactions must use the adopted standard and
adhere to the content and format requirements of ASC X12N or NCPDP (used for certain
pharmacy transactions) for each transaction. An additional rule was adopted to standardize the
code sets for diagnoses and procedures. These code sets include: HCPCS (Healthcare Common
Procedure Coding System—ancillary services and procedures); CPT® (Current Procedural
Terminology—physician's procedures); CDT® (Current Dental Terminology—dental procedures);
ICD-9 (International Classification of Diseases-9th revision— diagnosis and inpatient hospital
procedures); ICD-10 (International Classification of Diseases-10th Revision, which replaced ICD-
9 on October 1, 2015); and NDC (National Drug Codes).
unique identifier - In addition to the standardization of the codes used to request
payment for medical services, a _______ for employers and providers must be used on all
transactions.
Business associates - _______ perform certain functions or activities, which involve the
use or disclosure of individually identifiable health information, on behalf of another person or
organization, without being a member of the entity's workforce. These services include claims
processing or administration, data analysis, utilization review, billing, benefit management, and
re-pricing.
Business - _______ associate services to a covered entity are limited to legal, actuarial,
accounting, consulting, data aggregation, management, administrative, accreditation, or
financial services.
protected health information - To be considered a business associate, the persons or
organizations would involve the use or disclosure of ________ between the two parties.
can - A covered entity ____ be a business associate of another covered entity.
Health Information Technology for Economic and Clinical Health Act - HITECH
