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14 Cards in this Set

  • Front
  • Back

Business associates

A person or organization that performs a function or activity on behalf of a covered entity but is not part of the covered entity itself. They just adhere to HIPAA standards in order to do business with a covered entity


A company that handles electronic transactions for providers such as submitting claims using HIPAA formats and may also manage electronic medical records

Consolidated omnibus budget reconciliation act

Cobra stands for what


An amendment to title 1 of HIPAA that gives enployess the right to continue health coverage as a private payer for a limited period of time once they leave a job

Covered entity

A health plan,a healthcare clearing house, or a health care provider who transmits any health information in electronic form in connection with a HIPAA transaction

Direct provider

A health care provider who has a direct treatment relationship with a patient such as a physician or therapist

Group health plan

Medical insurance offered to employees and paid for in part or in full by an employer

Health insurance portability and accountability act of 1996

The federal legislation covering rules regarding the health care industry specifically how it is administered and the rights of patients in regard to health care coverage and privacy

Health plan

Any individual or group plan that provides or pays in medical care

Indirect provider

A health care provider is a person or business that has an indirect treatment relationship with the patient such as a laboratory


The rule that HIPAA rules supersede state laws except when HIPAA deems a state law necessary to prevent fraud and abuse or when the state law is more restrictive than the HIPAA rule


People or businesss that furnish bill or are paid for health care in the normal course of business. Under HIPAA a covered provider is one who submits electronic administrative and financial transactions

Title 1 health insurance reform

The portion of the HIPAA law concerned with health insurance reform. The main purpose is to ensure the continuation of health coverage when employees change jobs. It also entitles people who leave a job to continue their health insurance coverage as a private payer for a limited period of time under cobra

Title 2 administrative simplification

Portion of the HIPAA law the rules in this section cover administrative, financial, and case management policies and procedures. It contains strict requirements for the uniform transfer of electronic health data and covers rules of patient confidentiality