AAPC CPB Medical Billing Chapter 1
Intro to Healthcare Exam 100% Correct!!
Stablization Act - 1942 - ANSWERS1. Wages and price controls were placed on
employers
2. Congress limited the wages that could be offered, but allowed the adoption of
employee insurance plans
Internal Revenue Code - 1954 - ANSWERSStated employer contributions to employee
health plans were exempt from employee taxable income
When was Medicare established? - ANSWERS1965
Medicare Part A - ANSWERSThe part of the Medicare program that pays for
hospitalization, care in a skilled nursing facility, home health care, and hospice care.
When are you eligible for medicare? - ANSWERSAge 65
Medicare Part B - ANSWERSThe part of the Medicare program that pays for physician
services, outpatient hospital services, durable medical equipment, and other services
and supplies.
HMO - ANSWERShealth maintenance organization
What was the purpose of health maintenance organization? - ANSWERS1. To try help
try to control healthcare cost
2. Overode state laws that prohibited the establishment of prepaid health plans
3. Required employers with 25 or more employees to offer an HMO option if they
furnished healthcare coverage to their employees
HIPPAA - ANSWERSHealth Insurance Portability and Accountability Act
What did HIPPA provide? - ANSWERS1. Rights and protections for participants and
beneficiaries of group health plans
2. exclusions for pre-existing conditions were limited, and discrimination against
employees and dependents basted on their health status were prohibited
HCFAC - ANSWERSHealth Care Fraud and Abuse Control Program
, What is the health care fraud and abuse control program? - ANSWERSa far reaching
program to combat fraud and abuse in healthcare including both public and private
health plans
What was HCFAC designed to do? - ANSWERScoordinate federal, state and local law
enforcement activities with respect to healthcare fraud and abuse
HHS - ANSWERSHealth and Human Services
DOJ - ANSWERSDepartment of Justice
What is required annually from the HHS and DOJ? - ANSWERSannual report detailing
the efforts and recoveries made by the HCFAC program
HIPPAA Administrative Simplification provisions required what? - ANSWERSSections of
the law be publicized to explain the standards for the electronic exchange, privacy, and
security of health information
Privacy rule of HIPAA - ANSWERS-protects all individually identifiable health
information held or transmitted by a hospital (or other covered entity/business
associate) in any form of media.
-privacy rule call this information protected health information (PHI)
PHI - ANSWERSProtected Health Information
Examples of common identifiers - ANSWERS- demographic data, name, address, birth
date, and social security numbers.
- Also includes information relates to an individual's past, present, and future physical or
mental health or condition
- the provision of health care to the individual
- the past, present, or future payment for the provision of healthcare to the individual
Health Information - ANSWERSany information, whether oral or recorded in any form or
medium, that
A. is created or received by a healthcare provider, health plan, public health authority,
employer, life insurer, school or university, or healthcare clearinghouse
B. relates to the past, present, or future physical or mental health or condition of an
individual; the provision of healthcare to an individual; or the past, present, or future
payment for the provision of healthcare to an individual
individually identifiable health information - ANSWERSAny part of an individual's health
information, including demographic information collected from the individual, that is
created or received by a covered entity.
covered entities under HIPAA - ANSWERShealth plans, healthcare clearinghouses, and
any healthcare provider who transmits health information in an electronic format
Intro to Healthcare Exam 100% Correct!!
Stablization Act - 1942 - ANSWERS1. Wages and price controls were placed on
employers
2. Congress limited the wages that could be offered, but allowed the adoption of
employee insurance plans
Internal Revenue Code - 1954 - ANSWERSStated employer contributions to employee
health plans were exempt from employee taxable income
When was Medicare established? - ANSWERS1965
Medicare Part A - ANSWERSThe part of the Medicare program that pays for
hospitalization, care in a skilled nursing facility, home health care, and hospice care.
When are you eligible for medicare? - ANSWERSAge 65
Medicare Part B - ANSWERSThe part of the Medicare program that pays for physician
services, outpatient hospital services, durable medical equipment, and other services
and supplies.
HMO - ANSWERShealth maintenance organization
What was the purpose of health maintenance organization? - ANSWERS1. To try help
try to control healthcare cost
2. Overode state laws that prohibited the establishment of prepaid health plans
3. Required employers with 25 or more employees to offer an HMO option if they
furnished healthcare coverage to their employees
HIPPAA - ANSWERSHealth Insurance Portability and Accountability Act
What did HIPPA provide? - ANSWERS1. Rights and protections for participants and
beneficiaries of group health plans
2. exclusions for pre-existing conditions were limited, and discrimination against
employees and dependents basted on their health status were prohibited
HCFAC - ANSWERSHealth Care Fraud and Abuse Control Program
, What is the health care fraud and abuse control program? - ANSWERSa far reaching
program to combat fraud and abuse in healthcare including both public and private
health plans
What was HCFAC designed to do? - ANSWERScoordinate federal, state and local law
enforcement activities with respect to healthcare fraud and abuse
HHS - ANSWERSHealth and Human Services
DOJ - ANSWERSDepartment of Justice
What is required annually from the HHS and DOJ? - ANSWERSannual report detailing
the efforts and recoveries made by the HCFAC program
HIPPAA Administrative Simplification provisions required what? - ANSWERSSections of
the law be publicized to explain the standards for the electronic exchange, privacy, and
security of health information
Privacy rule of HIPAA - ANSWERS-protects all individually identifiable health
information held or transmitted by a hospital (or other covered entity/business
associate) in any form of media.
-privacy rule call this information protected health information (PHI)
PHI - ANSWERSProtected Health Information
Examples of common identifiers - ANSWERS- demographic data, name, address, birth
date, and social security numbers.
- Also includes information relates to an individual's past, present, and future physical or
mental health or condition
- the provision of health care to the individual
- the past, present, or future payment for the provision of healthcare to the individual
Health Information - ANSWERSany information, whether oral or recorded in any form or
medium, that
A. is created or received by a healthcare provider, health plan, public health authority,
employer, life insurer, school or university, or healthcare clearinghouse
B. relates to the past, present, or future physical or mental health or condition of an
individual; the provision of healthcare to an individual; or the past, present, or future
payment for the provision of healthcare to an individual
individually identifiable health information - ANSWERSAny part of an individual's health
information, including demographic information collected from the individual, that is
created or received by a covered entity.
covered entities under HIPAA - ANSWERShealth plans, healthcare clearinghouses, and
any healthcare provider who transmits health information in an electronic format
