AAPC CPB - Chapter 1 Review Exam Questions and Answers

What does the acronym PHI stand for? a. Patient Healthcare Information b. Patient History of Illness c. Protected Health Information d. Protected Healthcare Index - Answer- c. Protected Health Information 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. Stark Laws b. HIPAA c. Anti-Kickback law d. Qui Tam - Answer- c. Anti-Kickback law Which of the following is NOT a component of the Preferred Provider Organizations (PPO) payer model? a. Offer a discounted fee schedule b. Operate within networks c. Require the enrollee to maintain a PCP d. Utilization of preferred providers - Answer- c. Require the enrollee to maintain a PCP In which of the following circumstances may PHI not be disclosed without the patient's authorization or permission? a. An office receives a court order. b. An office receives requests for medical records for a Medicare audit. c. An office receives a call from a patient's husband asking for information about his wife's recent office visit. d. An office releases patient information to the Coroner's office upon the death of a patient. - Answer- c. An office receives a call from a patient's husband asking for information about his wife's recent office visit. Which of the following is not a covered entity in the Privacy Rule? a. Commercial insurance company b. A healthcare consulting firm c. A Pediatric practice d. A billing service - Answer- b. A healthcare consulting firm What types of entities do conditions of participation (CoP) apply to for health plans? I. Hospitals II. Clinics III. Transplant centers IV. Psychiatric hospitals a. I, II, III b. I, III, IV c. II, III, IV d. I, II, III, IV - Answer- d. I, II, III, IV When a practice sends an electronic claim to a commercial health plan for payment, what is this considered? a. A code set b. A transaction c. A data set d. Minimum necessary - Answer- b. A transaction According to the Privacy Rule, what must a Business Associate and covered entity have in order to do business? a. A mutually exclusive agreement describing the services that will be rendered by the business associate b. A notice of privacy c. A background check of both parties to ensure full disclosure d. A contract with specific safeguards on the individually identifiable health information used or disclosed by the business associate - Answer- d. A contract with specific safeguards on the individually identifiable health information used or disclosed by the business associate