1. Medicare was passed into law under the title XVIII of d. Social Security
what Act? Act
a. HIPAA
b. Stabilization Act
c. HMO
d. Social Security Act
2. A new radiology company opens in town. The manag- a. Anti-Kickback
er calls your practice and offers to pay $20 for every law
Medicare patient you send to them for radiology ser-
vices. What does this offer violate?
a. Anti-Kickback law
b. Stark Laws
c. HIPAA
d. Qui Tam
3. A practice agrees to pay $250,000 to settle a lawsuit d. Qui Tam
alleging that the practice used X-rays of one patient
to justify services on multiple other patients' claims.
The manager of the office brought the civil suit. What
type of case is this?
a. HIPAA
b. Stark case
c. Anti-Kickback
d. Qui Tam
4. A private practice hires a consultant to come in and b. A business as-
audit some medical records. Under the Privacy Rule, sociate
what is this consultant considered?
a. A covered entity
b. A business associate
c. An employee
d. A clearinghouse
5. What is the standard time frame established for d. There is no
record retention? single standard
, AAPC CPB Final Exam
record retention, it
a. Seven years varies by state and
b. The life of the patient federal regulation
c .Five years
d. There is no single standard record retention, it
varies by state and federal regulation
6. What entities are exempt from HIPAA and not consid- a. Workers' com-
ered to be covered entities? pensation
a. Workers' compensation
b. Employers with less than 100 employees
c .Church-sponsored plans
d. Sponsored group plans
7. A patient is seen in your clinic. Her husband calls b. HIPAA
later in the day to ask for information about the visit.
The practice pulls the patient's privacy authorization
to see if they can speak to the husband. What act does
this action fall under?
a. Health Information Act
b. HIPAA
c. Social Security Act
d. ADA
8. When a patient is enrolled in an HMO, which options b. I, III, IV
below are the responsibilities of the primary care
physician (PCP)?
I. Manage the member's treatment
II. Be the only provider for all of the patient's health-
care
III. Provide referrals to specialists
IV. Approve emergency department visits
V. Provide referrals for inpatient admissions
a. I, II, III
b. I, III, IV
, AAPC CPB Final Exam
c. I, III, V
d. I, II
9. What is the benefit of using NPI numbers for payers? d. I, IV
I. It is a single identifier for all payers
II. It contains the providers' birthdates to allow certain
identification
III. Each payer can make their own number
IV. It has no personal identifying information in the
number
a. I, II
b. I, II, IV
c. III, IV
d. I, IV
10. A group contracts with a third-party administrator to c. Self-Funded
manage paperwork. This group pays for the operation ERISA
of the insurance plan and the costs of administration.
What type of plan does this represent?
a. Association Group
b. Management Service Organization
c. Self-Funded ERISA
d. Fully Insured Employer Group
11. A patient presents for an immunization. When the c. Medicaid
patient pays his bill, he asks for a receipt so that he
may turn it in to meet his spenddown. What type of
coverage does this patient have?
a. Commercial insurance
b. Medicare
c. Medicaid
d. TRICARE
12. What is an insurance plan that provides a gatekeeper a. HMO
to manage the patient's healthcare?
a. HMO
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