ERROR:
JavaScript is not enabled. You must enable JavaScript in your browser to use this form
Please fill in a valid value for all required fields
Please ensure all values are in a proper format.
Are you sure you want to leave this form and resume later?
Are you sure you want to leave this form and resume later? If so, please enter a password below to securely save your form.
Save and Resume Later
Save and get link
You must upload one of the following file types for the selected field:
There was an error displaying the form. Please copy and paste the embed code again.
Apply Discount
You saved
with code
SUBMIT QUIZ
Submitting
Validating
There was an error initializing the payment processor on this form. Please contact the form owner to correct this issue.
Please check the field:
Fields
Office Name
*
Email to Send Results to
*
Level 1: Management & Staff Continuing Education Exam
1. HIPAA permits the dental team to discuss a patient with any member of the patient’s family.
*
TRUE
FALSE
You answered wrong. Please change your answer to continue.
2. If a dental team member fails to comply with the practice’s HIPAA policies and procedures:
*
A. HIPAA requires the dental practice to apply appropriate sanctions
B. The dental practice must notify the U.S. Department of Health and Human Services
C. The dental practice must notify the patient
D. No action is required by HIPAA
You answered wrong. Please change your answer to continue.
3. Dental practice HIPAA policies and procedures apply to protected health information:
*
A. In electronic form only.
B. In any format, including electronic, hard copy (paper, photographs, films) and oral information.
C. Only if the dental practice list the information in its Notice of Privacy Practices
D. In paper form only
You answered wrong. Please change your answer to continue.
4. If a patient asks to inspect his or her dental records, or to obtain copies of them, HIPAA requires you to grant the request immediately.
*
TRUE
FALSE
You answered wrong. Please change your answer to continue.
5. Which kinds of penalties can the government impose for HIPAA violations?
*
A. Civil monetary penalties
B. Criminal penalties
C. Civil monetary penalties and criminal penalties
D. None of the above
You answered wrong. Please change your answer to continue.
6. The dental practice must have appropriate safeguards to protect the privacy of PHI. Which of the following would not be an appropriate safeguard?
*
A. Locks on the office doors and windows.
B. Requiring that staff dispose of unneeded duplicate copies of PHI by shredding
C. Prohibiting staff from leaving logged in computer unattended
D. Prohibiting staff from telephoning patients
You answered wrong. Please change your answer to continue.
7. A dental office employee who uses a patient’s social security number or credit card number with the intent to sell, for personal gain, or for malicious harm can go to jail for up to ten years and can be fined up to $250,000.
*
TRUE
FALSE
You answered wrong. Please change your answer to continue.
8. What should an employee do if he or she discovers a suspected breach?
*
A. Refer the patient to the Notice of Privacy Practices
B. Research the incident or suspected incident
C. Report the suspected breach immediately to the appropriate dental team member
D. Inform patients
You answered wrong. Please change your answer to continue.
9. Once all of the staff has been trained on HIPAA compliance, the training requirement is met.
*
TRUE
FALSE
You answered wrong. Please change your answer to continue.
10. A suspected “Breach” refers to a situation where
*
A. The Notice of Privacy Practices is not displayed in the office
B. PHI is improperly acquired, accessed, used or disclosed
C. A practice does not train the staff on HIPAA compliance
D. A practice risk assessment is not completed
You answered wrong. Please change your answer to continue.
EMPLOYEE INFORMATION
Date/Time
https://vnbnioxhek.formstack.com/forms/images/2/calendar.png
Month
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Day
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2019
2020
2021
2022
2023
2024
2025
2026
2027
2028
2029
Name
*
First Name
*
Last Name
*
Signature
*
[clear]
Use your mouse or finger to draw your signature above
Email
*
Previous
←
Next
→
Enter your save and resume password
Cancel
Confirm