AAPC CPB Final| 198 QUESTIONS| WITH COMPLETE SOLUTIONS

covered entity correct answer: Health plan, clearinghouses, and any entity transmitting health information is considered by the Privacy Rule to be a: healthcare consulting firm correct answer: Which of the following is not a covered entity in the Privacy Rule release reqt to ins co correct answer: 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? 12 correct answer: How many national priority purposes under the Privacy Rules for disclosure of specific PHI without an individual's authorization or permission? no correct answer: 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? Truth in Lending Act correct answer: A practice sets up a payment plan with a patient. If more than four installments are extended to the patient, what regulation is the practice subject to that makes the practice a creditor? workers comp correct answer: Which of the following situations allows release of PHI without authorization from the patient? abuse correct answer: Entities that have been identified as having improper billing practices is defined by CMS as a violation of what standard? abuse correct answer: 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. abuse correct answer: 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? phys provider number correct answer: According to the Privacy Rule, what health information may not be de-identified? fraud correct answer: making false statements or misrepresenting facts to obtain an undeserved benefit or payment from a federal healthcare program inadequate med recd correct answer: All the following are considered Fraud, E