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Definition
| The HIPAA Act was enacted in ______. |
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Definition
HIPAA governs over:
a) Health coverage portability
b) Health information privacy
c) Administrative simplification
d) Medical savings accounts
e) long-term care insurance
f) all of the above
g) a and b |
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Term
| administrative simplification |
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Definition
| HIPAA has caused major changes in ____________ simplification. |
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Definition
Administrative simplification includes:
a) electronic transactions
b) code stadard requirements
c) privacy requirements
d) security requirements
e) national identifier requirements
f) all of the above
g) all but c and d |
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Definition
| T or F: Third-party payers need to have unique requirements for processing claims. |
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Definition
| What is the goal of adopting transaction standards for electronic health information transactions? |
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Term
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Definition
| activities involving the transfer of health care information |
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Term
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Definition
| the movement of electronic data between two entities and the technology that supports the transfer |
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Term
| electronic data interchange |
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Definition
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Definition
| codes that identify specific diagnosis and clinical procedures on claims and encounter forms |
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Definition
What is a standard transaction for EDI transmission?
a) claims or equivalent encounter information
b) payment and remittance advice
c) claim status inquiry and response
d) eligibility inquiry and response
e) referral certification and authorization inquiry and response
f) enrollment and disenrollment in a health plan
g) health plan premium payments
h) coordination of benefits
i) claims attachments
j) first report of injury
k) all of the above
l) all but f-j |
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Term
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Definition
What code sets are used by physician and other health services? (Can have more than one answer)
a) HCPCS
b) CPT
c) ICD-9-CM, Volumes 1-2
d) ICD-9-CM, Volume 3
e) D codes
f) National Drug Classifications
g) all of the above |
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Term
| Durable Medical Equipment |
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Definition
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Term
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Definition
What code sets are used to report medical supplies, orthotics, and DME?
a) HCPCS
b) CPT
c) ICD-9-CM, Volumes 1-2
d) ICD-9-CM, Volume 3
e) D codes
f) National Drug Classifications
g) all of the above
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Term
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Definition
HCPCS A-V codes are used with:
a) drugs
b) medical supplies, orthotics, DME
c) dentists
d) all of the above
e) a and b |
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Term
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Definition
What code sets are used for diagnosis codes?
a) HCPCS
b) CPT
c) ICD-9-CM, Volumes 1-2
d) ICD-9-CM, Volume 3
e) D codes
f) National Drug Classifications
g) all of the above
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Term
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Definition
What code sets are used for inpatient hospital procedures?
a) HCPCS
b) CPT
c) ICD-9-CM, Volumes 1-2
d) ICD-9-CM, Volume 3
e) D codes
f) National Drug Classifications
g) all of the above
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Term
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Definition
| D codes are used with ______ services. |
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Term
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Definition
What code sets are used with dental services?
a) HCPCS
b) CPT
c) ICD-9-CM, Volumes 1-2
d) ICD-9-CM, Volume 3
e) D codes
f) National Drug Classifications
g) all of the above
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Term
| National Drug Classifications |
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Definition
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Term
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Definition
What codes sets are used for drugs and biologics?
a) HCPCS
b) CPT
c) ICD-9-CM, Volumes 1-2
d) ICD-9-CM, Volume 3
e) D codes
f) National Drug Classifications
g) all of the above
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Term
| protected health information |
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Definition
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Term
| No. Since the actress is not her patient, she is not authorized to access the medical chart. |
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Definition
| A famous actress is admitted to the hospital. Mary is a nurse on the floor the actress was put on. The actress isn't her patient. Mary accesses the actresses medical chart to satisfy her curiosity. Is this okay? |
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Term
| No. You should only access charts when you have a work-related reason. |
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Definition
| Elissa is a nurse caring for a famous actress admitted to her floor. Elissa does have authorization to access the actress's medical records. Elissa looks in the actress's medical chart, but she does it out of curiosity and not for a work-related reason. Is this okay? |
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Term
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Definition
| What are two formats of electronic health records? |
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Term
| electronic medical record |
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Definition
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Term
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Definition
| a computerized health record limited to one practice |
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Definition
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Definition
| the entire health record including multiple practices |
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Term
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Definition
| What does HIPAA require health care providers, health plans, and employers to have? |
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Term
| National Provider Identification |
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Definition
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