AAPC CPB Final Exam 2022/2023
1. Health plan, clearinghouses, and any entity transmitting health
informa- tion is considered by the Privacy Rule to be a (answer) covered
entity
2. Which of the following is not a covered entity in the Privacy Rule
(answer) health- care consulting firm
3. A request for medical records is received for a specific date of service
from patient's insurance company with regards to a submitted claim. No
authorization for release of information is provided. What action should
be taken(answer) release reqt to ins co
4. How many national priority purposes under the Privacy Rules for disclo-
sure of specific PHI without an individual's authorization or
permission(answer) 12
5. A health plan sends a request for medical records in order to adjudicate
a claim. Does the office have to notify the patient or have them sign a
release to send the information(answer) no
6. A practice sets up a payment plan with a patient. If more than four
install- ments are extended to the patient, what regulation is the practice
subject to that makes the practice a creditor(answer) Truth in Lending
Act
7. Which of the following situations allows release of PHI without
authoriza- tion from the patient(answer) workers comp
,8. misusing any information on the claim, charging excessively for
services or supplies, billing for services not medically necessary, failure to
maintain adequate medical or financial records, improper billing practices,
or billing Medicare patients at a higher fee scale that non-Medicare
patients (answer) abuse
9. A claim is submitted for a patient on Medicare with a higher fee than
a patient on Insurance ABC. What is this considered by CMS(answer)
abuse
10.According to the Privacy Rule, what health information may not
be de-identified(answer) phys provider number
11.making false statements or misrepresenting facts to obtain an unde-
served benefit or payment from a federal healthcare program (answer)
fraud
12.All the following are considered Fraud, EXCEPT (answer) inadequate
med recd
13.A hospital records transporter is moving medical records from the
hos- pital to an off-site building. During the transport, a chart falls from the
box on to the street. It is discovered when the transporter arrives at the
off-site building and the number of charts is not correct. What type of
violation is this(answer) breach
14.impermissible release or disclosure of information is discovered
(answer) breach
, 15.What standard transactions is NOT included in EDI and adopted
under HIPAA(answer) waiver of liability
16.The Federal False Claim Act allows for claims to be reviewed for
a standard of how many years after an incident(answer) 7
17.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(answer) anti kickback
laws
18.A private practice hires a consultant to come in and audit some
medical records. Under the Privacy Rule, what is this consultant
considered(answer) biz associate
19.Medicare overpayments should be returned within days after the
overpayment has been identified (answer) 60
20.HIPAA mandated what entity to adopt national standards for
electronic transactions and code sets(answer) HHS
21.Entities that have been identified as having improper billing practices
is defined by CMS as a violation of what standard(answer) abuse
22.In addition to the standardization of the codes (ICD-10, CPT, HCPCS,
and NDC) used to request payment for medical services, what must be
used on all transactions for employers and providers(answer) unique id
1. Health plan, clearinghouses, and any entity transmitting health
informa- tion is considered by the Privacy Rule to be a (answer) covered
entity
2. Which of the following is not a covered entity in the Privacy Rule
(answer) health- care consulting firm
3. A request for medical records is received for a specific date of service
from patient's insurance company with regards to a submitted claim. No
authorization for release of information is provided. What action should
be taken(answer) release reqt to ins co
4. How many national priority purposes under the Privacy Rules for disclo-
sure of specific PHI without an individual's authorization or
permission(answer) 12
5. A health plan sends a request for medical records in order to adjudicate
a claim. Does the office have to notify the patient or have them sign a
release to send the information(answer) no
6. A practice sets up a payment plan with a patient. If more than four
install- ments are extended to the patient, what regulation is the practice
subject to that makes the practice a creditor(answer) Truth in Lending
Act
7. Which of the following situations allows release of PHI without
authoriza- tion from the patient(answer) workers comp
,8. misusing any information on the claim, charging excessively for
services or supplies, billing for services not medically necessary, failure to
maintain adequate medical or financial records, improper billing practices,
or billing Medicare patients at a higher fee scale that non-Medicare
patients (answer) abuse
9. A claim is submitted for a patient on Medicare with a higher fee than
a patient on Insurance ABC. What is this considered by CMS(answer)
abuse
10.According to the Privacy Rule, what health information may not
be de-identified(answer) phys provider number
11.making false statements or misrepresenting facts to obtain an unde-
served benefit or payment from a federal healthcare program (answer)
fraud
12.All the following are considered Fraud, EXCEPT (answer) inadequate
med recd
13.A hospital records transporter is moving medical records from the
hos- pital to an off-site building. During the transport, a chart falls from the
box on to the street. It is discovered when the transporter arrives at the
off-site building and the number of charts is not correct. What type of
violation is this(answer) breach
14.impermissible release or disclosure of information is discovered
(answer) breach
, 15.What standard transactions is NOT included in EDI and adopted
under HIPAA(answer) waiver of liability
16.The Federal False Claim Act allows for claims to be reviewed for
a standard of how many years after an incident(answer) 7
17.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(answer) anti kickback
laws
18.A private practice hires a consultant to come in and audit some
medical records. Under the Privacy Rule, what is this consultant
considered(answer) biz associate
19.Medicare overpayments should be returned within days after the
overpayment has been identified (answer) 60
20.HIPAA mandated what entity to adopt national standards for
electronic transactions and code sets(answer) HHS
21.Entities that have been identified as having improper billing practices
is defined by CMS as a violation of what standard(answer) abuse
22.In addition to the standardization of the codes (ICD-10, CPT, HCPCS,
and NDC) used to request payment for medical services, what must be
used on all transactions for employers and providers(answer) unique id
