HIPAA for Medical Office Personnel

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  • Edition: 1st
  • Format: Paperback
  • Copyright: 2004-07-22
  • Publisher: Cengage Learning

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HIPAA for Medical Office Personnel will provide information to learners on how the HIPAA ruling of 1996 affects their behavior when on the job. The book provides a brief background on the ruling; outlines the five titles included in the ruling, and delineates items from Title II that affect the medical office environment and what changes are necessary to be in compliance with this ruling.

Table of Contents

Introductionp. vii
About the Authorsp. ix
Acknowledgmentsp. xi
Introduction to HIPAAp. 1
Chapter Outlinep. 1
Key Termsp. 2
Think About Itp. 2
True Storiesp. 2
Introductionp. 4
Overview of the Rulingsp. 5
Development of the Rulingsp. 5
Titles in HIPAAp. 6
Health Insurance Access, Portability, and Renewalp. 6
Preventing Health Care Fraud and Abusep. 6
Tax-related Provisionsp. 7
Group Health Plan Requirementsp. 7
Revenue Offsetsp. 7
Other Titles in HIPAAp. 7
General Provisions, Peer Review, and Administrative Simplificationp. 7
Assuring Portability, Availability and Renewability of Health Insurance Coveragep. 8
HIPAA: An Organizational and Business Challengep. 8
Summaryp. 11
End of Chapter Questionsp. 12
Scenariosp. 12
Referencesp. 13
Privacy Issues Explainedp. 15
Chapter Outlinep. 15
Key Termsp. 16
Think About Itp. 16
True Storiesp. 16
Introductionp. 17
To Whom Does Title II Apply?p. 17
Who is a "Covered Entity"?p. 18
The HIPAA Officerp. 19
Locating the Latest Title II Rules and Changesp. 20
What is Protected Health Information?p. 21
Authorization Versus Consentp. 22
Protected Health Information Concerns and Disclosuresp. 23
Required Disclosuresp. 24
Permitted Use and Disclosure Without Authorizationp. 24
For Individual Accessp. 24
For Treatment, Payment, and Health Care Operationsp. 24
When Permission to Disclose is Obtainedp. 24
Disclosures that are Incidentalp. 25
Disclosures for Public Interest or to Benefit the Publicp. 26
Disclosures for Researchp. 27
Permitted Use and Disclosure With Authorizationp. 27
Disclosure of Psychotherapy Notesp. 27
Disclosure for Marketing Purposesp. 27
Limiting Uses and Disclosuresp. 28
Minimum Necessary Usesp. 28
Business Associates under Privacy Rulingp. 29
Training of Workforce and the Publicp. 29
Enforcement Guidelinesp. 30
Summaryp. 31
End of Chapter Questionsp. 32
Scenariosp. 33
Referencesp. 34
Transaction Standards and Code Setsp. 35
Chapter Outlinep. 35
Key Termsp. 36
Think About Itp. 36
Introductionp. 36
Purpose of Transaction Standardsp. 37
Designated Code Setsp. 39
Diagnosis Codesp. 39
Inpatient Procedure Codesp. 40
Outpatient Procedure Codesp. 40
Dental Procedure Codesp. 41
Drug Codesp. 41
Non-medical Code Setsp. 42
ASC X12 Nomenclaturep. 42
Data Overviewp. 43
Architecturep. 43
Use of Loopsp. 46
Sample of EDI Claim Datap. 48
Limitations to Claims Encountersp. 51
Remittance Advice and Secondary Payerp. 51
Working with Outside Entitiesp. 52
Trading Partner Agreementsp. 52
Business Use and Definitionp. 52
Summaryp. 53
End of Chapter Questionsp. 53
Scenariosp. 56
Referencesp. 56
HIPAA Security Rulingp. 57
Chapter Outlinep. 57
Key Termsp. 58
Think About Itp. 58
True Storiesp. 58
Introductionp. 59
Core Requirementsp. 59
Administrative Safeguardsp. 61
Security Managementp. 61
Assigned Security Responsibility--Security Officerp. 62
Workforce Securityp. 63
Information Accessp. 63
Security Awareness and Trainingp. 63
Security Incidentsp. 64
Contingency Planp. 64
Evaluation of Security Effectivenessp. 65
Business Associate Contractsp. 65
Physical Safeguardsp. 65
Facility Access Controlsp. 65
Workstation Use or Accessp. 66
Workstation Securityp. 66
Device and Media Controlsp. 67
Technical Safeguardsp. 67
Access Controlp. 68
Audit Controlsp. 69
Integrityp. 69
Person or Entity Authenticationp. 69
Transmission Securityp. 70
Organizational Requirementsp. 70
Policies, Procedures, and Documentationp. 70
Impact on Organizationsp. 71
Challenges to Compliancep. 72
Summaryp. 73
End of Chapter Questionsp. 74
Scenariosp. 75
Referencesp. 84
Unique Health Identifiers and Misconceptionsp. 87
Chapter Outlinep. 87
Key Termsp. 88
Think About Itp. 88
Introductionp. 88
Reasons for Identification Numbersp. 88
Employer Identifierp. 89
Health Care Provider Identifierp. 90
Health Plan Identifierp. 91
Personal Identifierp. 91
What is Important to Know About HIPAA?p. 94
Misconceptions About HIPAAp. 94
Summaryp. 98
End of Chapter Questionsp. 99
Scenariosp. 100
Referencesp. 100
Resources for Further Informationp. 99
Required and Addressable Security Standardsp. 103
Further Scenarios and Questions for Considerationp. 107
Glossaryp. 109
Indexp. 115
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