HIPAA Background
What does "HIPAA" stand for?
Health Insurance Portability & Accountability Act of 1996
What should you do before you leave your computer?
Lock it
What are the first 2 pieces of information you need to verify the caller?
Member's first and last name
DOB
How often is HIPAA compliance training required?
Upon hire and annually
What does HIPAA ensure?
Protects PHI
Due to HIPAA compliance, should you be working in a distraction free work environment where other adults can not hear you?
Yes
Is it okay to just verify the parent's first name?
No - we need to verify the first and last name.
You receive a call from a Molina Health Care representative, and they need to transfer a member to you. What should you state on the call before gathering any information?
FCC statement
To protect information on computer screens you should always do this before leaving:
Lock your screen
What does PHI stand for?
Protected Health Information
Should you share our member's information with other people?
Absolutely NOT!
What information do we verify before submitting an application?
-Name
-DOB
-Address
-Phone Number
-SS number
If a caller provides a SSN or DOB with one wrong digit or two transposed numbers, what should you do?
Verify all other verification questions. We can use the phone number and mailing address.
Why is it mandatory to follow HIPAA guidelines?
It is the law
What year was HIPAA established?
T/F If your roommate is locked out of their computer and needs to access information quickly and asks to use your computer, it's okay to let them use your computer?
False - this is NEVER okay!
Shirley is calling in for her husband, Jon. Jon is currently taking a nap, but she received our letter in the mail and is interested in our services for him. Can we speak to Shirley and do a screening with her?
No, although they are married, we would need to speak with Jon first to give verbal permission to speak with Shirley first.
A 17 year old calls in regarding her 2 month old child. Can we speak with the 17 year old or do we need to speak with the 17 year old's parent/legal guardian?
If the 17 year old is emancipated, we can speak with her, but if they are not, in this case we would need to speak with the parent or legal guardian of the 17 year old.
You must obtain this prior to sharing or releasing information to others who arent on file?
Authorization/consent to speak with them from the member
Who needs to comply with HIPAA?
Anyone assisting with PHI
T/F It's okay to plug your phone into your computer to charge it.
Can we speak to the grandmother who is the legal guardian of a child?
Yes we can, as long as she can verify PHI.
What information can you confirm but not give out?
The member's name we are calling for and the health plan associated with the member. We can not give out any other personal information.
A persons' name, DOB, email address and SSN are all examples of this
PHI