Exam (elaborations)
NHA CBCS PRACTICE TESTS 2024 Actual Questions with Verified Answers, 100% Guarantee Pass
- Course
- Institution
NHA CBCS PRACTICE TESTS 2024 Actual Questions with Verified Answers, 100% Guarantee Pass
[Show more]
Content preview
NHA NEW CBCS PRACTICE TESTS- study.pdf file:///C:/Users/HP/Desktop/SSSSSSS/NHA%20NEW%20CBCS%NHA NEW CBCS PRACTICE TESTS- STUDY
1. Medical Ethics: Standards of conduct based on moral principles. Generally accepted as
a guide for behavior towards patients, physicians, co-workers, the government, and
insurance compaines.
2. Compliance Regulations: billing-related cases are based on HIPAA and False Claims Act.
3. Health Insurance Portability and Accountability Act of 1996 (HIPPA): Created the Health
Care Frad and Abuse Control Prpgram enacted nt check for fraud and abuse in the Medicare
and Medicaid programs, and private payers.
4. Two provisions of HIPPA: Titile I: Insurance Reform Title II:
Administrative Simplification
5. Insurance Reform. -Primary purpose to provide continuous insurance cov- erage for
workers and their dependents when they change or lose their jobs.-
: -Limits the use of preexisting conditions exclusions
-Prohibits discrimination for part or present poor health
-Guarantees cetraom employees and individuals the right to purchase health insur- ance coverage
after losing a job
1 of 59 8/30/2024, 3:30
,NHA NEW CBCS PRACTICE TESTS- study.pdf file:///C:/Users/HP/Desktop/SSSSSSS/NHA%20NEW%20CBCS%
- Allows renewal of health insurance coverage regardless of an individual's health condition that
is covered under the particular policy
6. Administrative Simplification-The goal is to focus on the health care prac- tice setting
to reduce administrative cost and burdens.: Two parts:
1. Development and implementation of standardized health-related financial and
administrative activities electronically.
2. Implementation of privacy and security procedures to prevent the misuse of health information
by ensuring confidentiality.
7. False Claim Act (FCA): Federal law that prohibits submittimg a fraudulent claim or making
statement or representation in connection with a claim.
8. National Correct Coding Initiative (NCCI): Developed by the CMS to promote national
correct coding methodologies and to control improper coding that leads to inappropriate
payment of part B health insurance claims.
9. Two type of NCCA edits - 1. Column 1 /Column 2 or Comprehensive Com- ponent Edits
identifies code pairs that should not be billed together because one code. Column 1
includes all the services described by another code in Column 2.: 2. Mutually Exclusive
Edits: identifies code pairs that, for clinical reason, are unlikely to be performed on the same
patient on the same day.
2 of 59 8/30/2024, 3:30
,NHA NEW CBCS PRACTICE TESTS- study.pdf file:///C:/Users/HP/Desktop/SSSSSSS/NHA%20NEW%20CBCS%
10. Office of Inspector General (OIG): Investigates and prosecute health care fraud and
abuse.
11. Fraud: Knowingly and intentionally deceiving or misrepresenting information that may
result in unauthorized benefits.
3 of 59 8/30/2024, 3:30
,NHA NEW CBCS PRACTICE TESTS- study.pdf file:///C:/Users/HP/Desktop/SSSSSSS/NHA%20NEW%20CBCS%
12. Abuse: Defined as incidents or practices, not usually considered fradulaent that are
inconsistant with the accepted medical business or fiscal practices in the industry.
13. Patient Confidentiality- All patients have the right to privacy, and all in- formation
should remain privileged.: Discuss patient information with only the patient's physician or
office personnel that need cetain information to do their job. Obtained a signed consent form
to release medical infomation to the insurance company or other individual.
14. Under HIPPA Privacy Rule, providers may use patient's Protected Health Information
(PHI) without specific authorization for: Treatment: primarily for the purpose of discussion
fo the patient's case with other providers.
Payment: providers submit claims on behalf of patients.
Operations: for purposes such as stafff training and quality improvment.
15. Employern Liability: Physicians are legally responsible for their own conduct and any
action of their employees (their designee) perform within the context of their employment.
Refered to as "vacarious liability"also known as "respondent superior" which means "let the
master answer".
16. Employee Liabiltiy: "Errors and omissions insurance" is protection against loss of monies
by failure through error or unintentional omission on the part of the individual or service
4 of 59 8/30/2024, 3:30
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller TIPSCORE. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $12.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
72964 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now