Describe the difference between informed and implied consent?
Correct Answer: Informed consent is required in writing after explanation of a
procedure, with time to ask questions, while implied consent is assumed
What is documentation?
Correct Answer: Documentation is a complete, accurate, up-...
Describe the difference between informed and implied consent?
Correct Answer: Informed consent is required in writing after explanation of a
procedure, with time to ask questions, while implied consent is assumed
What is documentation?
Correct Answer: 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:
Correct Answer: given to an outside person or organization.
What is the difference between consent and authorization?
Correct Answer: **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.
1
,True or False: Physicians have the option to decide whether to explain privacy rules to
their patients.
Correct Answer: 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
Correct Answer: 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.
Correct Answer: true
define upcoding
Correct Answer: Assigning a code that will deliberately result in a higher payment
The Stark Law states that:
(choose one)
2
,*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.
Correct Answer: physicians can't refer patients to practitioners with whom they have
a financial relationship.
The Office of the Inspector General is responsible for:
Correct Answer: fighting fraud.
What is a claim?
Correct Answer: 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.
Correct Answer: 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.
3
, 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.
Correct Answer: 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.
Correct Answer: true
The primary insurance plan does which of the following? (choose one)
Pays for everything
4
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