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Exam (elaborations)

AAPC CPB Final Exam Study Guide Solutions

  • Course
  • CPB
  • Institution
  • CPB

AAPC CPB Final Exam Study Guide Solutions covered entity - ANSWER-Health plan, clearinghouses, and any entity transmitting health information is considered by the Privacy Rule to be a: healthcare consulting firm - ANSWER-Which of the following is not a covered entity in the Privacy Rule relea...

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  • October 30, 2024
  • 24
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • CPB
  • CPB
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Emillect
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AAPC CPB Final Exam Study Guide

Solutions


covered entity - ANSWER✔✔-Health plan, clearinghouses, and any entity transmitting health

information is considered by the Privacy Rule to be a:


healthcare consulting firm - ANSWER✔✔-Which of the following is not a covered entity in the Privacy

Rule


release reqt to ins co - ANSWER✔✔-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?


12 - ANSWER✔✔-How many national priority purposes under the Privacy Rules for disclosure of specific

PHI without an individual's authorization or permission?


no - ANSWER✔✔-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?




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Truth in Lending Act - ANSWER✔✔-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?


workers comp - ANSWER✔✔-Which of the following situations allows release of PHI without

authorization from the patient?


abuse - ANSWER✔✔-Entities that have been identified as having improper billing practices is defined by

CMS as a violation of what standard?


abuse - ANSWER✔✔-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 - ANSWER✔✔-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?


phys provider number - ANSWER✔✔-According to the Privacy Rule, what health information may not be

de-identified?


fraud - ANSWER✔✔-making false statements or misrepresenting facts to obtain an undeserved benefit

or payment from a federal healthcare program


inadequate med recd - ANSWER✔✔-All the following are considered Fraud, EXCEPT:



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breach - ANSWER✔✔-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?


breach - ANSWER✔✔-impermissible release or disclosure of information is discovered


waiver of liability - ANSWER✔✔-What standard transactions is NOT included in EDI and adopted under

HIPAA?


7 - ANSWER✔✔-The Federal False Claim Act allows for claims to be reviewed for a standard of how many

years after an incident?


anti kickback laws - ANSWER✔✔-A new radiology company opens in town. The manager calls your

practice and offers to pay $20 for every Medicare patient you send to them for radiology services. What

does this offer violate?


biz associate - ANSWER✔✔-A private practice hires a consultant to come in and audit some medical

records. Under the Privacy Rule, what is this consultant considered?


60 - ANSWER✔✔-Medicare overpayments should be returned within ___ days after the overpayment

has been identified




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