AAPC CPB Final Exam (Answered 100% Correctly)

AAPC CPB Final Exam (Answered 100% Correctly) 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 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 How many national priority purposes under the Privacy Rules for disclosure of specific PHI without an individual's authorization or permission? 12 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 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. 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 a federal healthcare program