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 ...
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)
Voordelen van het kopen van samenvattingen bij Stuvia op een rij:
Verzekerd van kwaliteit door reviews
Stuvia-klanten hebben meer dan 700.000 samenvattingen beoordeeld. Zo weet je zeker dat je de beste documenten koopt!
Snel en makkelijk kopen
Je betaalt supersnel en eenmalig met iDeal, creditcard of Stuvia-tegoed voor de samenvatting. Zonder lidmaatschap.
Focus op de essentie
Samenvattingen worden geschreven voor en door anderen. Daarom zijn de samenvattingen altijd betrouwbaar en actueel. Zo kom je snel tot de kern!
Veelgestelde vragen
Wat krijg ik als ik dit document koop?
Je krijgt een PDF, die direct beschikbaar is na je aankoop. Het gekochte document is altijd, overal en oneindig toegankelijk via je profiel.
Tevredenheidsgarantie: hoe werkt dat?
Onze tevredenheidsgarantie zorgt ervoor dat je altijd een studiedocument vindt dat goed bij je past. Je vult een formulier in en onze klantenservice regelt de rest.
Van wie koop ik deze samenvatting?
Stuvia is een marktplaats, je koop dit document dus niet van ons, maar van verkoper jackline98. Stuvia faciliteert de betaling aan de verkoper.
Zit ik meteen vast aan een abonnement?
Nee, je koopt alleen deze samenvatting voor €8,84. Je zit daarna nergens aan vast.