Family MedCenters, PA
Employee Privacy and Security Questionnaire
Date:
Name:______Clinic/Dept:.
Job Title:______Date of Hire:
Please complete the following questionnaire and return to your manager or supervisor.
Manager or Supervisor: Please send completed form to the Compliance Office.
Privacy and Security Questionnaire
Multiple choice questions may have one or more correct answers
1. Does a patient have to receive and sign a "Notice of Privacy Practices" to be seen by a physician?
2. What is the first thing you do to use the computer?
3. What is the "Minimum Necessary Rule"?
A. The minimum amount of information about a patient needed to complete yourjob.
B. The minimum amount of information about a patient needed from the computerto complete a task.
C. The minimum amount of information about a patient you are allowed to sharewith another employee so they may complete a task.
D. All of the above.
4. Are FMC employees required to wear their badge even if they are at different FMC locations?
5. Do patients have the right to access their chart, ask for copy of their chart, review their chart or ask us to change something in their chart?
A. Yes-it is their chart and it is their right under HIPAA.
B. Yes-but they must fill out the appropriate requests and we have the right torespond to the request.
C. No-the chart is the property of the FMC.
D. No-HIPAA allows us to determine who can access the chart.
6. When you leave your workstation that has a computer, charts or other patients' health care information, what should you do and why?
7. If a patient or a family member calls to get test results, verify an appointment or check their account information, what must you verify/ask?
8. What is an "Accidental Disclosure"?
A. Information regarding a patient is over heard but not needed to do your job.
B. Information regarding a patient is told outside of the office to a friend.
C. Information regarding a patient is faxed to the wrong office.
D. Information regarding a patient is seen by you and repeated to another staff
member.
E. All of the above.
9. What is PHI?
A.Protected Health Information.
B.Private Health Information.
C. Portable Health Information.
D. Possible Health Information.
10. If a vendor for FMC comes in, such as Merry X-Ray, our lab consultant, etc., what must you do?
11. Do privacy protections apply to information recorded on paper and information stored electronically?
12. What is an "Incidental Disclosure"?
A.Giving lab or diagnostic results to a patient or to a referring physician.
B. Discussing a prescription with a patient or pharmacy over the phone.
C. Explaining insurance payment to a patient.
D.All of the above.
E.None of the above.
13. Under what circumstances can we share patient information without having to get a signed authorization from the patient?
A. Treatment
B.Payment
C.Healthcare Operations
D. Public Health Department (to report child abuse or vital events)
E. All of the above
14. Is the accidental destruction of information a security problem?
15. Can you as an employee of FMC be fined and go to jail for not complying with the HIPAA regulations?