AAPC CPB Final Exam
Health plan, clearinghouses, and any entity transmitting covered entity
health information is considered by the Privacy Rule to be
a:
Which of the following is not a covered entity in the Privacy healthcare consulting firm
Rule
A request for medical records is received for a specific release reqt to ins co
date of service from patient's insurance company with
regards to a submitted claim. No authorization for release
of information is provided. What action should be taken?
How many national priority purposes under the Privacy 12
Rules for disclosure of specific PHI without an individual's
authorization or permission?
A health plan sends a request for medical records in order no
to adjudicate a claim. Does the office have to notify the
patient or have them sign a release to send the
information?
A practice sets up a payment plan with a patient. If more Truth in Lending Act
than four installments are extended to the patient, what
regulation is the practice subject to that makes the practice
a creditor?
Which of the following situations allows release of PHI workers comp
without authorization from the patient?
misusing any information on the claim, charging abuse
excessively for services or supplies, billing for services not
medically necessary, failure to maintain adequate medical
or financial records, improper billing practices, or billing
Medicare patients at a higher fee scale that non-Medicare
patients.
A claim is submitted for a patient on Medicare with a higher abuse
fee than a patient on Insurance ABC. What is this
considered by CMS?
According to the Privacy Rule, what health information phys provider number
may not be de-identified?
making false statements or misrepresenting facts to obtain fraud
an undeserved benefit or payment from a federal
healthcare program
All the following are considered Fraud, EXCEPT: inadequate med recd
A hospital records transporter is moving medical records breach
from the hospital to an off-site building. During the
transport, a chart falls from the box on to the street. It is
discovered when the transporter arrives at the off-site
building and the number of charts is not correct. What type
of violation is this?
Stuvia 2026-2027
, AAPC CPB Final Exam
impermissible release or disclosure of information is breach
discovered
What standard transactions is NOT included in EDI and waiver of liability
adopted under HIPAA?
The Federal False Claim Act allows for claims to be 7
reviewed for a standard of how many years after an
incident?
A new radiology company opens in town. The manager anti kickback laws
calls your practice and offers to pay $20 for every
Medicare patient you send to them for radiology services.
What does this offer violate?
A private practice hires a consultant to come in and audit biz associate
some medical records. Under the Privacy Rule, what is this
consultant considered?
Medicare overpayments should be returned within ___ 60
days after the overpayment has been identified
HIPAA mandated what entity to adopt national standards HHS
for electronic transactions and code sets?
Entities that have been identified as having improper billing abuse
practices is defined by CMS as a violation of what
standard?
In addition to the standardization of the codes (ICD-10, unique id
CPT, HCPCS, and NDC) used to request payment for
medical services, what must be used on all transactions for
employers and providers?
A person that files a claim for a Medicare beneficiary False Claims Act
knowing that the service is not correctly reported is in
violation of what statute?
Medicare was passed into law under the title XVIII of what SS Act
Act?
While working in a large practice, Medicare overpayments fraud
are found in several patient accounts. The manager states
that the practice will keep the money until Medicare asks
for it back. What does this action constitute?
A practice agrees to pay $250,000 to settle a lawsuit qui tam
alleging that the practice used X-rays of one patient to
justify services on multiple other patients' claims. The
manager of the office brought the civil suit. What type of
case is this?
OIG, CMS, and Department of Justice are the government fed abuse and fraud laws
agencies enforcing ________.
Stuvia 2026-2027
Health plan, clearinghouses, and any entity transmitting covered entity
health information is considered by the Privacy Rule to be
a:
Which of the following is not a covered entity in the Privacy healthcare consulting firm
Rule
A request for medical records is received for a specific release reqt to ins co
date of service from patient's insurance company with
regards to a submitted claim. No authorization for release
of information is provided. What action should be taken?
How many national priority purposes under the Privacy 12
Rules for disclosure of specific PHI without an individual's
authorization or permission?
A health plan sends a request for medical records in order no
to adjudicate a claim. Does the office have to notify the
patient or have them sign a release to send the
information?
A practice sets up a payment plan with a patient. If more Truth in Lending Act
than four installments are extended to the patient, what
regulation is the practice subject to that makes the practice
a creditor?
Which of the following situations allows release of PHI workers comp
without authorization from the patient?
misusing any information on the claim, charging abuse
excessively for services or supplies, billing for services not
medically necessary, failure to maintain adequate medical
or financial records, improper billing practices, or billing
Medicare patients at a higher fee scale that non-Medicare
patients.
A claim is submitted for a patient on Medicare with a higher abuse
fee than a patient on Insurance ABC. What is this
considered by CMS?
According to the Privacy Rule, what health information phys provider number
may not be de-identified?
making false statements or misrepresenting facts to obtain fraud
an undeserved benefit or payment from a federal
healthcare program
All the following are considered Fraud, EXCEPT: inadequate med recd
A hospital records transporter is moving medical records breach
from the hospital to an off-site building. During the
transport, a chart falls from the box on to the street. It is
discovered when the transporter arrives at the off-site
building and the number of charts is not correct. What type
of violation is this?
Stuvia 2026-2027
, AAPC CPB Final Exam
impermissible release or disclosure of information is breach
discovered
What standard transactions is NOT included in EDI and waiver of liability
adopted under HIPAA?
The Federal False Claim Act allows for claims to be 7
reviewed for a standard of how many years after an
incident?
A new radiology company opens in town. The manager anti kickback laws
calls your practice and offers to pay $20 for every
Medicare patient you send to them for radiology services.
What does this offer violate?
A private practice hires a consultant to come in and audit biz associate
some medical records. Under the Privacy Rule, what is this
consultant considered?
Medicare overpayments should be returned within ___ 60
days after the overpayment has been identified
HIPAA mandated what entity to adopt national standards HHS
for electronic transactions and code sets?
Entities that have been identified as having improper billing abuse
practices is defined by CMS as a violation of what
standard?
In addition to the standardization of the codes (ICD-10, unique id
CPT, HCPCS, and NDC) used to request payment for
medical services, what must be used on all transactions for
employers and providers?
A person that files a claim for a Medicare beneficiary False Claims Act
knowing that the service is not correctly reported is in
violation of what statute?
Medicare was passed into law under the title XVIII of what SS Act
Act?
While working in a large practice, Medicare overpayments fraud
are found in several patient accounts. The manager states
that the practice will keep the money until Medicare asks
for it back. What does this action constitute?
A practice agrees to pay $250,000 to settle a lawsuit qui tam
alleging that the practice used X-rays of one patient to
justify services on multiple other patients' claims. The
manager of the office brought the civil suit. What type of
case is this?
OIG, CMS, and Department of Justice are the government fed abuse and fraud laws
agencies enforcing ________.
Stuvia 2026-2027
