AAPC CPB Final Exam Study Guide
2026/2027 | Certified Professional Biller
Exam Prep | Complete Review + Practice
Questions & Answers
HIPPA OF 1996 includes a security rule that is established to provide what
national stands for protecting and transmitting patient data. Which of the
following is NOT true?
A) The security rule applies to healthcare providers, health plans, and any covered
entity involved in the care of a patient.
B) The security role applies only to the Institute that initiates the release of
protected health information
C) Standards for storing transmitting patient data and electronic form include
portable electronic devices
D) The security rule states that safeguards must be in place to prevent unsecured
release of information - correct answer-B
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 - correct 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? - correct 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 - correct 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 -
correct 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? -
correct answer-Anti-Kickback Statute
, Federal healthcare plans include what payers? - correct 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 - correct 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?
- correct 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? - correct 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? - correct
answer-Group Health Plan
2026/2027 | Certified Professional Biller
Exam Prep | Complete Review + Practice
Questions & Answers
HIPPA OF 1996 includes a security rule that is established to provide what
national stands for protecting and transmitting patient data. Which of the
following is NOT true?
A) The security rule applies to healthcare providers, health plans, and any covered
entity involved in the care of a patient.
B) The security role applies only to the Institute that initiates the release of
protected health information
C) Standards for storing transmitting patient data and electronic form include
portable electronic devices
D) The security rule states that safeguards must be in place to prevent unsecured
release of information - correct answer-B
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 - correct 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? - correct 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 - correct 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 -
correct 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? -
correct answer-Anti-Kickback Statute
, Federal healthcare plans include what payers? - correct 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 - correct 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?
- correct 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? - correct 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? - correct
answer-Group Health Plan
