Privacy Terms
In 1996, this was signed into law by President Bill Clinton to restrict allowable uses and disclosures of protected health information.
What is HIPAA (Health Insurance Portability and Accountability Act)?
The questions, "Is it legal? Is it fair? Does it feel right?" are examples this.
What are questions you should ask yourself when facing a possible ethical conflict?
These three things can damage a company's reputation as well as cause serious financial and/or legal problems.
What are fraud, waste, and abuse?
Prevention, detection, and correction.
What is the Circle of Compliance (Compliance Fundamentals)?
Account numbers, addresses, birth dates, and phone numbers are all examples of this.
What is PHI (Protected Health Information)?
Anonymous resource phone line, via email, directly contact an ethics officer, talk to your manager or supervisor are examples of this.
What are acceptable methods for asking an ethics question or making a report?
This is estimated to be between $90 and $230 billion every year.
What is the annual cost of U.S. healthcare fraud?
This includes training, creating and following policies and procedures, building effective controls and implementing new legal requirements.
What is prevention?
This term is used when one person has some level of involvement or the care of another person.
What is Involved in Care?
Personal relationships (such as a spouse, long-time family friend, siblings) can sometimes be considered this.
What is a potential or actual conflict of interest?
This is any intentional misrepresentation of a material fact on which payment or services depends.
What is Fraud?
These activities include active monitoring of key operational metrics or outcomes, targeting auditing, investigating reports of legal violations.
What is detection?
Substance use disorder, mental health, transgender services, domestic violence, and sexually transmitted diseases are examples of this.
What are examples of sensitive conditions?
Every year, we (at Cambia) complete this to disclose any connections, interests, and relationships that we may have with other Cambia employees.
What is a Conflict of Interest (COI) Disclosure Statement?
These are the five common types of fraud.
What are provider, member, group, ID theft, and broker?
These activities are those actions that resolve identified legal violations. These actions impact people (including employees and consumers), systems, and processes.
What is correction?
A group of records maintained by the covered entity (Regence) that includes medical records, billing information, and any other records used to make decisions about an individual is called this.
What is a Designated Record Set?
Loss of a job, denial of a promotion, verbal abuse, intimidation, exclusion from work activities are all examples of this.
What is retaliation?
You should be cautious of opening a link on an email because it can sometimes be this.
What is phishing?
This phone number is the number you would call to report compliance issues.
What is the Anonymous Compliance hotline:
877-878-2273