AAPC Official CPC Certification Study
Guide Notes
"hold harmless clause" - * found in some non-Medicare health plan contracts
* prohibits billing to patient for anything beyond deductibles and co-pays.
A compliance plan may offer several benefits, including: - * more accurate payment of
claims
* fewer billing mistakes
* improved documentation and more accurate coding
* less chance of violating self-referral and anti-kickback status
A healthcare clearing house is a - entity that processes nonstandard health information
they receive from another entity into a standard format
A key provision in HIPAA is the Minimum Necessary requirement. this means - only the
minimum necessary protected health information should be shared to satisfy a particular
purpose.
A medically necessary service is the - least radical service/procedure that allows for
effective treatment of the patients' complaint or condition
A patient sustaining an injury to her great saphenous vein would have sustained injury to
which of anatomical site? - Leg
APC - Ambulatory Payment Classification
ARRA - American Recovery and Reinvestment Act (of 2009)
ASC - Ambulatory Surgical Centers
Abuse consists of - payment for items or services that are billed by providers in error that
should not be paid for by Medicare.
An ABN protects the provider's financial interest by - creating a paper trail that CMS
requires before a provider can bill the patient for payment if Medicare denies coverage for
the stated service or procedure.
An entity that processes nonstandard health information they receive from another entity
into a standard format is considered what? - Clearinghouse
As a part of Health Care Reform, the Affordable Care Act of 2010 amended the definition of
fraud to remove the __________ requirement - intent
