NHA CBCS EVALUATION TEST ANSWERS AND
QUESTIONS SET A+
✔✔Stealing money that has be entrusted to one's care is know as - ✔✔embezzlement
✔✔Coined term by AHIMA's eHealth Task Force to describe transactions in which
health care information is accessed, processed, stored, and transferred using electronic
chronologies is usually abbreviated as - ✔✔EHIM {electronic health information
management}
✔✔Individual designated to help a provider remain in compliance by setting policies and
procedures in place, train staff regarding HIPAA, and act as the contact person for
questions and complaints - ✔✔•Privacy officer, •Privacy official
✔✔A health care coverage carrier, clearinghouse, or physician who transmits health
information in electronic for in connection with transaction covered by HIPAA is called -
✔✔Covered entity
✔✔Who renders medical services, furnishes bills, or is paid for health care in the normal
course of business? - ✔✔Health care provider
✔✔3rd Party administrator who receives insurance claims from physician's office,
performs edits, and redistributes the claims electronically to various insurance carriers?
- ✔✔Clearinghouse
✔✔Who is hired by medical practice to process claims to 3rd party payer? -
✔✔Business Associate
✔✔List 5 disciplinary standards resulting from misconduct - ✔✔verbal warning, written
warning, written reprimand, suspension or probation, demotion, termination
✔✔Security rule that addresses electronic protected health information is divided into
what 3 main sections? - ✔✔1. Administrative safeguards
, 2. Technical safeguards
3. Physical safeguards
✔✔CAP - ✔✔Claims Assistance Professional
✔✔AHIMA - ✔✔American Health Information Management Association
✔✔In locating a diagnosis, look up the main term, which is the - ✔✔Condition or
disease
✔✔Reasons for documentation are - ✔✔Defense of a Professional liability claim.
Insurance carriers require accurate Documentation that supports procedure and
diagnostic codes
✔✔SOAP is - ✔✔•Subjective
•Objective
•Assessment
•Plan
✔✔A diseased condition or state is known as - ✔✔morbidity
✔✔According to birth law, if both parents have the same birthday - ✔✔The hour of birth
determines who pays first
✔✔What is the correct term to determine if a procedure is covered and medically
necessary - ✔✔Pre-authorization
✔✔Obtaining and recording patient data before the person's first visit is known as -
✔✔Pre-registration
✔✔Discovering the maximum $ amount that the carrier will pay for a procedure is called
- ✔✔predetermination
✔✔Criteria used by insurance companies when making decisions to limit or deny
payment of medical services or procedures must be justified by the patient's symptoms
and diagnosis are called - ✔✔medical necessity
✔✔If husband & wife both have insurance through their employers, and each has added
the spouse to their primary insurance plans for coverage. If the wife is seen for
treatment then her plan is considered - ✔✔Primary
✔✔The Health Insurance Claim Form, also know as universal claim form is often called
- ✔✔CMS-1500
QUESTIONS SET A+
✔✔Stealing money that has be entrusted to one's care is know as - ✔✔embezzlement
✔✔Coined term by AHIMA's eHealth Task Force to describe transactions in which
health care information is accessed, processed, stored, and transferred using electronic
chronologies is usually abbreviated as - ✔✔EHIM {electronic health information
management}
✔✔Individual designated to help a provider remain in compliance by setting policies and
procedures in place, train staff regarding HIPAA, and act as the contact person for
questions and complaints - ✔✔•Privacy officer, •Privacy official
✔✔A health care coverage carrier, clearinghouse, or physician who transmits health
information in electronic for in connection with transaction covered by HIPAA is called -
✔✔Covered entity
✔✔Who renders medical services, furnishes bills, or is paid for health care in the normal
course of business? - ✔✔Health care provider
✔✔3rd Party administrator who receives insurance claims from physician's office,
performs edits, and redistributes the claims electronically to various insurance carriers?
- ✔✔Clearinghouse
✔✔Who is hired by medical practice to process claims to 3rd party payer? -
✔✔Business Associate
✔✔List 5 disciplinary standards resulting from misconduct - ✔✔verbal warning, written
warning, written reprimand, suspension or probation, demotion, termination
✔✔Security rule that addresses electronic protected health information is divided into
what 3 main sections? - ✔✔1. Administrative safeguards
, 2. Technical safeguards
3. Physical safeguards
✔✔CAP - ✔✔Claims Assistance Professional
✔✔AHIMA - ✔✔American Health Information Management Association
✔✔In locating a diagnosis, look up the main term, which is the - ✔✔Condition or
disease
✔✔Reasons for documentation are - ✔✔Defense of a Professional liability claim.
Insurance carriers require accurate Documentation that supports procedure and
diagnostic codes
✔✔SOAP is - ✔✔•Subjective
•Objective
•Assessment
•Plan
✔✔A diseased condition or state is known as - ✔✔morbidity
✔✔According to birth law, if both parents have the same birthday - ✔✔The hour of birth
determines who pays first
✔✔What is the correct term to determine if a procedure is covered and medically
necessary - ✔✔Pre-authorization
✔✔Obtaining and recording patient data before the person's first visit is known as -
✔✔Pre-registration
✔✔Discovering the maximum $ amount that the carrier will pay for a procedure is called
- ✔✔predetermination
✔✔Criteria used by insurance companies when making decisions to limit or deny
payment of medical services or procedures must be justified by the patient's symptoms
and diagnosis are called - ✔✔medical necessity
✔✔If husband & wife both have insurance through their employers, and each has added
the spouse to their primary insurance plans for coverage. If the wife is seen for
treatment then her plan is considered - ✔✔Primary
✔✔The Health Insurance Claim Form, also know as universal claim form is often called
- ✔✔CMS-1500
