EXAM QUESTIONS AND CORRECT ANSWERS (100% CORRECT
ANSWERS ) ALREADY GRADED A+/2024 AAPC CPB FINAL EXAM
PREP 205 QUESTIONS AND CORRECT ANSWERS .
Health plan, clearinghouses, and any entity transmitting health
information is considered by the Privacy Rule to be a:
- ANSWER-
covered entity
Which of the following is not a covered entity in the Privacy Rule -
ANSWER-healthcare consulting firm
A request for medical records is received for a specific 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? -
ANSWER-release
reqt to ins co
How many national priority purposes under the Privacy Rules for
disclosure of specific PHI without an individual's
authorization or
permission? - ANSWER-
12
,A health plan sends a request for medical records in order to
adjudicate a claim. Does the office have to notify the
patient or have them sign a release to send
the information? - ANSWER-no
A practice sets up a payment plan with a patient. If more than four
installments are extended to the patient, what
regulation is the practice subject to that makes the practice a
creditor? - ANSWER-Truth in Lending Act
Which of the following situations allows release of PHI without
authorization from the patient? - ANSWER-workers
comp
misusing any information on the claim, charging 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. - ANSWER-abuse
A claim is submitted for a patient on Medicare with a higher fee
than a patient on Insurance ABC. What is this
considered by CMS? -
ANSWER-abuse
,According to the Privacy Rule, what health information may not be de-
identified? - ANSWER-phys provider number
making false statements or misrepresenting facts to obtain an
undeserved benefit or payment from a federal
healthcare program -
ANSWER-fraud
All the following are considered Fraud, EXCEPT: - ANSWER-
inadequate med recd
A hospital records transporter is moving medical records 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? - ANSWER-breach
impermissible release or disclosure of information is discovered -
ANSWER-breach
What standard transactions is NOT included in EDI and adopted under
HIPAA? - ANSWER-waiver of liability
The Federal False Claim Act allows for claims to be reviewed for a
standard of how many years after an incident? -
, ANSWER-
7
A new radiology company opens in town. The manager calls your
practice and offers to pay $20 for every Medicare
patient you send to them for radiology services. What does this
offer violate? - ANSWER-anti kickback laws
A private practice hires a consultant to come in and audit some
medical records. Under the Privacy Rule, what is this
consultant considered? -
ANSWER-biz associate
Medicare overpayments should be returned within ___ days after the
overpayment has been identified - ANSWER-60
HIPAA mandated what entity to adopt national standards for electronic
transactions and code sets? - ANSWER-HHS
(Health and
Human Services)
Entities that have been identified as having improper billing
practices is defined by CMS as a violation of what
standard? -
ANSWER-abuse