AAPC CPB FINAL EXAM FULL QUESTIONS AND
ANSWERS 2026 GUARANTEED TO PASS
◉ Eight standard transactions were adopted for electronic data,
interchange under HIPAA which of the following is not included as a
standard transaction
A) payment and remittance advice
B) eligibility in a health plan
C) coordination of benefits
D) physician unique identify number. Answer: D
◉ A claim is received by a payer that subsequently request the
medical records for the date of service on the claim what procedure
should be followed by the practice?. Answer: Only the date of service
on the claim should be sent to the payer. The records can be sent as
part of HIPAA based on treatment payment and operations.
◉ HIPAA requires that privacy practice notices be provided in
several circumstances, which of the following is not required
A) must be available on any website that practice maintains
B) must be provided upon request
C) must be presented to all patients
D) must be placed into the patient's file. Answer: D
,◉ When is subpoena is received by the practice for medical records,
and what circumstances may the records be released according to
the HIPAA privacy rule
A) the subpoena allows for the release of the medical records
B) this subpoena is accompanied by a court order, or the patient is
notified, and given a chance to object
C) the individual must sign an authorization for release at the
information
D) records cannot be released under any circumstances based on the
subpoena. Answer: B
◉ A physician received office space at a reduced rate for referring
patients to the hospitals, outpatient physical therapy center. What
law does this violate?. Answer: Anti-Kickback Statute
◉ Federal healthcare plans include what payers?. Answer: Medicare,
Medicaid, Tricare
◉ One of the most severe penalties that can be associated with
violations at the Social Security act is exclusion from federal
healthcare plans, which of the following statements is true of
excluded individuals?
A) physicians that have been excluded can build the patient for
services, but cannot bill federal health plans
, B) physicians that have been excluded can refer further patients to
other facilities for treatment
C) physicians that have been excluded or prohibited from billing for
any service to a federally administered health plan
D) physicians that have been excluded are exempt from billing for
services, but are allowed to write prescriptions and order tests.
Answer: C
◉ A physician built claims to Medicare and Medicaid for procedures
that were not performed on 800 patients resulting in loss of $2.6
million. Is this fraud or abuse?. Answer: Fraud; subject to the false
claims act
◉ The regulation of finance charges or interest, applied to
outstanding balances, and medical practice is under what law?.
Answer: Truth in Lending Act
◉ What type of insurance is paid for by employers for employees
and takes advantage of purchasing power of having large member
numbers?. Answer: Group Health Plan
◉ An internist sees a 20-year-old patient for an office visit. The
patient needs to see an endocrinologist for a consultation regarding
her diabetes. The internist is a participating provider in her plan.
She can choose any provider she wishes for her consultation, but she
will save money if she sees a specialist that is in her network. She
ANSWERS 2026 GUARANTEED TO PASS
◉ Eight standard transactions were adopted for electronic data,
interchange under HIPAA which of the following is not included as a
standard transaction
A) payment and remittance advice
B) eligibility in a health plan
C) coordination of benefits
D) physician unique identify number. Answer: D
◉ A claim is received by a payer that subsequently request the
medical records for the date of service on the claim what procedure
should be followed by the practice?. Answer: Only the date of service
on the claim should be sent to the payer. The records can be sent as
part of HIPAA based on treatment payment and operations.
◉ HIPAA requires that privacy practice notices be provided in
several circumstances, which of the following is not required
A) must be available on any website that practice maintains
B) must be provided upon request
C) must be presented to all patients
D) must be placed into the patient's file. Answer: D
,◉ When is subpoena is received by the practice for medical records,
and what circumstances may the records be released according to
the HIPAA privacy rule
A) the subpoena allows for the release of the medical records
B) this subpoena is accompanied by a court order, or the patient is
notified, and given a chance to object
C) the individual must sign an authorization for release at the
information
D) records cannot be released under any circumstances based on the
subpoena. Answer: B
◉ A physician received office space at a reduced rate for referring
patients to the hospitals, outpatient physical therapy center. What
law does this violate?. Answer: Anti-Kickback Statute
◉ Federal healthcare plans include what payers?. Answer: Medicare,
Medicaid, Tricare
◉ One of the most severe penalties that can be associated with
violations at the Social Security act is exclusion from federal
healthcare plans, which of the following statements is true of
excluded individuals?
A) physicians that have been excluded can build the patient for
services, but cannot bill federal health plans
, B) physicians that have been excluded can refer further patients to
other facilities for treatment
C) physicians that have been excluded or prohibited from billing for
any service to a federally administered health plan
D) physicians that have been excluded are exempt from billing for
services, but are allowed to write prescriptions and order tests.
Answer: C
◉ A physician built claims to Medicare and Medicaid for procedures
that were not performed on 800 patients resulting in loss of $2.6
million. Is this fraud or abuse?. Answer: Fraud; subject to the false
claims act
◉ The regulation of finance charges or interest, applied to
outstanding balances, and medical practice is under what law?.
Answer: Truth in Lending Act
◉ What type of insurance is paid for by employers for employees
and takes advantage of purchasing power of having large member
numbers?. Answer: Group Health Plan
◉ An internist sees a 20-year-old patient for an office visit. The
patient needs to see an endocrinologist for a consultation regarding
her diabetes. The internist is a participating provider in her plan.
She can choose any provider she wishes for her consultation, but she
will save money if she sees a specialist that is in her network. She
