HIPAA | Baamboozle - Baamboozle | The Most Fun Classroom Games!

English 12 Public

HIPAA

Study Slideshow

During validation a member provides the non public element 12-22-23 as a DOS for where in CSI can you confirm that info?

Claims- Customer service tree

15

Name one example of PHI?

medical charts/records, claims records, policy numbers, ssn #'s RXinfo pcp -any non public item

15

How do you verify staff calling from providers offices ?

First name - last initial of caller- providers name/location- NPI -call back number

15

Where do you assign the issue when the member provides their new address or phone #

Enrollment

15

Grandmother is calling for member her adult grandson. She is on her way to the pharmacy to pick up his RX she wants to know when the RX was filled- Can you assist?

NO - that is PHI

15

What must you confirm when staff calls from Children and Youth?

first and last name - what office ? call back number - confirm the name is on the children and youth list

15

How do you verify a members PCP per DHS requirments ?

Ask the member who is your PCP ?where do you See that PCP at? If they cant provide BOTH - You must provide both to the member

15

How many validation questions are we required to ask a member?

6-

15

what does the acronym HIPAA stand for?

Health Insurance Portability and Accountability Act

15

A mom calls in to request an ID card sent for her 3 member kids - the kids accounts are linked so you don't need to verify each one. T or F

FALSE -!

15

When emailing member material what must you put in the subject line ?

e-secure

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Mother of 15 year old member calls because she has questions about a bill for members therapist visit . Can you assist?

You need verbal permission from the member to discuss any behavioral heath claims

15