AAPC CPB Final Exam, Questions And Answers. Health plan, clearinghouses, and any entity transmitting health information is
considered by the Privacy Rule to be a: Correct Answer: covered entity
Which of the following i
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AAPC CPB Final Exam, Questions And Answers. Health plan, clearinghouses, and any entity transmitting health information is
considered by the Privacy Rule to be a: Correct Answer: covered entity
Which of the following is not a covered entity in the Privacy Rule Correct Answer:
healthcare consulting firm
A request for medical records is received for a specific date of service from
patient's insurance company with regards to a submitted claim. No authorization
for release of information is provided. What action should be taken? Correct
Answer: release reqt to ins co
How many national priority purposes under the Privacy Rules for disclosure of
specific PHI without an individual's authorization or permission? Correct Answer:
12
A health plan sends a request for medical records in order to adjudicate a claim.
Does the office have to notify the patient or have them sign a release to send the
information? Correct Answer: no
A practice sets up a payment plan with a patient. If more than four installments are
extended to the patient, what regulation is the practice subject to that makes the
practice a creditor? Correct Answer: Truth in Lending Act
Which of the following situations allows release of PHI without authorization from
the patient? Correct Answer: workers comp
misusing any information on the claim, charging excessively for services or
supplies, billing for services not medically necessary, failure to maintain adequate
medical or financial records, improper billing practices, or billing Medicare
patients at a higher fee scale that non-Medicare patients. Correct Answer: abuse
A claim is submitted for a patient on Medicare with a higher fee than a patient on
Insurance ABC. What is this considered by CMS? Correct Answer: abuse
According to the Privacy Rule, what health information may not be de-identified?
Correct Answer: phys provider number
making false statements or misrepresenting facts to obtain an undeserved benefit or
payment from a federal healthcare program Correct Answer: fraud
All the following are considered Fraud, EXCEPT: Correct Answer: inadequate
med recd
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