MEDICAL BILLING QUESTIONS AND
ANSWERS WITH SOLUTIONS 2024
AMA - ANSWER American Medical Association
cash flow - ANSWER The amount of actual money available to the medical practice
ethics - ANSWER Standards of conduct generally accepted as a moral guide for behavior.
etiquette - ANSWER customs, rules of conduct, courtesy, and manners of the medical profession
HIPAA - ANSWER Health Information Portability and Accountability Act
abuse - ANSWER Incidents or practices, not usually considered fraudulent, that are inconsistent with
accepted sound medical business or fiscal practices.
authorization form - ANSWER A document signed by the patient that is needed for use and disclosure of
protected health information for purposes other than treatment, payment or health care operations
breach of confidential communication - ANSWER unauthorized release of information
business associate - ANSWER A person, who on behalf of the covered entity, performs or assists in the
performance of a function or activity involving the use or disclosure of individually identifieable health
information.
clearinghouse - ANSWER An independent organization that receives insurance claims from the
physician's office, performs software edits, and redistributes the claims electronically to various
insurance carriers.
compliance - ANSWER A process of meeting regulations, recommendations, and expectations of federal
and state agencies that pay for health care services and regulate the industry
, compliance plan - ANSWER A management plan composed of policies and procedures to accomplish
uniformity, consistency, and conformity in medical record keeping that fulfills offical requirements.
confidential communication - ANSWER A privileged communication that may be disclosed only with the
patient's permission.
confidentiality - ANSWER The state of treating privately or secretly, and not disclosing to other
individuals or for public knowledge, the patient's conversations or medical records.
consent - ANSWER Verbal or written agreement that gives approval to some action, situation, or
statement.
consent form - ANSWER A document that is not required before physicians use or disclose protected
health information for treatment, payment, or routine health care operations of the patient. (For other
purposes, see Authorization form)
covered entity - ANSWER An entity that transmits health information in electronic form in connection
with a transaction covered by HIPAA. The covered entity may be a helath care coverage carrier such as
Blue Cross, a health care clearinghouse through which claims are submitted, or a health care provider
such as the primary care physician.
disclosure - ANSWER The release, transfer, provision of access to, or divulging in any other manner of
information outside the entity holding the information.
e-health information management - ANSWER Any and all transations in which health care information is
accessed, processed, stored, and transferred using electronic technologies.
electronic media - ANSWER The mode of electronic transmission (e.g. Internet, extranet, leased phone
or dial-up phone lines, fax modems).
embezzlement - ANSWER A willful act by an employee of taking possession of an employer's money
fraud - ANSWER An intentional misrepresentation of the facts to deceive or mislead another.
ANSWERS WITH SOLUTIONS 2024
AMA - ANSWER American Medical Association
cash flow - ANSWER The amount of actual money available to the medical practice
ethics - ANSWER Standards of conduct generally accepted as a moral guide for behavior.
etiquette - ANSWER customs, rules of conduct, courtesy, and manners of the medical profession
HIPAA - ANSWER Health Information Portability and Accountability Act
abuse - ANSWER Incidents or practices, not usually considered fraudulent, that are inconsistent with
accepted sound medical business or fiscal practices.
authorization form - ANSWER A document signed by the patient that is needed for use and disclosure of
protected health information for purposes other than treatment, payment or health care operations
breach of confidential communication - ANSWER unauthorized release of information
business associate - ANSWER A person, who on behalf of the covered entity, performs or assists in the
performance of a function or activity involving the use or disclosure of individually identifieable health
information.
clearinghouse - ANSWER An independent organization that receives insurance claims from the
physician's office, performs software edits, and redistributes the claims electronically to various
insurance carriers.
compliance - ANSWER A process of meeting regulations, recommendations, and expectations of federal
and state agencies that pay for health care services and regulate the industry
, compliance plan - ANSWER A management plan composed of policies and procedures to accomplish
uniformity, consistency, and conformity in medical record keeping that fulfills offical requirements.
confidential communication - ANSWER A privileged communication that may be disclosed only with the
patient's permission.
confidentiality - ANSWER The state of treating privately or secretly, and not disclosing to other
individuals or for public knowledge, the patient's conversations or medical records.
consent - ANSWER Verbal or written agreement that gives approval to some action, situation, or
statement.
consent form - ANSWER A document that is not required before physicians use or disclose protected
health information for treatment, payment, or routine health care operations of the patient. (For other
purposes, see Authorization form)
covered entity - ANSWER An entity that transmits health information in electronic form in connection
with a transaction covered by HIPAA. The covered entity may be a helath care coverage carrier such as
Blue Cross, a health care clearinghouse through which claims are submitted, or a health care provider
such as the primary care physician.
disclosure - ANSWER The release, transfer, provision of access to, or divulging in any other manner of
information outside the entity holding the information.
e-health information management - ANSWER Any and all transations in which health care information is
accessed, processed, stored, and transferred using electronic technologies.
electronic media - ANSWER The mode of electronic transmission (e.g. Internet, extranet, leased phone
or dial-up phone lines, fax modems).
embezzlement - ANSWER A willful act by an employee of taking possession of an employer's money
fraud - ANSWER An intentional misrepresentation of the facts to deceive or mislead another.
