AAPC CPB - Chapter 1 Quiz: HIPAA and Healthcare Compliance, Exams of Nursing

Download AAPC CPB - Chapter 1 Quiz: HIPAA and Healthcare Compliance and more Exams Nursing in PDF only on Docsity!

AAPC CPB - Chapter 1 Quiz

Eight standard transactions were adopted for Electronic Data Interchange (EDI) under HIPAA. Which of the following is NOT included as a standard transaction? a. Payment and remittance advice b. Eligibility in a health plan c. Coordination of benefits d. Physician unique identifier number - correct answer d. Physician unique identifier number 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 - correct answer a. Anti-Kickback Statute 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. - correct answer c. Physicians that have been excluded are prohibited from billing for any services to a federally administered health plan.

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. - correct 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). 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 - correct answer d. Must be placed into the patient's file The regulation of finance charges or interest applied to outstanding balances in the medical practice is under what law? a. Truth in Lending Act b. Criminal Health Care Act c. HIPAA d. Conditions of Participation - correct answer a. Truth in Lending Act Federal healthcare plans include what payers? a. Blue Cross, Medicare, Humana