©SOPHIABENNETT
EXAM_SOLUTIONS GUARANTEED SUCCESS 2024/2025 ACADEMIC YEAR
©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HIPAA aka as ______ bill, was originally enacted to provide rights and protections for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
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, ©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
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, ©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
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