Guide
1. "hold harmless clause" * found in some
non-Medicare health plan
contracts
* prohibits billing to pa-
tient for anything beyond
de- ductibles and co-
pays.
2. A compliance plan may offer several *more accurate payment
benefits, in- cluding:
of claims
*fewer billing mistakes
*improved
documentation and
more accurate coding
*less chance of violating
self-referral and anti-
kickback status
3. A healthcare clearing house is a entity that processes
non- standard health
information they receive
from another en- tity into a
standard format
4. A key provision in HIPAA is the Minimum Necessary only the minimum
necessary
requirement. this protected health information
means should be shared to
satisfy a particular
purpose.
5. A medically necessary service is the least radical
service/proce- dure that
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, CPC Certification Notes from the AAPC Study
Guide
allows for ettec- tive
treatment of the patients'
complaint or condition
6. Leg
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22
, CPC Certification Notes from the AAPC Study
Guide
A patient sustaining an injury to her great saphe-
nous vein would have sustained injury to which
of anatomical site?
7. APC Ambulatory Payment
Classifi-
cation
8. ARRA American Recovery and
Rein-
vestment Act (of 2009)
9. ASC Ambulatory Surgical
Centers
10. Abuse consists of payment for items or
services that are billed by
providers in error that
should not be paid for by
Medicare.
11. An ABN protects the provider's financial interest by creating a paper
trail that
CMS requires before a
provider can bill the
patient for payment if
Medicare de- nies
coverage for the stated
service or procedure.
12. An entity that processes nonstandard 13. As a part of
health infor- mation they receive from Health Care
another entity into a stan- dard format is Reform, the
considered what? Affordable
Care Act of
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44
, CPC Certification Notes from the AAPC Study
Guide
2010 amended the definition of fraud to Clearinghouse
remove the requirement
intent
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44