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CBCS Exam Study Guide questions and answers 100% CORRECT|CBCS questions and answers all correct

When was the Health Information and Accountability Act (HIPAA) created? Correct Answer: 1996 What are Medical Ethics? Correct Answer: Standards of conduct based on moral principals. What are the two... provisions of HIPPA? Correct Answer: 1. Insurance Reform 2. Administrative Simplification What is the False Claims Act (FCA) Correct Answer: A Federal law that prohibits submitting a false claim or making a false statement or representation in connection with a claim. What is the National Correct Coding Initiative (NCCI)? Correct Answer: Initiative developed by CMS to promote national correct coding methods and control improper coding that leads to wrong payments of Part B health claims. What are the two types of edits that the NCCI implements? Correct Answer: 1. Column 1/ Column 2; identified unbundled codes. 2. Mutually Exclusive Edits: Codes that are unlikely to be performed on the same patient in the same day. Who investigates and prosecutes Health Care fraud? Correct Answer: Office of Inspector General (OIG) When can a provider share PHI without specific permission from the patient? Correct Answer: 1. For treatment (discussing the case with another professional) 2.Payment (When providers submit claims on the patient's behalf). 3. Operations: Staff training and Quality Improvement.Medical Billing & Coding as a Career Correct Answer: *Claims assistant professional or claims manager, *Coding Specialist, * Collection Manager, *Electronic Claims Processor, *Insurance Billing Specialist, * Insurance Coordinator, *Insurance Counselor, *Medical Biller, *Medical & Financial Records Manager, * Billing & Coding Specialist What are Medical Ethics? Correct Answer: Standards of conduct based on moral principle. They are generally accepted as a guide for behavior towards pt's, dr's, co-workers, the gov, and ins co's. What does acting within ethical behavior boundaries mean? Correct Answer: carrying out one's responsibilities w/ integrity, dignity, respect, honesty, competence, fairness, & trust. Legal Aspects of of Medical Billing & Coding: Correct Answer: ... Compliance regulations: Correct Answer: Most billing-related cases are based on HIPPA and False Claims Act Health Insurance Portability & Accountability Act (HIPPA) Correct Answer: Enacted in 1996, created by the Health Care Fraud & Abuse Control Program-enacted to check for fraud and abuse in the Medicare/Medicaid Programs and private payers What are the 2 provisions of HIPPA? Correct Answer: Title I: Insurance Reform Title II: Administrative Simplification [Show More]

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