AAPC CPB FINAL EXAM |ACTUAL QUESTIONS AND
VERIFIED ANSWERS|BRAND NEW 2026-2027
UPDATE|GRADED A+
Question 1
Medicare was passed into law under the title XVIII of what Act?
a. HIPAA
b. Stabilization Act
c. HMO
d. Social Security Act
CORRECT ANSWER
d. Social Security Act
Question 2
A new radiology company opens in town. The manager calls your practice and offers to
pay $20 for every Medicare patient you send to them for radiology services. What does
this offer violate?
a. Anti-Kickback law
b. Stark Laws
c. HIPAA
d. Qui Tam
CORRECT ANSWER
a. Anti-Kickback law
1
,Question 3
A practice agrees to pay $250,000 to settle a lawsuit alleging that the practice used X-rays
of one patient to justify services on multiple other patients' claims. The manager of the
office brought the civil suit. What type of case is this?
a. HIPAA
b. Stark case
c. Anti-Kickback
d. Qui Tam
CORRECT ANSWER
d. Qui Tam
Question 4
A private practice hires a consultant to come in and audit some medical records. Under the
Privacy Rule, what is this consultant considered?
a. A covered entity
b. A business associate
c. An employee
d. A clearinghouse
CORRECT ANSWER
b. A business associate
Question 5
What is the standard time frame established for record retention?
a. Seven years
2
,b. The life of the patient
c .Five years
d. There is no single standard record retention, it varies by state and federal regulation
CORRECT ANSWER
d. There is no single standard record retention, it varies by state and federal regulation
Question 6
What entities are exempt from HIPAA and not considered to be covered entities?
a. Workers' compensation
b. Employers with less than 100 employees
c .Church-sponsored plans
d. Sponsored group plans
CORRECT ANSWER
a. Workers' compensation
Question 7
A patient is seen in your clinic. Her husband calls later in the day to ask for information
about the visit. The practice pulls the patient's privacy authorization to see if they can
speak to the husband. What act does this action fall under?
a. Health Information Act
b. HIPAA
c. Social Security Act
d. ADA
CORRECT ANSWER
3
, b. HIPAA
Question 8
When a patient is enrolled in an HMO, which options below are the responsibilities of the
primary care physician (PCP)?
I. Manage the member's treatment
II. Be the only provider for all of the patient's healthcare
III. Provide referrals to specialists
IV. Approve emergency department visits
V. Provide referrals for inpatient admissions
a. I, II, III
b. I, III, IV
c. I, III, V
d. I, II
CORRECT ANSWER
b. I, III, IV
Question 9
What is the benefit of using NPI numbers for payers?
I. It is a single identifier for all payers
II. It contains the providers' birthdates to allow certain identification
III. Each payer can make their own number
IV. It has no personal identifying information in the number
a. I, II
4
VERIFIED ANSWERS|BRAND NEW 2026-2027
UPDATE|GRADED A+
Question 1
Medicare was passed into law under the title XVIII of what Act?
a. HIPAA
b. Stabilization Act
c. HMO
d. Social Security Act
CORRECT ANSWER
d. Social Security Act
Question 2
A new radiology company opens in town. The manager calls your practice and offers to
pay $20 for every Medicare patient you send to them for radiology services. What does
this offer violate?
a. Anti-Kickback law
b. Stark Laws
c. HIPAA
d. Qui Tam
CORRECT ANSWER
a. Anti-Kickback law
1
,Question 3
A practice agrees to pay $250,000 to settle a lawsuit alleging that the practice used X-rays
of one patient to justify services on multiple other patients' claims. The manager of the
office brought the civil suit. What type of case is this?
a. HIPAA
b. Stark case
c. Anti-Kickback
d. Qui Tam
CORRECT ANSWER
d. Qui Tam
Question 4
A private practice hires a consultant to come in and audit some medical records. Under the
Privacy Rule, what is this consultant considered?
a. A covered entity
b. A business associate
c. An employee
d. A clearinghouse
CORRECT ANSWER
b. A business associate
Question 5
What is the standard time frame established for record retention?
a. Seven years
2
,b. The life of the patient
c .Five years
d. There is no single standard record retention, it varies by state and federal regulation
CORRECT ANSWER
d. There is no single standard record retention, it varies by state and federal regulation
Question 6
What entities are exempt from HIPAA and not considered to be covered entities?
a. Workers' compensation
b. Employers with less than 100 employees
c .Church-sponsored plans
d. Sponsored group plans
CORRECT ANSWER
a. Workers' compensation
Question 7
A patient is seen in your clinic. Her husband calls later in the day to ask for information
about the visit. The practice pulls the patient's privacy authorization to see if they can
speak to the husband. What act does this action fall under?
a. Health Information Act
b. HIPAA
c. Social Security Act
d. ADA
CORRECT ANSWER
3
, b. HIPAA
Question 8
When a patient is enrolled in an HMO, which options below are the responsibilities of the
primary care physician (PCP)?
I. Manage the member's treatment
II. Be the only provider for all of the patient's healthcare
III. Provide referrals to specialists
IV. Approve emergency department visits
V. Provide referrals for inpatient admissions
a. I, II, III
b. I, III, IV
c. I, III, V
d. I, II
CORRECT ANSWER
b. I, III, IV
Question 9
What is the benefit of using NPI numbers for payers?
I. It is a single identifier for all payers
II. It contains the providers' birthdates to allow certain identification
III. Each payer can make their own number
IV. It has no personal identifying information in the number
a. I, II
4
