AAPC Practice Test Questions and Correct Answers

Which of the following actions is considered under the False Claim Act? Upcoding or unbundling services 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? No, since the information is used for payment activities it is not necessary to notify or obtain authorization from the patient The Federal False Claim Act allows for claims to be reviewed for a standard of how many years after an incident? seven years 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? Truth in Lending Act OIG, CMS, and Department of Justice are the government agencies enforcing Federal fraud and abuse laws What types of entities do conditions of participation (CoP) apply to for health plans? HospitalsII. Clinics Transplant center. Psychiatric hospitals All the following are considered Fraud, EXCEPT: failure to maintain adequate medical records A request for medical records is received for a specific date of service from the patient's insurance company with regards to a submitted claim. No authorization for release of information is provided. What action should be taken? Release the requested records to the insurance company 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? A breach What were the eight standard transactions for electronic data interchange adopted under? What were the eight standard transactions for electronic data interchange adopted under? What entities are exempt from HIPAA and not considered to be covered entities? Workers' compensation