HIPAA
HIPAA
What is Health Insurance and Portability and Accountability Act
Windows icon and L on a computer
what Locks your computer so that PHI is protected when you aren't at your computer.
Intentional deception for unauthorized payment or benefit
What is fraud
Misuse or inefficient use of resources
What is Waste
You share information with a doctor's office and you don't have an ROI
What is not a violation, this is coordination of care and is allowed under HIPAA. But, best practice would be having an ROI and transparency.
HIPAA does this
What Protects the privacy of health information (mental health and physical health)
Who are covered entities: Health plan, health care clearing house and providers of behavioral health and physical health services
Computers and EHRs should be protected with these
What are Passwords, bonus if don't keep your passwords saved or written down on a piece of paper next to your computer
billing for a service that was never provided
what is fraud
What is abuse
what is complicated....It does not rise to the level of a breach of privacy but it does require some thoughts about this and doing something different instead.
PHI
What is Protected Health Information which is information about client's dx, tx, or payment for services. When combined with this information, PHI also includes names, phone numbers, email addresses, Medicare Beneficiary Numbers, biometric identifiers, emotional support animals, and any other identifying information.
sending client information through unsecured emails
What is a breach of Privacy and Security.
Sending PHI to each other here at JHouse is not a breach as we are on the same network, it is if it has to cross a network that this is problematic. However, do not put PHI in a subject line even for J House.
rounding up time for services that are being billed
What is fraud as we are required to bill for exact times
Providing services that do not meet medical necessity standards
What is abuse and potentially fraud
Person who can access client records
What is a need to know/legitimate work related purpose.
Reported to a supervisor or privacy officer
What is any client information that has been disclosed improperly. This includes emails not sent securely, client information shared with the wrong person, client information in another client's chart. Bonus who is the privacy officer?
Government Accountability Office or Oregon Secretary of State
What is where you can report fraud, waste or abuse (money)
You recognize someone who comes in for an assessment in clinical services and you go to Box to see what they reported.
What is potentially a trick question....only approved people can look at those files, however, only those who need to review the records should be looking at them. If there isn't a reason to look at the file, then it could be a privacy violation.
Release of information
a legal document that authorizes the release of information. Needs to include: Name, DOB, what information is to be released, purpose of the release, dated and date the ROI ends and signed by guardian/adult and determined by age of client
It also requires the least amount necessary to be released
Difference between Privacy and Security
What is PHI/private information and how the private information is stored
Security rule: reasonable security policies, ensure confidentiality, integrity and availability of all ePHI created, maintained and transmitted. Protect against impermissible use or disclosures. Analyze security risks, review security measures and ensure employee compliance.
Privacy rule: right to a copy of their records, request corrections to their medical records and restrict access to information
Billing for services before documentation is completed
What is fraud. This is why notes need to done timely because if we bill for services without the completed note, we can be charged with fraud.
Department of Labor
What is where you are protected under whistle blower protection act if you report FWA and are retaliated against for this action.
sharing information with a parent of a client who is 15
What is complicated...... If a youth comes in for services without parent knowledge, it could be a privacy/confidentiality issue. However, OARs state that a "parent shall" be involved in services before the end. And Parents still have legal rights unless it is under Substance Use treatment. So the answer is What is consult with supervisor.