CPB Test Prep Exam Questions And
Answers 100% Pass.
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?
a. Physicians that have been excluded can bill the patient for services but cannot bill federal
health plans.
b. Physicians that have been excluded can refer their patients to other facilities for treatment.
c. Physicians that have been excluded are prohibited from billing for any services to a federally
administered health plan.
d. Physicians that have been excluded are exempt from billing for services but are allowed to
write prescriptions and order tests. - answer✔C. Physicians that have been excluded are
prohibited from billing for any services to a federally administered health plan
Eight standard transactions were adopted for Electronic Data Interchange (EDI) under HIPAA.
Which of the following is NOT
a. Payment and remittance advice
b. Eligibility in a health plan
c. Coordination of Benefits
d.Physician unique identifier number - answer✔D. Physician unique identifier number
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?
:a.
The subpoena allows for the release of the medical records.
b.
The subpoena is accompanied by a court order or the patient is notified and given a chance to
object.
c.
The individual must sign an authorization for release of the information.
d.
Records cannot be released under any circumstance based on a subpoena. - answer✔B. 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?
:a.
Fraud; subject to the Anti-kickback Statute
b.
Fraud; subject to the False Claims Act
c.
Abuse; subject only to education of the provider
d.
Abuse; subject to the Stark Law - answer✔B. 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?
a.
Must be available on any website the practice maintains
b.
Must be provided upon request
c.
Must be presented to all patients
d.
Must be placed into the patient's file - answer✔D. Must be placed into the patient's file
Federal healthcare plans include what payers?
a.
Blue Cross, Medicare, Humana
b.
Medicare, Medicaid, TRICARE
c.
Medicare, TRICARE, Blue Cross
d.
Humana, VA, TRICARE - answer✔B. Medicare, Medicaid, TRICARE
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?
a.
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).
b.
The records for the claim can be sent after authorization is received from the patient.
c.
The entire patient record should be sent as part of HIPAA based on treatment, payment, and
operations.
d.
The payer is required to provide authorization signed from the patient prior to requesting the
medical records. - answer✔A. 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).
The regulation of finance charges or interest applied to outstanding balances in the medical
practice is under what law?
a.
Truth in Lending Act
Conditions of Participation - answer✔a. Truth in lending act
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?
a.
Anti-Kickback Statute
b.
Stark Law
c.
False Claims Act
d.
Truth in Lending Act - answer✔a. Anti-kickback statute
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.
a.
The Security rule applies to health care providers, health plans, and any covered entity involved
in the care of the patient.
b.
The Security Rule applies only to the entity that initiates the release of protected health
information.
c.
Standards for storing and transmitting patient data in electronic form includes portable electronic
devices.
d.
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