Medical Office Concepts Final Exam Review
UPDATED ACTUAL Questions and
CORRECT Answers
Breach - CORRECT ANSWER - Which term refers to the acquisition, access, use or
disclosure of unsecured PHI in a manner not permitted under the HIPAA Privacy Rule, thus
compromising the security or privacy of the PHI
X-12 837 Health Care Claim - CORRECT ANSWER - Most physician practices are
required to use this HIPAA-standard electronic claim format called
ICD - CORRECT ANSWER - Which of the following refers to diagnostic codes
ERA - CORRECT ANSWER - An electronic document that lists patients, dates of service,
charges, and the amount paid or denied by the insurance carrier is the
at either check-in or check-out - CORRECT ANSWER - When are copayments routinely
collected
business associate - CORRECT ANSWER - An individual or entitiy that creates, receives,
maintains, or transmits PHI on behalf of a covered entity and may also include subcontractors of
an entity is known as
accountable care organization - CORRECT ANSWER - A network of doctors and
hospitals that shares responsibility for managing the quality and cost of care provided to a group
of patients is known as
audit - CORRECT ANSWER - A formal examination or review undertaken to determine
whether a healthcare organization's staff members comply with regulations is known as an
, diagnosis code - CORRECT ANSWER - The patient's primary complaint (the illness or
condition that is the reason for the visit)
codes on payment transactions match the claim, payment listed for each procedure is expected,
any unpaid charges explained - CORRECT ANSWER - Each remittance advice is
compared against the claim to check that
individuals, secretary of health and human services, and the media - CORRECT
ANSWER - If a breach of unsecured health information affects more than 500 individuals,
HIPAA breach notification rule requires covered entities and their business associates to notify
fee schedule - CORRECT ANSWER - A_________is a listing of standard charges for
procedures and the amount the provider bills for the provided services.
adjudication - CORRECT ANSWER - What is a series of steps designed to determine
whether a claim should be paid
health information technology HIT - CORRECT ANSWER - What term refers to the
computer hardware,software, and networks that are used to record,store, and manage health
information
audit trail - CORRECT ANSWER - A report that traces who has accessed electronic
information, when information was accessed, and whether any information was changed is an
technical safeguard - CORRECT ANSWER - An automated process used to protect data
and control access to data is known as a
fee-for-service - CORRECT ANSWER - A model of physician reimbursement in which
payment is provided for specific, individual services provided to a patient
UPDATED ACTUAL Questions and
CORRECT Answers
Breach - CORRECT ANSWER - Which term refers to the acquisition, access, use or
disclosure of unsecured PHI in a manner not permitted under the HIPAA Privacy Rule, thus
compromising the security or privacy of the PHI
X-12 837 Health Care Claim - CORRECT ANSWER - Most physician practices are
required to use this HIPAA-standard electronic claim format called
ICD - CORRECT ANSWER - Which of the following refers to diagnostic codes
ERA - CORRECT ANSWER - An electronic document that lists patients, dates of service,
charges, and the amount paid or denied by the insurance carrier is the
at either check-in or check-out - CORRECT ANSWER - When are copayments routinely
collected
business associate - CORRECT ANSWER - An individual or entitiy that creates, receives,
maintains, or transmits PHI on behalf of a covered entity and may also include subcontractors of
an entity is known as
accountable care organization - CORRECT ANSWER - A network of doctors and
hospitals that shares responsibility for managing the quality and cost of care provided to a group
of patients is known as
audit - CORRECT ANSWER - A formal examination or review undertaken to determine
whether a healthcare organization's staff members comply with regulations is known as an
, diagnosis code - CORRECT ANSWER - The patient's primary complaint (the illness or
condition that is the reason for the visit)
codes on payment transactions match the claim, payment listed for each procedure is expected,
any unpaid charges explained - CORRECT ANSWER - Each remittance advice is
compared against the claim to check that
individuals, secretary of health and human services, and the media - CORRECT
ANSWER - If a breach of unsecured health information affects more than 500 individuals,
HIPAA breach notification rule requires covered entities and their business associates to notify
fee schedule - CORRECT ANSWER - A_________is a listing of standard charges for
procedures and the amount the provider bills for the provided services.
adjudication - CORRECT ANSWER - What is a series of steps designed to determine
whether a claim should be paid
health information technology HIT - CORRECT ANSWER - What term refers to the
computer hardware,software, and networks that are used to record,store, and manage health
information
audit trail - CORRECT ANSWER - A report that traces who has accessed electronic
information, when information was accessed, and whether any information was changed is an
technical safeguard - CORRECT ANSWER - An automated process used to protect data
and control access to data is known as a
fee-for-service - CORRECT ANSWER - A model of physician reimbursement in which
payment is provided for specific, individual services provided to a patient
