AAPC CPB Final Exam - tion is considered by the Privacy Rule to be a ...

AAPC CPB Final Exam

• Health plan, clearinghouses, and any entity transmitting health informa-

tion is considered by the Privacy Rule to be a >>>covered entity

• Which of the following is not a covered entity in the Privacy Rule

>>>health- care 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>>> release reqt to ins co

• How many national priority purposes under the Privacy Rules for disclo-

sure of specific PHI without an individual's authorization or permission>>> 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 1 / 3

to send the information>>> no

• A practice sets up a payment plan with a patient. If more than four install-

ments are extended to the patient, what regulation is the practice subject to that makes the practice a creditor>>> Truth in Lending Act

• Which of the following situations allows release of PHI without authoriza-

tion from the patient>>> 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 >>>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>>> abuse

• According to the Privacy Rule, what health information may not be

de-identified>>> phys provider number 2 / 3

• making false statements or misrepresenting facts to obtain an unde-

served benefit or payment from a federal healthcare program >>>fraud

• All the following are considered Fraud, EXCEPT >>>inadequate med recd

• A hospital records transporter is moving medical records from the hos-

pital to an off-site building. During the transport, a chart falls from the box on to the street. It is discovered when the transporter arrives at the off-site building and the number of charts is not correct. What type of violation is this>>> breach

• impermissible release or disclosure of information is discovered

>>>breach

• / 3