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Examen

CDEO - Chapter 2 Exam Study Guide with Complete Solutions

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CDEO - Chapter 2 Exam Study Guide with Complete Solutions (HIPAA) - Answer️️ -Health Insurance Portability and Accountability Act of 1996 HIPAA was enacted on _________. - Answer️️ -August 21, 1996 HIPAA aka as ______ bill, was originally enacted to provide rights and protections for participants and beneficiaries of group health plans.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. - Answer️️ -Kennedy- Kassebaum HIPAA also established the Healthcare _____ and _____ Control Program, a far- reaching program in healthcare, including both public and private health plans to combat both - Answer️️ -Fraud, Abuse HIPAA _______ provisions required that sections of the law be publicized to explain the standards for the electronic exchange, privacy, and security of health information. - Answer️️ -Administrative Simplification 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 ______. - Answer️️ -August 14, 2002 ©SOPHIABENNETT EXAM SOLUTIONS_2024/2025 Monday, September 2, 2024 12:59 PM Page | 2 _____ issued a privacy rule to set a national standard for the protection of certain health information. - Answer️️ -HHS The _______ standards address how an individual's protected health information (PHI) may be used. Its purpose is to protect individual - Answer️️ -Privacy Rule - Answer️️ -privacy, while promoting high-quality healthcare and public health and well-being. The Privacy Rule was designed to be ______ and ______, to allow for the various uses and disclosures the healthcare community must address. - Answer️️ -flexible, comprehensive ____ covered entities are required to follow the Privacy Rule. - Answer️️ -All Covered entities are defined as health _____, healthcare ________, and any healthcare _________ who transmits health - Answer️️ -plans, clearinghouses, provider - Answer️️ -information in an electronic format. 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, - Answer️️ -plan - Answer️️ -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 ©SOPHIABENNETT EXAM SOLUTIONS_2024/2025 Monday, September 2, 2024 12:59 PM Page | 3 - Answer️️ -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. 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;

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CDEO

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©SOPHIABENNETT 9/2/24 2024/2025

, ©SOPHIABENNETT EXAM SOLUTIONS_2024/2025 Monday, September 2, 2024 12:59 PM



CDEO - Chapter 2 Exam Study Guide
with Complete Solutions

(HIPAA) - Answer✔️✔️-Health Insurance Portability and Accountability Act of 1996


HIPAA was enacted on _________. - Answer✔️✔️-August 21, 1996

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. - Answer✔️✔️-Kennedy-

Kassebaum

HIPAA also established the Healthcare _____ and _____ Control Program, a far-

reaching program in healthcare, including both public and private health plans to

combat both - Answer✔️✔️-Fraud, Abuse

HIPAA _______ provisions required that sections of the law be publicized to explain the

standards for the electronic exchange, privacy, and security of health information. -

Answer✔️✔️-Administrative Simplification

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 ______. - Answer✔️✔️-August 14, 2002




Page | 1

, ©SOPHIABENNETT EXAM SOLUTIONS_2024/2025 Monday, September 2, 2024 12:59 PM


_____ issued a privacy rule to set a national standard for the protection of certain health

information. - Answer✔️✔️-HHS

The _______ standards address how an individual's protected health information (PHI)

may be used. Its purpose is to protect individual - Answer✔️✔️-Privacy Rule

- Answer✔️✔️-privacy, while promoting high-quality healthcare and public health and

well-being.

The Privacy Rule was designed to be ______ and ______, to allow for the various uses

and disclosures the healthcare community must address. - Answer✔️✔️-flexible,

comprehensive

____ covered entities are required to follow the Privacy Rule. - Answer✔️✔️-All

Covered entities are defined as health _____, healthcare ________, and any healthcare

_________ who transmits health - Answer✔️✔️-plans, clearinghouses, provider

- Answer✔️✔️-information in an electronic format.

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, - Answer✔️✔️-plan

- Answer✔️✔️-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




Page | 2

, ©SOPHIABENNETT EXAM SOLUTIONS_2024/2025 Monday, September 2, 2024 12:59 PM


- Answer✔️✔️-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.

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. -

Answer✔️✔️-providers

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. - Answer✔️✔️-clearinghouses

_______ occur through electronic exchanges, which allow information to be transferred

between two parties for specific purposes. - Answer✔️✔️-Transactions

Page | 3

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Subido en
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