AND HITECH: SHARING AND PROTECTING
PATIENTS’ HEALTH INFORMATION
S tep 1
S te
St
e
0 p1 Follow up payments and collections
Preregister patients KEY TERMS
p2
Establish financial responsibility
St
ep
3
Step
9
Generate patient statements
Check in patients Review coding compliance Ste
p4
Medical Billing Cycle
Monitor
payer adjudication St
ep
8
Prepare and transmit claims
Ste
Check out patients Review billing compliance p7
St
ep
5
S tep 6
Learning Outcomes
After studying this chapter, you should be able to:
2.1 Explain the importance of accurate documentation when working with medical records.
2.2 Compare the intent of HIPAA and ARRA/HITECH laws.
2.3 Describe the relationship between covered entities and business
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associates.
2.4
2.5
2.6
2.7
2
Explain the purpose of the HIPAA Privacy Rule.
Briefly state the purpose of the HIPAA Security Rule.
Explain the purpose of the HITECH Breach Notification Rule.
Explain how the HIPAA Electronic Health Care Transactions and
Code Sets standards influence the electronic exchange of health information. 2.8 Explain how to guard against potentially fraudulent situations.
2.9 Explain how various organizations enforce HIPAA.
2.10 Assess the benefits of a compliance plan.
abuse accountable care organization (ACO) accounting of disclosure
American Recovery and Reinvestment Act
(ARRA) of 2009 audit authorization breach breach notification business associate (BA)
Centers for Medicare and Medicaid
Services (CMS) clearinghouse code set compliance plan covered entity (CE) de-identified health information designated record set (DRS) documentation electronic data interchange (EDI) encounter encryption evaluation and management (E/M) fraud Health Care Fraud and Abuse Control Program health information