INSURANCE CHAPTER 5 KEY
TERMS EXAM ACTUAL UPDATED QUESTIONS AND VERIFIED
ANSWERS
abuse - ANSWER actions inconsistent with accepted, sound medical, business, or fiscal practices
ANSI ASC X12N 837 - ANSWER variable-length file format used to bill institutional, professional,
dental and drug claims
authorization - ANSWER document that provides official instruction, such as the customized
document that gives covered entities permission to use specified PHI for specified purposes or
to disclose PHI to a third party specified by the individual
black box edit - ANSWER nonpublished code edits, which were discontinued in 2000
breach of confidentiality - ANSWER unauthorized release of patient information to a third party
case law - ANSWER based on a court decision that establishes a precedent (common law)
check digit - ANSWER one-digit character, alphabetic or numeric, used to verify the validity of a
unique identifier
civil law - ANSWER area of law not classified as criminal
, Clinical Data Abstracting Center (CDAC) - ANSWER requests and screens medical records for the
Payment Error Prevention Program to survey samples for medical review, DRG validation and
medical necessity
common law - ANSWER based on a court decision that establishes a precedent
Comprehensive Error Rate Testing (CERT) program - ANSWER assesses and measures improper
medicare fee-for-service payments
confidentiality - ANSWER restricting patient information access to those with proper
authorization and maintaining the security of patient information
criminal law - ANSWER public law governed by statute or ordinance that deals with crimes and
their prosecution
Current Dental Terminology (CDT) - ANSWER medical code set maintained and copyrighted by
the American Dental Association
decrypt - ANSWER to decode an encoded computer file so that it can be viewed
Deficit Reduction Act of 2005 - ANSWER created medicaid integrity program (MIP), which
increased resources available to CMS to combat abuse, fraud, and waste in the Medicaid
program.
deposition - ANSWER legal proceeding during which a party answers questions under oath (but
not in open court)
digital - ANSWER application of a mathematical function to an electronic document to create a
computer code that can be encrypted
TERMS EXAM ACTUAL UPDATED QUESTIONS AND VERIFIED
ANSWERS
abuse - ANSWER actions inconsistent with accepted, sound medical, business, or fiscal practices
ANSI ASC X12N 837 - ANSWER variable-length file format used to bill institutional, professional,
dental and drug claims
authorization - ANSWER document that provides official instruction, such as the customized
document that gives covered entities permission to use specified PHI for specified purposes or
to disclose PHI to a third party specified by the individual
black box edit - ANSWER nonpublished code edits, which were discontinued in 2000
breach of confidentiality - ANSWER unauthorized release of patient information to a third party
case law - ANSWER based on a court decision that establishes a precedent (common law)
check digit - ANSWER one-digit character, alphabetic or numeric, used to verify the validity of a
unique identifier
civil law - ANSWER area of law not classified as criminal
, Clinical Data Abstracting Center (CDAC) - ANSWER requests and screens medical records for the
Payment Error Prevention Program to survey samples for medical review, DRG validation and
medical necessity
common law - ANSWER based on a court decision that establishes a precedent
Comprehensive Error Rate Testing (CERT) program - ANSWER assesses and measures improper
medicare fee-for-service payments
confidentiality - ANSWER restricting patient information access to those with proper
authorization and maintaining the security of patient information
criminal law - ANSWER public law governed by statute or ordinance that deals with crimes and
their prosecution
Current Dental Terminology (CDT) - ANSWER medical code set maintained and copyrighted by
the American Dental Association
decrypt - ANSWER to decode an encoded computer file so that it can be viewed
Deficit Reduction Act of 2005 - ANSWER created medicaid integrity program (MIP), which
increased resources available to CMS to combat abuse, fraud, and waste in the Medicaid
program.
deposition - ANSWER legal proceeding during which a party answers questions under oath (but
not in open court)
digital - ANSWER application of a mathematical function to an electronic document to create a
computer code that can be encrypted
