CPB Final Exam questions with correct answers

A practice agrees to pay $250,000.00 to settle a lawsuit alleging that the practice used x-rays of one patient to justify services on multiple other patients' claims. The office manager brought the civil suit. What type of case is this? Answer Qui Tam In which of the following circumstances may PHI not be disclosed without the patient's authorization or permission? Answer An office receives a call from the patient's husband asking for information about his wife's recent office visit. According to the Privacy Rule, what must a Business Associate and a Covered Entity have in order to do business? Answer A contract HMO plans require the enrollee to: Answer To have referrals to see a specialist that is generated by the patient's primary care provider. Which of the following is NOT a component of the PPO payer model? Answer Require the enrollee to maintain a Primary Care Provider. Under the Privacy Rule a health plan, clearinghouses, and any entity transmitting health information is considered? Answer Covered entity A request for medical records is received for a specific date of service from a 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 the requested records to the insurance company. Which of the following situations allows the release of PHI without au