question

covered entity (CE)

answer

a health plan, a healthcare clearinghouse, or a healthcare provider that transmits any health information in electronic form in connection with a HIPAA transaction

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current procedural terminology (CPT)

answer

a medical code set maintained and copyrighted by the American Medical Association that has been selected for use under HIPAA for non-institutional and non-dental professional transactions

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disclosure

answer

release or divulgence of information by an entity to people or organizations outside of that entity

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electronic data interchange (EDI)

answer

the transfer of routine information or transactions from one computer to another in a standard format, using standard communications protocols

question

health information

answer

any information, whether oral or recorded in any form or medium, that is created or received by a healthcare provider, health plan, public health authority, employer, life insurer, school or university, or healthcare clearinghouse and relates to the past, present, or future physical or mental health or condition of an individual; the provision of healthcare to an individual; or the past, present, or future payment for the provision of healthcare to an individual

question

HIPAA written authorization

answer

a document that must be signed by a patient, explains the uses and disclosures a covered entity may make without the individual's authorization as permitted by the Privacy Rule, and states that any other uses or disclosures will be made only with the individual's written authorization

question

individually identifiable health information

answer

any information that is a subset of health information, including demographic information collected from an individual; is created or received by a healthcare provider, health plan, employer, or healthcare clearinghouse and relates to the past, present, or future physical or mental health or condition of an individual; the provision of healthcare to an individual; or the past, present, or future payment for the provision of healthcare to an individual; and that identifies the individual or with respect to which there is a reasonable basis to believe the information can be used to identify the individual

question

informed consent

answer

a person's agreement to allow an action, such as surgery or an invasive diagnostic procedure, based on full disclosure of risks, benefits, alternatives, and consequences of refusal

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International Classification of Diseases (ICD)

answer

a set of medical codes that identifies morbidity factors or diagnoses and that has been selected for use in HIPAA transactions

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Joint Commission

answer

an independent, not-for-profit organization that accredits and certifies more than 15,000 healthcare organizations and programs in the U.S. and, as such, plays a role in certifying those organizations' compliance with the HIPAA Privacy Rule

question

National Drug Code (NDC)

answer

a medical code set that identifies prescription drugs and some over-the-counter products and that has been selected for use in HIPAA transactions

question

National Patient ID

answer

a system for uniquely identifying all recipients of healthcare services and sometimes referred to as the National Individual Identifier (NII) or as the Healthcare ID

question

National Payer ID

answer

a system for uniquely identifying all organizations that pay for healthcare services, also known as Health Plan ID, or Plan ID

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National Provider ID (NPI)

answer

a system for uniquely identifying all providers of healthcare services, supplies, and equipment

question

privacy officer

answer

a person appointed to receive and be responsible for complaints about privacy policies and procedures required by HIPAA's Privacy Rule

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protected health information

answer

individually identifiable health information

question

research

answer

a systematic investigation, including development, testing, and evaluation, designed to develop or contribute to generalizable knowledge

question

treatment

answer

the provision, coordination, or management of healthcare and related services by one or more healthcare providers, including the coordination or management of healthcare by a healthcare provider with a third party, consultation between healthcare providers relating to a patient, or the referral of a patient for healthcare from one healthcare provider to another

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TPO

answer

treatment, payment, and operations

question

DRG

answer

Diagnosis-Related Groups

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PPS

answer

Prospective Payment System

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POA

answer

present on admission

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OCR

answer

Office of Civil Rights

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IRB

answer

institutional review board

question

EPHI

answer

electronic protected health information

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AHA

answer

American Hospital Association

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REGARDS

answer

Reasons for Geographic and Racial Differences in Stroke

question

HIM

answer

health information management

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EHR

answer

electronic health record

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IOM

answer

Institute of Medicine

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E/M

answer

evaluation and management

question

ICD-10-CM

answer

International Classification of Diseases, 10th revision, Clinical Modification

question

public health diseases

answer

reportable diseases or the nationally notifiable infectious diseases, leading causes of death, and morbidity/mortality related to terrorism

question

The patient specifically indicated her spouse as her representative. The patient has a large family and they have been calling frequently asking about her status. How should you respond to a phone call from the patient's sister?

answer

Tell her sister that she must speak to the patient's spouse to obtain information.

question

The patient's sister responds to the suggestion to contact the patient's spouse with, "Oh, we don't get along. He won't tell me anything!" You appropriately reply

answer

Leave your name and number and I will relay your request.

question

Your patient has settled into her room. You are at the nurses' station documenting her blood pressure. As you are doing so, a housekeeper asks you what kind of surgery your patient has had. The housekeeper states that she saw the patient coming back from surgery and that she looks like her neighbor. You appropriately reply

answer

I cannot answer that question. It is very important to protect our patients' privacy.

question

The next day, you are giving discharge instructions to your patient. The patient tells you that she would like a copy of her health record. You appropriately reply

answer

I will let your doctor know and have the medical records department follow up.

question

You are at the nurses' station when a family member reports that she cannot get information from the doctor about her brother. You appropriately respond

answer

I will check with your brother and discuss the matter with him.

question

You enter the patient's room to discuss the sister's concern. The patient is very specific about whom he wants information given to. What is the appropriate action?

answer

Indicate who can be given the information on the card file and pass the information on in shift report.

question

Later that day while eating lunch, you hear two nurses discussing your patient's diagnosis. The proper response is

answer

I don't know if you are aware but your discussion can be overheard and is considered a privacy violation.

question

After lunch, you return to your unit. A visitor stops to ask you if you have a patient named Smith on the unit. That is your patient's name. You appropriately tell the visitor

answer

Please give me your name and phone number. Someone will contact you if we are able to give you that information.

question

As you help the patient into a wheelchair, the transportation assistant asks the patient, "So what happened to you?" You appropriately

answer

gently remind the transportation assistant to respect the patient's privacy.

question

AP

answer

assistive personnel

question

During your initial assessment rounds, you notice an AP using one of the computers to document a patient's vital signs. Two visitors are standing over him, chatting about their vacation. You

answer

tell the AP that you need to talk with him privately and ask him to log off.

question

A family member of one of the patients asks the nurse if he can have a printout of the medications his brother is taking. What is an appropriate response?

answer

I understand that you are concerned, but let's check with your brother.

question

Near the end of the shift you are notified that the computers are not working and that you will be notified when they resume. The registry contract nurse tells you she has not completed her charting for the shift. What is the appropriate action?

answer

Advise the nurse to document in written format until the end of her shift.

question

As you are walking down the hall, you notice another RN has left the computer unattended and has not logged off. What is the appropriate action for you to take?

answer

Find the other RN and have her return to the computer to log off.

question

The AP says that she has lost her password. Your best action is to

answer

Direct her to the appropriate resource to obtain a new password.

question

EIN

answer

employer identification number

question

NPI

answer

National Provider Identifier

question

ePHI

answer

electronic protected health information

question

A nurse is orienting to his new place of employment. Information is being provided regarding HIPAA's Privacy Rule. What comment by the nurse indicates an accurate understanding of these standards?

answer

I can give information about a patient over the phone if the patient gives his permission.

question

A parent calls a pediatrician's office to make an appointment for her school-age child. The nurse should instruct the parent to call the previous pediatrician's office and request that

answer

a form authorizing release of copies of the record be sent to her to sign and return.

question

What action is appropriate for a nurse who has witnessed a breach of a patient's privacy in a primary care provider's office?

answer

Complete a health information privacy complaint form and submit it to the appropriate agency.

question

A nurse passing by a computer at the nurses' station notes that patient information is currently being displayed. What action should the nurse take?

answer

Locate the nurse responsible for the information and have that person log off.

question

Nurses on a clinical unit wish to research the incidence of falls among patients following joint replacement surgery. What should they do to ensure the study complies with the HIPAA Privacy Rules?

answer

Submit their proposal to the institutional review board for review and describe how they will de-identify patient information.

question

A patient feels his privacy has been violated and wants to file a formal complaint. Through what agency should the nurse instruct the patient to file the complaint?

answer

Office of Civil Rights (OCR)

question

A patient is brought to the emergency department after a motor-vehicle crash. She is unresponsive due to a head injury. Permission for emergency surgical stabilization of a cervical injury was obtained over the phone from her husband, who is currently overseas. What should the assigned nurse document to verify HIPAA guidelines were maintained?

answer

Document the patient's condition and that consent was obtained after the primary care provider discussed the proposed surgery with the husband.

question

What method of information exchange is in compliance with HIPAA?

answer

Walking rounds that involve two nurses discussing an assigned patient at his bedside in a private room.

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