EHR Technology Practice wk5

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University of Phoenix *

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140T

Subject

Health Science

Date

Dec 6, 2023

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docx

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4

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Assignment Content 1. This week, Sonya is learning more about her work in medical billing and coding. She’s learning about the electronic data interchange (EDI) and the billing workflow process she uses every day. Practice the terms and acronyms with Sonya to explore the impact of HIPAA privacy requirements and regulations on health care practices. 2. Question 1 10/10 Final Grade: 10 points out of 10 points possible Match the acronym to its associated full name. Prompts Answers 1. 1 EDI Correct: Electronic data interchange 2. 2 HIPAA Correct: Health Insurance Portability and Accountability Act of 1996 3. 3 COB Correct: Coordination of benefit claims 4. 4 EOB Correct: Explanation of benefits 5. 5 RA Correct: Remittance advice 6. 6 TPO Correct: Treatment, payment, and health care operations 3. Question 2
6.66/10 Final Grade: 6.6667 points out of 10 points possible Match the term with its definition or purpose. Partial and negative credit Points may have been deducted for incorrect answers. Prompts Answers 1. 1 HIPAA privacy rule Correct: Gives patients the right to access the information found in their health record 2. 2 HIPAA security rule Correct: Addresses protection of protected health information (PHI) in electronic form (ePHI) 3. 3 270/271 transaction Correct: An eligibility/benefit inquiry 4. 4 Administrative Simplification standards Incorrect: Administrative, technical, and physical standards Correct answer: Provisions introduced in 2010 concerning the use of transactions 5. 5 HIPAA requirements that specify how health care information is stored and accessed in the EHR Incorrect: Provisions introduced in 2010 concerning the use of transactions Correct answer: Administrative, technical, and physical standards 6. 6 EDI transactions in health care
Correct: They standardize electronic transactions so all information systems can send and receive the same electronic transactions as mandated by HIPAA 4. Question 3 10/10 Final Grade: 10 points out of 10 points possible Match the term with its definition. Prompts Answers 1. 1 HIPAA privacy rule Correct: Gives patients the right to access the information found in their health record 2. 2 HIPAA security rule Correct: Addresses protection of protected health information (PHI) in electronic form (ePHI) 5. Question 4 10/10 Final Grade: 10 points out of 10 points possible Match the term with its components. Prompts Answers 1. 1 Basic medical billing workflow Correct: Verifying insurance eligibility, billing third-party plans, using codes and patient registration, submitting claims, managing payment and patient accounts, coordinating benefit claims (COB), reviewing co-pays and explanation of benefits (EOB) 2. 2
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HIPAA privacy requirements Correct: A patient’s identification can only be shared with authorized health care providers; a patient’s identification and health information must be kept out of public view; a patient’s consent must be received when patient information needs to be shared with others; staff must complete annual HIPAA training and education 3. 3 Necessity of c oordination of benefits (COB) Correct: When patients are covered by more than one health plan 4. 4 HIPAA covered entities Correct: Health plans, health care clearinghouses, and health care providers who transmit health information electronically for transactions that have standards established by U.S. Health and Human Services, commonly billing and payment for services and insurance coverage