1st Celebration of Knowledge Review

The three primary HIPAA identifiers that are required when taking any calls are as follows: ( Check all that apply )

• Members Full Name

• Members Middle Name

• Members ID Number

• Members DOB

Associates in possession of _______ are accountable to protect that information at all times, including while at work, at home, and while traveling.

• PHI

• Company Websites

• Anthem Purpose, Vision and Values

• Money

You receive a call regarding a bill from the provider. The caller gives you their full name and a member ID number. When you pull up the policy, you notice that the caller is NOT listed on the policy. The caller tells you they are calling for their father and then proceeds to give you the members first, last name and date of birth. You want to deem the caller an informal rep. Using the HIPAA Verification & Disclosure Guide what is your next step?

• Ask if he would like classified information

• Ask if the member is available to speak with.

• Request the caller provide the Members Full name and DOB before you can disclose any PHI

• No further action is needed

Jan from United Health Care calls requesting information on a member. What option in the HIPAA Verification & Disclosure Guide would you choose for who is contacting us?

• Member

• Informal Rep

• Business Contact

• BCBS Plans or Other Insurance Plans

A Broker (with a signed business agreement) calls in and gives you their full name and firm name. What other piece of information do you need to verify the broker?

• Members ID number

• Brokers SSN

• Brokers Tax ID number

• Broker's Date of Birth

Every time an associate steps away from his/her computer, he/she must lock the computer. Which of the following describes the two methods used to lock a computer?

• Nothing Computer locks after a certain time

• Press Control + Alt+ Delete and Select Lock Computer

• Spin around 3 times and count down from 10

• Throw some salt over your shoulder every time you leave.

If a caller does NOT have his/her member ID number and will NOT give the Social Security Number, which other piece of identification can you obtain instead?

• Callers phone number

• Callers Address

• Name of Callers employer

• Name of Callers Medical Plan

Subscriber Ann Herman calls. She gives you her first and last name and member ID number. Ms. Herman says she is requesting the correct amount to pay for her 17-year-old son's MRI. She gives you her son's first and last name, DOB and date of service for the claim. What option in the HIPAA tool should you choose for About Whom?

• Dependent

• Member about his/her own PHI

• Parent about their Minor Child

• Ex-Spouse Covered on the same contract

Evan Price is calling on behalf of his sister, Alicia, who is very sick. Evan needs to get her benefit information and has her member ID. He is NOT a member on the contract. Alicia is NOT available to speak with; however, Evan knows all of her information. You are unsure of what information you can provide to Evan. Using the HIPAA Verification & Disclosure Guide, who would you choose for who is contacting us?

• Personal Rep

• Informal Rep

• You cant assist Evan

• Power of Attorney

Which of the following DOES NOT define “no healthcare homework?

• Follow up timely when issues have been corrected

• Tell the member they need to contact the provider to get the information

• Call providers and vendors to get information for our members