©EMILLECT 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
AAPC CPB Final Exam Study Guide
Solutions
covered entity - ANSWER✔✔-Health plan, clearinghouses, and any entity transmitting health
information is considered by the Privacy Rule to be a:
healthcare consulting firm - ANSWER✔✔-Which of the following is not a covered entity in the Privacy
Rule
release reqt to ins co - ANSWER✔✔-A request for medical records is received for a specific date of
service from patient's insurance company with regards to a submitted claim. No authorization for release
of information is provided. What action should be taken?
12 - ANSWER✔✔-How many national priority purposes under the Privacy Rules for disclosure of specific
PHI without an individual's authorization or permission?
no - ANSWER✔✔-A health plan sends a request for medical records in order to adjudicate a claim. Does
the office have to notify the patient or have them sign a release to send the information?
Page 1/24
, ©EMILLECT 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
Truth in Lending Act - ANSWER✔✔-A practice sets up a payment plan with a patient. If more than four
installments are extended to the patient, what regulation is the practice subject to that makes the
practice a creditor?
workers comp - ANSWER✔✔-Which of the following situations allows release of PHI without
authorization from the patient?
abuse - ANSWER✔✔-Entities that have been identified as having improper billing practices is defined by
CMS as a violation of what standard?
abuse - ANSWER✔✔-misusing any information on the claim, charging excessively for services or supplies,
billing for services not medically necessary, failure to maintain adequate medical or financial records,
improper billing practices, or billing Medicare patients at a higher fee scale that non-Medicare patients.
abuse - ANSWER✔✔-A claim is submitted for a patient on Medicare with a higher fee than a patient on
Insurance ABC. What is this considered by CMS?
phys provider number - ANSWER✔✔-According to the Privacy Rule, what health information may not be
de-identified?
fraud - ANSWER✔✔-making false statements or misrepresenting facts to obtain an undeserved benefit
or payment from a federal healthcare program
inadequate med recd - ANSWER✔✔-All the following are considered Fraud, EXCEPT:
Page 2/24
, ©EMILLECT 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
breach - ANSWER✔✔-A hospital records transporter is moving medical records from the hospital to an
off-site building. During the transport, a chart falls from the box on to the street. It is discovered when
the transporter arrives at the off-site building and the number of charts is not correct. What type of
violation is this?
breach - ANSWER✔✔-impermissible release or disclosure of information is discovered
waiver of liability - ANSWER✔✔-What standard transactions is NOT included in EDI and adopted under
HIPAA?
7 - ANSWER✔✔-The Federal False Claim Act allows for claims to be reviewed for a standard of how many
years after an incident?
anti kickback laws - ANSWER✔✔-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?
biz associate - ANSWER✔✔-A private practice hires a consultant to come in and audit some medical
records. Under the Privacy Rule, what is this consultant considered?
60 - ANSWER✔✔-Medicare overpayments should be returned within ___ days after the overpayment
has been identified
Page 3/24
FIRST PUBLISH OCTOBER 2024
AAPC CPB Final Exam Study Guide
Solutions
covered entity - ANSWER✔✔-Health plan, clearinghouses, and any entity transmitting health
information is considered by the Privacy Rule to be a:
healthcare consulting firm - ANSWER✔✔-Which of the following is not a covered entity in the Privacy
Rule
release reqt to ins co - ANSWER✔✔-A request for medical records is received for a specific date of
service from patient's insurance company with regards to a submitted claim. No authorization for release
of information is provided. What action should be taken?
12 - ANSWER✔✔-How many national priority purposes under the Privacy Rules for disclosure of specific
PHI without an individual's authorization or permission?
no - ANSWER✔✔-A health plan sends a request for medical records in order to adjudicate a claim. Does
the office have to notify the patient or have them sign a release to send the information?
Page 1/24
, ©EMILLECT 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
Truth in Lending Act - ANSWER✔✔-A practice sets up a payment plan with a patient. If more than four
installments are extended to the patient, what regulation is the practice subject to that makes the
practice a creditor?
workers comp - ANSWER✔✔-Which of the following situations allows release of PHI without
authorization from the patient?
abuse - ANSWER✔✔-Entities that have been identified as having improper billing practices is defined by
CMS as a violation of what standard?
abuse - ANSWER✔✔-misusing any information on the claim, charging excessively for services or supplies,
billing for services not medically necessary, failure to maintain adequate medical or financial records,
improper billing practices, or billing Medicare patients at a higher fee scale that non-Medicare patients.
abuse - ANSWER✔✔-A claim is submitted for a patient on Medicare with a higher fee than a patient on
Insurance ABC. What is this considered by CMS?
phys provider number - ANSWER✔✔-According to the Privacy Rule, what health information may not be
de-identified?
fraud - ANSWER✔✔-making false statements or misrepresenting facts to obtain an undeserved benefit
or payment from a federal healthcare program
inadequate med recd - ANSWER✔✔-All the following are considered Fraud, EXCEPT:
Page 2/24
, ©EMILLECT 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED
FIRST PUBLISH OCTOBER 2024
breach - ANSWER✔✔-A hospital records transporter is moving medical records from the hospital to an
off-site building. During the transport, a chart falls from the box on to the street. It is discovered when
the transporter arrives at the off-site building and the number of charts is not correct. What type of
violation is this?
breach - ANSWER✔✔-impermissible release or disclosure of information is discovered
waiver of liability - ANSWER✔✔-What standard transactions is NOT included in EDI and adopted under
HIPAA?
7 - ANSWER✔✔-The Federal False Claim Act allows for claims to be reviewed for a standard of how many
years after an incident?
anti kickback laws - ANSWER✔✔-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?
biz associate - ANSWER✔✔-A private practice hires a consultant to come in and audit some medical
records. Under the Privacy Rule, what is this consultant considered?
60 - ANSWER✔✔-Medicare overpayments should be returned within ___ days after the overpayment
has been identified
Page 3/24
