Hipaa Compliance Questions And Answers

Health Insurance Portability and Accountability Act

any person or organization who furnishes, bills, or is paid for healthcare in the normal course of business

individually identifiable health information (demographics like name or SSN, or medial records) -- do not disclose information someone could use to reverse engineer individual

make reasonable efforts to limit the use or disclosure of PHI to a minimum amount necessary to accomplish intended goal

1. ensuring computer security 2. communication on the phone 3. sending/receiving faxes and emails 4. printing information 5. Using PHI at desk 6. Dispose of information (only shred)

1. speak to supervisor 2. speak with EPPA's privacy official (Chad Strathman) 3. you know you've made a mistake - self report

1. office for civil right enforces privacy rule 2. civl money penalties - $100 to $50,000 per violation 3. criminal penalties - up to $250,000 and 10 years in jail

a way of self-policing and reporting any impropriety within a business entity

the intentional deception or misrepresentation that an individual knows to be false or does not believe to be true and makes knowing that deception could result in some unauthorized benefit

Acting with gross negligence or reckless disregard for the truth in a manner that results in any unnecessary cost or any unnecessary consumption of a healthcare resource

those incidents that are inconsistent with accepted medial or business practices, improper or excessive

billing for services that were never performed or provided upcoding - billing for a higher-level treatment than was actually provided unbundling - billing separately for services that are already included in primary procedure billing for services that are not medically necessary false ID - use of medical benefits by an unauthorized individual

1. report fraud and abuse 2. provide documentation 3. attend education sessions

verbal, visual, or physical conduct that relates to another person's sex, race, color, nationality, creed, religion, or other status protected by law examples can arise in personal contact, comments, visual displays, exposure to email, social media, other media

may include suggestive sexual comments, jokes or innuendo, persistent, unwanted flirtation or invitations for dates or social activities. Unwanted remarks or questions about a person's body clothing or sexual activities,