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AAPC CPB EXAM WITH COMPLETE QUESTIONS & ANSWERS
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AAPC CPB EXAM WITH COMPLETE QUESTIONS & ANSWERS
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AAPC CPB EXAM WITH COMPLETEQUESTIONS & ANSWERS
HRA - -Health Reimbursement Account
-What part of Medicare pays for prescriptions - -Part D
-What type of plan allows an insurer to administer straight indemnity
insurance, an HMO, or a PPO insurance plans to its members? - -Triple
Option Plan
-HIPAA - -Health Insurance Portability and Accountability Act of 1996
-Fraud (CMS defines) - -Making false stmts or misrepresenting facts to
obtain an undeserved benefit or payment from a federal healthcare program.
Ie. misusing codes on claims, billing for services not medically necessary,
higher fees charged, etc
-Penalties for fraud - -Monetary penalties, exclusion from Federal healthcare
program, imprisonments
-Fraud Claimsexample Acct - -Billing a code that is not performed is a
violation
-HMO plans require - -A referral from PCP to see a specialist
-CMS Abuse - -Charge unnecessary cost to federal healthcare program
-What is the standard time frame established for record retention? - -There
is no standardretention requirement, it varies by state and federal
regulations. CMS 5 year time line for providers to submit cost reports. 7
years is the length of time that false claims can be investigated.
-Privacy Rule Purpose - -Is to protect individual privacy, while promoting
high quality healthcare and public health and well being
-What entities are exempt from HIPAA Andy are not considered to be
covered entities - -HIPAA allows exemption for entities providing only
worker's compensation plans, employers with less than 50 employees as well
as government funded programs such as food stamps and community health
centers
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