HIPAA Exam Questions and Answers 100% Pass

HIPAA Exam Questions and Answers 100% Pass HIPAA - Answer- Public Law 104-191. The Health Insurance Portability and Accountability Act of 1996 Purpose: To improve portability and continuity of health insurance coverage in the group and individual markets. To combat waste, fraud, and abuse in health insurance and healthcare delivery. To promote the use of medical savings accounts To improve access to long-term care services and coverage To simplify the administration of health insurance. Title 1 - Answer- Insurance Portability. Healthcare access, portability, and renewability. Title 2 - Answer- Fraud and Abuse Medical Liability Reform; Administrative simplification Preventing healthcare fraud and abuse, ADMINISTRATIVE SIMPLIFICATION, Medical liability reform. Title 3 - Answer- Tax Related Health Provisions Title 4 - Answer- Application and Enforcement of Group Health Plan Requirements. Title 5 - Answer- Revenue Off-sets Code Sets - Answer- Standardized numeric or alphanumeric descriptions of things like provider location, diagnosis, procedure, medical concepts or terms, or types of transactions being sent between healthcare entities electronically HIPAA codes must be utilized by covered entities. Data Element - Answer- Each detail of a visit to a provider such as patient name, address, date of service, location, and other information captured for record keeping and future evaluation, treatment, billing, and reporting purposes. Dental Codes (CDT) - Answer- Standards set by the American Dental Association to identify procedures done by dentists in their offices published as the Code on Dental Procedures and Nomenclature. ICD10 - Answer- A code group which can be assigned to diagnosis and procedures. The list is called the International Classification of Diseases, Ninth Revision, Clinical Modification, and is created and maintained by National Center for Health Statistics (NCHS) and the Center for Medicare and Medicaid Service (CMS). National Employer Identifier (EIN) - Answer- An employer identification number originally created by the IRS for tax purposes and subsequently adopted as the national standard to designate companies providing employee healthcare coverage for HIPAA purposes. Electronic Data Interchange (EDI) - Answer- The generic standards for exchanging business data electronically on which the rules and guidelines for HIPAA Transactions are based. EDI is more universal in scope than just providing guidance for the healthcare industry. Healthcare Financing Administration Procedure Coding System (HCPCS) - Answer- The Healthcare Financing Administration has undergone a name change and is now known as the Centers for Medicare and Medicaid Services (CMS). CMS and HHS update and distribute this code set to be used for things not identified in other approved lists. National Drug Code (NDC) - Answer- These codes are created and maintained by the FDA and allow standardized identification of drugs. National Health Identifier for Individuals (NHI) - Answer- Still has not been implemented due to privacy concerns. National Health Plan Identifier (HPID) - Answer- A proposed unique identifier for health plans and other payers of healthcare claims not formally proposed or defined at this time. National Council for Prescription Drug Programs (NCPDP) - Answer- Used for retail pharmacy transactions. Retail pharmacies are the only healthcare entities which use a different set of transmission standards (not codes). The two NCPDP formats which health plans must accept are Telecommunications Standard Format Version 5.1 and Batch Standard Version 1.0. National Plan and Provider Enumeration System (NPPES) - Answer- A plan within the HIPAA legislation to allow a third party contractor or contractors to create, verify, and assign NPI numbers, and to maintain the National Provider System and the National Provider File Database. National Provider Identifier (NPI) - Answer- The unique identifier for healthcare providers used for HIPAA compliance