Eight standard transactions were adopted for Electronic Data Interchange (EDI) under HIPAA. Which of the following is NOT included as a standard transaction? - ANSWERSd. Physician unique identifier number
A claim is received by a payer that subsequently requests the medical records for the date of...
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Eight standard transactions were adopted for Electronic Data Interchange (EDI) under
HIPAA. Which of the following is NOT included as a standard transaction? -
ANSWERSd. Physician unique identifier number
A claim is received by a payer that subsequently requests the medical records for the
date of service on the claim. What procedure should be followed by the practice? -
ANSWERSa. Only the date of service on the claim should be sent to the payer. The
records can be sent as part of HIPAA based on treatment, payment, and operations
(TPO).
HIPAA of 1996 includes a Security Rule that is established to provide what national
standards for protecting and transmitting patient data. Which of the following is NOT
true. - ANSWERSb. The Security Rule applies only to the entity that initiates the release
of protected health information.
When a subpoena is received by the practice for medical records, in what
circumstances may the records be released according to the HIPAA Privacy Rule? -
ANSWERSb. The subpoena is accompanied by a court order or the patient is notified
and given a chance to object.
A physician billed claims to Medicare and Medicaid for procedures that were not
performed on 800 patients resulting in loss of 2.6 million dollars. Is this fraud or abuse?
- ANSWERSb. Fraud; subject to the False Claims Act
HIPAA requires that privacy practice notices be provided in several circumstances.
Which if the following is NOT required? - ANSWERSd. Must be placed into the patient's
file
The regulation of finance charges or interest applied to outstanding balances in the
medical practice is under what law? - ANSWERSa. Truth in Lending Act
Federal healthcare plans include what payers? - ANSWERSb. Medicare, Medicaid,
TRICARE
A physician received office space at a reduced rate for referring patients to the
hospital's out- patient physical therapy center. What Law does this violate? -
ANSWERSa. Anti-Kickback Statute
One of the most severe penalties that can be associated with violations of the Social
Security Act is exclusion from federal health care plans. Which of the following
statements is true of excluded individuals? - ANSWERSc. Physicians that have been
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