AAPC CPB - Chapter 1 Review Updated 2024/2025 Actual Questions and answers with complete solutions
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Course
AAPC CPB
Institution
AAPC CPB
CMS defines ___________ as 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 services that were not performed.
a. Fraud
b. Abuse
c. a Stark violation
d. an An...
AAPC CPB - Chapter 1 Review CMS defines ___________ as 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 services that were not performed. a. Fraud b. Abuse c. a Stark violation d. an Anti -kickback - Answer -a. Fraud A patient is seen in your clinic. Her husband calls later in the day to ask for information about the visit. The practice pulls the patient's privacy authorization to see if they can speak to the husband. What act does this action fall under? a. HIPAA b. Social Security Act c. ADA d. Health Information Act - Answer -a. HIPAA A practice agrees to pay $250,000 to settle a lawsuit alleging that the practice used X -rays of one patient to justify services on multiple other patients' claims. The manager of the office brought the civil suit. What type of case is this? a. Qui Tam b. Stark case c. Anti -Kickback d. HIPAA - Answer -a. Qui Tam 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? a. Truth in Lending Act b. False Claims Act c. HIPAA d. Social Security Act - Answer -a. Truth in Lending Act A private practice hires a consultant to come in and audit some medical records. Under the Privacy Rule, what is this consultant considered? a. An employee b. A business associate c. A covered entity d. A clearinghouse - Answer -b. A business associate 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? a. A breach b. A minimum necessary violation c. A disclosure violation d. Fraud - Answer -a. A breach 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.
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