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NHA 176 EXAM Questions with 100% Correct Answers | Verified | Latest Update And Verified|55 Pages

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Describe the difference between informed and implied consent? - ️️Informed consent is required in writing after explanation of a procedure, with time to ask questions, while implied consent is assumed What is documentation? - ️️Documentation is a complete, accurate, up-to-date record of ...

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NHA EXAM
Describe the difference between informed and implied consent? - ✔ ✔ Informed consent is required
in writing after explanation of a procedure, with time to ask questions, while implied consent is assumed



What is documentation? - ✔ ✔ Documentation is a complete, accurate, up-to-date record of the
care a patient receives at a health care facility.



Disclosure refers to the way health information is: - ✔ ✔ given to an outside person or organization.



What is the difference between consent and authorization? - ✔ ✔ **Authorization** is permission
granted by the patient or the patient's representative to release information for reasons *other than*
treatment, payment, or health care operations.



**Consent** is used only when the permission is for treatment, payment, or health care operations.



True or False: Physicians have the option to decide whether to explain privacy rules to their patients. -
✔ ✔ False



Auditing refers to which of the following?

(choose one)



*Writing claims

*Signing off on claims

*sending claims to third-party payers

*Reviews claims for accuracy and completeness - ✔ ✔ Reviews claims for accuracy and
completeness

,True or False: Fraud is intentional misrepresentation of information for the purposes of receiving higher
payments, while abuse happens unintentionally, often because of poor business practices. - ✔ ✔
true



define upcoding - ✔ ✔ Assigning a code that will deliberately result in a higher payment



The Stark Law states that:

(choose one)



*debt collection agencies can't use abusive or unfair practices to collect payments.



*the government can't be charged for substandard goods or services.



*physicians can't refer patients to practitioners with whom they have a financial relationship.



*private health information must be kept secure. - ✔ ✔ physicians can't refer patients to
practitioners with whom they have a financial relationship.



The Office of the Inspector General is responsible for: - ✔ ✔ fighting fraud.



What is a claim? - ✔ ✔ A claim is a complete record of all the services provided to a patient.



Identify two items of information that need to be on a claim. - ✔ ✔ Possible answers include the
patient's name, health record number, account number, and demographic information, the subscriber
number, group or plan number, and the provider's name.

,Which of the following describes a clean claim?

(choose one)



All the data elements are completed.




All the data elements are written on a white piece of paper.




Almost all the data elements are right.




All the necessary data elements are completed. - ✔ ✔ All the necessary data elements are
completed.



True or False: In 2012, the Administration Simplification Compliance Act (ASCA), part of HIPAA,
mandated that health care claims be submitted electronically, with some exceptions. - ✔ ✔ true



The primary insurance plan does which of the following? (choose one)



Pays for everything




Pays first

, Pays second




Has the option of paying first or second - ✔ ✔ Pays first



What is an NPI number? Where does it go on CMS-1500? - ✔ ✔ the NPI is a unique identification
number for all HIPAA-covered entities, including individuals, organizations, home health agencies,
clinics, long-term care facilities, residential treatment centers, laboratories, ambulances, group
practices, and health maintenance organizations (HMOs).




It is block 17b on the CMS-1500 form.



True or False: Misspelling a patient's name is a common processing error. - ✔ ✔ true



Nicknames and hyphenated last names can complicate the task of getting the patient's name correct.



True or False: You are allowed to use both six- and eight-digits for the date on one claim. - ✔ ✔ False



You need to pick one style and use it throughout the claim.



Describe when Medicare is the secondary insurance for a patient. - ✔ ✔ Medicare is the secondary
insurance for a patient when she has a group health insurance plan, is covered by workers'
compensation, or is on disability.



By signing block 12 on the CMS-1500 form, a patient is doing which of the following?

(choose one)

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