AAPC CPB - CHAPTER 1: QUESTIONS and study guide 2023/2o24

Eight standard transactions were adopted for Electronic Data Interchange (EDI) under HIPAA. Which of the following is NOT included as a standard transaction? a. Payment and remittance advice b. Eligibility in a health plan c. Coordination of benefits d. Physician unique identifier number - correct answer d. Physician unique identifier number A claim is received by a payer that subsequently requests the medical records for the date of service on the claim. What procedure should be followed by the practice? a. Only the date of service on the claim should be sent to the payer b. The records for the claim can be sent after authorization is received from the patient c. The entire patient record should be sent as part of HIPAA based on treatment, payment and operations d. The payer is required to provide authorization signed from the patient prior to requesting the medical records - correct answer a. Only the date of service on the claim should be sent to the payer.