@PROFDOCDIGITALLIBRARIES
AAPC CPB Final Exam-with 100% verified solutions-2024/
2025
Complete Guide A+
Health plan, clearinghouses, and any entity transmitting health information is considered by the
Privacy Rule to be a:
covered entity
Which of the following is not a covered entity in the Privacy Rule
healthcare consulting firm
PR
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?
release reqt to ins co
O
How many national priority purposes under the Privacy Rules for disclosure of specific PHI without
FD
an individual's authorization or permission?
12
O
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?
no
C
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?
Truth in Lending Act
Which of the following situations allows release of PHI without authorization from the patient?
workers comp
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.
, @PROFDOCDIGITALLIBRARIES
abuse
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?
abuse
According to the Privacy Rule, what health information may not be de-identified?
phys provider number
making false statements or misrepresenting facts to obtain an undeserved benefit or payment from
PR
a federal healthcare program
fraud
All the following are considered Fraud, EXCEPT:
O
inadequate med recd
FD
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?
O
breach
C
impermissible release or disclosure of information is discovered
breach
What standard transactions is NOT included in EDI and adopted under HIPAA?
waiver of liability
The Federal False Claim Act allows for claims to be reviewed for a standard of how many years after
an incident?
7
AAPC CPB Final Exam-with 100% verified solutions-2024/
2025
Complete Guide A+
Health plan, clearinghouses, and any entity transmitting health information is considered by the
Privacy Rule to be a:
covered entity
Which of the following is not a covered entity in the Privacy Rule
healthcare consulting firm
PR
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?
release reqt to ins co
O
How many national priority purposes under the Privacy Rules for disclosure of specific PHI without
FD
an individual's authorization or permission?
12
O
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?
no
C
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?
Truth in Lending Act
Which of the following situations allows release of PHI without authorization from the patient?
workers comp
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.
, @PROFDOCDIGITALLIBRARIES
abuse
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?
abuse
According to the Privacy Rule, what health information may not be de-identified?
phys provider number
making false statements or misrepresenting facts to obtain an undeserved benefit or payment from
PR
a federal healthcare program
fraud
All the following are considered Fraud, EXCEPT:
O
inadequate med recd
FD
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?
O
breach
C
impermissible release or disclosure of information is discovered
breach
What standard transactions is NOT included in EDI and adopted under HIPAA?
waiver of liability
The Federal False Claim Act allows for claims to be reviewed for a standard of how many years after
an incident?
7
