CPB Final Exam comprehensive questions |
FREQUENTLY MOST TESTED QUESTIONS AND
VERIFIED SOLUTIONS/GET IT 100% ACCURATE!!
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Terms in this set (140)
A practice agrees to pay Qui Tam
$250,000.00 to settle a
lawsuit alleging that the
practice used x-rays of
one patient to justify
services on multiple other
patients' claims. The office
manager brought the civil
suit. What type of case is
this?
In which of the following An office receives a call from the patient's husband
circumstances may PHI asking for information about his wife's recent office
not be disclosed without visit.
the patient's authorization
or permission?
According to the Privacy A contract
Rule, what must a Business
Associate and a Covered
Entity have in order to do
business?
,HMO plans require the To have referrals to see a specialist that is generated
enrollee to: by the patient's primary care provider.
Which of the following is Require the enrollee to maintain a Primary Care
NOT a component of the Provider.
PPO payer model?
Under the Privacy Rule a Covered entity
health plan,
clearinghouses, and any
entity transmitting health
information is considered?
A request for medical Release the requested records to the insurance
records is received for a company.
specific date of service
from a patient's insurance
company with regards to a
submitted claim. No
authorization for release
of information is provided.
What action should be
taken?
Which of the following Workers' Compensation
situations allows the
release of PHI without
authorization from the
patient?
HIPAA mandated what HHS
entity to adopt national
standards for electronic
transactions and code
sets?
What is the standard time There is no single standard for record retention; it
frame established for varies by state and federal regulations.
record retention?
, CMS defines _______ as Fraud
billing for a lower level of
care than is supported in
documentation, making
false statements to obtain
undeserved benefits or
payment from a federal
healthcare program, or
billing for a service that
was not performed.
A claim is submitted for a Abuse
patient on Medicare with a
higher fee than a patient
on Insurance ABC. What is
this considered by CMS?
A person that files a claim False Claims Act
for a Medicare Beneficiary
knowing that the service is
not correctly reported is
in violation of what
statute?
Which of the following Up-coding or unbundling services
actions is considered
under the False Claims
Act?
A practice sets up a Truth in Lending Act
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?
FREQUENTLY MOST TESTED QUESTIONS AND
VERIFIED SOLUTIONS/GET IT 100% ACCURATE!!
Save
Terms in this set (140)
A practice agrees to pay Qui Tam
$250,000.00 to settle a
lawsuit alleging that the
practice used x-rays of
one patient to justify
services on multiple other
patients' claims. The office
manager brought the civil
suit. What type of case is
this?
In which of the following An office receives a call from the patient's husband
circumstances may PHI asking for information about his wife's recent office
not be disclosed without visit.
the patient's authorization
or permission?
According to the Privacy A contract
Rule, what must a Business
Associate and a Covered
Entity have in order to do
business?
,HMO plans require the To have referrals to see a specialist that is generated
enrollee to: by the patient's primary care provider.
Which of the following is Require the enrollee to maintain a Primary Care
NOT a component of the Provider.
PPO payer model?
Under the Privacy Rule a Covered entity
health plan,
clearinghouses, and any
entity transmitting health
information is considered?
A request for medical Release the requested records to the insurance
records is received for a company.
specific date of service
from a patient's insurance
company with regards to a
submitted claim. No
authorization for release
of information is provided.
What action should be
taken?
Which of the following Workers' Compensation
situations allows the
release of PHI without
authorization from the
patient?
HIPAA mandated what HHS
entity to adopt national
standards for electronic
transactions and code
sets?
What is the standard time There is no single standard for record retention; it
frame established for varies by state and federal regulations.
record retention?
, CMS defines _______ as Fraud
billing for a lower level of
care than is supported in
documentation, making
false statements to obtain
undeserved benefits or
payment from a federal
healthcare program, or
billing for a service that
was not performed.
A claim is submitted for a Abuse
patient on Medicare with a
higher fee than a patient
on Insurance ABC. What is
this considered by CMS?
A person that files a claim False Claims Act
for a Medicare Beneficiary
knowing that the service is
not correctly reported is
in violation of what
statute?
Which of the following Up-coding or unbundling services
actions is considered
under the False Claims
Act?
A practice sets up a Truth in Lending Act
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?
