Exam (elaborations)
Chapter 1 Introduction to HIPAA QUESTIONS AND ANSWERS
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Chapter 1 Introduction to HIPAA QUESTIONS AND ANSWERS
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Chapter 1 Introduction to HIPAADefine protected health information (PHI) - questions and answers-individually identifiable
health information transmitted or maintained in any form or medium, which is held by a covered
entity or its Business Associate, and that (1) identifies the individual or offers a reasonable basis
for identification; (2) is created or received by a covered entity or an employer; (3) relate to a
past, present, or future physical or metal condition, provision of health care, or payment for
health care.
Department of Health and Human Services (DHHS) - questions and answers-
group health plan - questions and answers-an employee welfare benefit plan that provides
healthy coverage in the form of medical care and services through insurance, reimbursement, or
other means for a group of employers and dependents.
health care provider - questions and answers-anyone or organization that furnishes, bills, or is
paid for health care in the normal course of business
If HIPAA and state laws are different, which take precedence? Are there any exceptions? -
questions and answers-HIPAA laws; only when state or local laws are more stringent will their
laws be held as the standard
individually identifiable health information (IIHI) - questions and answers-is what the Centers for
Medicare and Medicaid Services (CMS) calls/defines protected health information (PHI)
List the three types of covered entities that must protect individually identifiable health
information - questions and answers-1. Health Plans and Prescription Drug Plans - a company,
individual, or group that agrees to pay part or all of the medical care for the people included in
their coverage
2. Healthy Care Provider - a provider of medical or other health services and any other person
who furnishes, bills, or is paid for health care in the normal course of business
3. Healthy Care Clearinghouse - a company that processes information it receives from health
care providers and sends that information as an insurance claim for payment
Non-covered entities - questions and answers-insurance underwriters such as automobile,
property, life, casualty, and workers compensation are not health plans and do not come under
this category
PHI privacy rule - questions and answers-states how the PHI is to be handled; when and to
whom PI may be shared, states when authorization is necessary, and requires policies that
protect disclosure of information that is in any form: electronic, paper, video, recordings, film, or
other
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