Health Insurance Portability and Accountability Act (HIPPA) Practice Exam

Disable ads (and more) with a membership for a one time $2.99 payment

Prepare for the Health Insurance Portability and Accountability Act Exam. Study with challenging questions and explanations. Boost your understanding and ace the HIPAA quiz!

Each practice test/flash card set has 50 randomly selected questions from a bank of over 500. You'll get a new set of questions each time!

Practice this question and more.

When is the use of the EIN on standard transactions mandated?

When the healthcare provider is out-of-network
When the sponsor of the health plan is a self-insured employer
When billing for preventive care services
When processing emergency health claims

The correct answer is: When the sponsor of the health plan is a self-insured employer

The use of the Employer Identification Number (EIN) on standard transactions is mandated primarily when the sponsor of the health plan is a self-insured employer. This requirement is because self-insured employers are responsible for their own claims and often utilize their own EIN for identification in transactions. The EIN allows them to manage their health plan's financial and operational aspects while maintaining compliance with regulations. In scenarios involving an out-of-network healthcare provider, billing for preventive care services, or processing emergency health claims, the use of the EIN may not be specifically mandated. These situations may not necessarily require an EIN because they can involve different claim processing rules or identifiers that are more relevant to the specific transaction or service type rather than the employment status of the insurance sponsor.