AAPC CPB - CHAPTER 3: QUESTIONS WITH CORRECT ANSWERS

Which of the following does NOT qualify a patient for coverage under Medicare? a. End Stage Renal Disease (ESRD) b. Age 65 or older c. Under age 65 with disabilities d. Low income individual - Answer- d. Low income individual The insurance claim process begins with: a. Patient information b. Charge entry c. Scheduling an appointment d. Submitting a claim - Answer- c. Scheduling an appointment Which of the following statements is TRUE regarding patient demographics? a. Demographic information can only be provided by the patient b. Patient demographic information can be released to a third party c. Patient demographic information entered incorrectly can result in claim denials d. Claim processing is not affected by patient demographic information - Answer- c. Patient demographic information entered incorrectly can result in claim denials Patient insurance card will contain vital information that will allow a claim to be processed. Which of the following is NOT provided on the insurance card? a. Policy holder, group number b. Claim number, CPT code, diagnosis c. Policy holder, copay, deductible d. Claims address, Group number - Answer- b. Claim number, CPT code, diagnosis A child is brought in by the mother to be seen. The mother (DOB 02/08/83) is the custodial parent and is remarried. She has an individual policy. The father (DOB 10/10/82) is covered by a policy from work. The step-father is also covered at work. Which of the following is correct? a. The mother's insurance is primary b. The step-parent is primary c. The father is always primary d. Either the mother or the father can be primary - Answer- a. The mother's insurance is primary Listed below are examples of patient reminders for appointments. Which one is HIPAA compliant? a. "This is the obstetrical office calling to remind you of your appointment Tuesday, April 12 at 9 am for your annual exam." b. "This is Dr. Smith's office calling to remind you of your appointment Tuesday, April 12 at 9 am for your annual exam." c. "This is to confirm your appointment for your first prenatal visit with Dr. Jones. Please notify us if you are not able to keep this appointment." d. "This is the doctor's office calling to remind you of your appointment Tuesday, April 12 at 9 am." - Answer- d. "This is the doctor's office calling to remind you of your appointment Tuesday, April 12 at 9 am." Child presents for care with the father. Both parents have coverage, date of birth for mother is 3/21 and date of birth for father is 6/20. The mother is covered by a COBRA. What is the primary coverage for the child? a. The mother's coverage is primary based on the birthday rule. b. The father's insurance is primary because the mother has COBRA c. The father is primary because he is older d. The father's is primary because he consented for care. - Answer- b. The father's insurance is primary because the mother has COBRA The parent with which the child resides is considered to be a: a. Step-parent b. Non-custodial parent c. Custodial parent d. Natural parent - Answer- c. Custodial parent HIPAA Section 164.508 states that covered entities may not use or disclose protected information without a valid auth