Certified Billing & Coding Specialist Exam Review – COMPLETE SOLUTIONS 394 Questions with 100% Correct Answers

What are Medical Ethics? - Standards of conduct based on moral principle. they are generally accepted as a guide for behavior towards pt's, dr's, coworkers, the gov, and ins co's What does acting within ethical behavior boundaries mean? - Carrying out one's responsibilities with integrity, dignity, respect, honesty, competence, fairness, and trust Compliance regulations - Most billing-related cases are based on HIPAA and False Claims Act Health Insurance Portability & Accountability Act (HIPAA) - Enacted in 1996, created by the Health Care Fraud & Abuse Control Program- enacted to check for fraud and abuse in the Medicare/ Medicaid Programs and private payers What are 2 provisions of HIPAA? - Title 1: Insurance Reform Title 2: Administrative Simplification What is Title 1 of HIPAA? - Insurance Reform-primary purpose is to provide continuous coverage for workers & their dependents when they change or lose jobs. Also Limits the use of pre-existing conditions exclusions Prohibits discrimination from past or present poor health Guarantees certain employees/ individual the right to purchase new health insurance coverage after losing job Allows renewal of health insurance coverage regardless of an individuals health condition that is covered under the particular policy What is Title 2 of HIPAA? - Administrative Simplification- goal is to focus on the health care practice setting to reduce administrative cost & burdens. Has 2 p