Meaning of ACO
What is Accountable Care Organization
The Act that provides immunity to medical providers who do peer reviews to investigate potential fraud & abuse.
What is HCQIA - Healthcare Quality Improvement Act
Part of the U.S. Department of Labor with the mission to ensure workplace safety and a healthy working environment.
Who is OSHA
Three safeguards required to meet
What is administrative, technical and physical
Type of consent where written or verbal permission is granted by the pt
What is Expressed?
Meaning of Dys
What is painful condition
When a pt does not receive adequate & appropriate care, which leads to suffering & harm
What is negligence
Oversees Medicare and Medicaid services
What is CMS
HIPAA stands for this
Health Insurance Portability and Accountability Act
The "up to" amount for HIPAA violations for Tiers 1 - 3
What is $50K?
Meaning of PMS
What is Practice Management System
Examples of information that is NOT private for authorities & health departments
What is child abuse, STDs/STIs, gunshot wounds, HIV
If NOT accredited by this organization, it could potentially affect billing of services
Who is TJC - The Joint Commission
Tier 2 of HIPAA violation
What is Reasonable Cause
This is the IIHI that is transmitted by a CE
What is PHI
Meaning of hidr/o
What is sweat?
Document that describes how PHI is used and disclosed by the facility
What is NPP (Notice of Privacy Practices)
Investigates all fraud & abuse cases suspected or reported for federally funded medical programs
Who is OIG - Office of Inspector General
All fraud & abuse allegations must be compiled here
What is the National Healthcare Integrity and Protection Data Bank (HIPDB)
A set of principles that differentiate between right and wrong
What is ethics
Meaning of seb/o
What is oil?
Standardized electronic formats when sending administrative and financial data.
What is EDI - Electronic Data Interchange
Oversees the compliance of HIPAA
OCR - Office of Civil Rights
An initiative that encourages providers to allow pt access to their progress notes.
What are Open Notes?
Assigning a diagnosis or procedure code at a higher level than the documentation supports
What is upcoding