AAPC CPB - Chapter 1 Review 100%
Accurate!!
What does the acronym PHI stand for?
a. Patient Healthcare Information
b. Patient History of Illness
c. Protected Health Information
d. Protected Healthcare Index - ANSWERSc. 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 - ANSWERSc. 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 - ANSWERSc. 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. - ANSWERSc. 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 - ANSWERSb. 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 - ANSWERSd. 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 - ANSWERSb. 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 - ANSWERSd. A contract with specific
safeguards on the individually identifiable health information used or disclosed by the
business associate
A records request is received from a health plan for three dates of service in a chart
months apart. What should the biller do?
a. Copy the entire chart and send it to make sure that the health plan has everything
they need and will not request more records.
b. Copy everything from the first date through the third date, even if it is not included to
cover the timeframe the health plan is looking at for the request.
c. Copy each date of service and black out all identifying information in the copies
before sending to the health plan.
d. Copy each date of service individually and send to the health plan. - ANSWERSd.
Copy each date of service individually and send to the health plan
Accurate!!
What does the acronym PHI stand for?
a. Patient Healthcare Information
b. Patient History of Illness
c. Protected Health Information
d. Protected Healthcare Index - ANSWERSc. 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 - ANSWERSc. 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 - ANSWERSc. 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. - ANSWERSc. 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 - ANSWERSb. 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 - ANSWERSd. 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 - ANSWERSb. 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 - ANSWERSd. A contract with specific
safeguards on the individually identifiable health information used or disclosed by the
business associate
A records request is received from a health plan for three dates of service in a chart
months apart. What should the biller do?
a. Copy the entire chart and send it to make sure that the health plan has everything
they need and will not request more records.
b. Copy everything from the first date through the third date, even if it is not included to
cover the timeframe the health plan is looking at for the request.
c. Copy each date of service and black out all identifying information in the copies
before sending to the health plan.
d. Copy each date of service individually and send to the health plan. - ANSWERSd.
Copy each date of service individually and send to the health plan
