CPB Final Exam comprehensive questions |
FREQUENTLY MOST TESTED QUESTIONS AND
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Terms in this set (140)
A practice agrees to pay Qui Tam
$250,000.00 to settle a lawsuit
alleging that the practice used x-
rays of one patient to justify
services on multiple other patients'
claims. The office manager brought
the civil suit. What type of case is
this?
In which of the following An office receives a call from the patient's
circumstances may PHI not be husband asking for information about his wife's
disclosed without the patient's recent office visit.
authorization or permission?
According to the Privacy Rule, what A contract
must a Business Associate and a
Covered Entity have in order to do
business?
,HMO plans require the enrollee to: To have referrals to see a specialist that is
generated by the patient's primary care provider.
Which of the following is NOT a Require the enrollee to maintain a Primary Care
component of the PPO payer Provider.
model?
Under the Privacy Rule a health Covered entity
plan, clearinghouses, and any entity
transmitting health information is
considered?
A request for medical records is Release the requested records to the insurance
received for a specific date of company.
service from a patient's insurance
company with regards to a
submitted claim. No authorization
for release of information is
provided. What action should be
taken?
Which of the following situations Workers' Compensation
allows the release of PHI without
authorization from the patient?
HIPAA mandated what entity to HHS
adopt national standards for
electronic transactions and code
sets?
What is the standard time frame There is no single standard for record retention; it
established for record retention? varies by state and federal regulations.
, CMS defines _______ as billing for a Fraud
lower level of care than is
supported in documentation,
making false statements to obtain
undeserved benefits or payment
from a federal healthcare program,
or billing for a service that was not
performed.
A claim is submitted for a patient on Abuse
Medicare with a higher fee than a
patient on Insurance ABC. What is
this considered by CMS?
A person that files a claim for a False Claims Act
Medicare Beneficiary knowing that
the service is not correctly
reported is in violation of what
statute?
Which of the following actions is Up-coding or unbundling services
considered under the False Claims
Act?
A practice sets up a payment plan Truth in Lending Act
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?
Medicare was passed into law Social Security Act
under the title XVIII of what Act?
FREQUENTLY MOST TESTED QUESTIONS AND
VERIFIED SOLUTIONS/GET IT 100% ACCURATE!!
Save
Terms in this set (140)
A practice agrees to pay Qui Tam
$250,000.00 to settle a lawsuit
alleging that the practice used x-
rays of one patient to justify
services on multiple other patients'
claims. The office manager brought
the civil suit. What type of case is
this?
In which of the following An office receives a call from the patient's
circumstances may PHI not be husband asking for information about his wife's
disclosed without the patient's recent office visit.
authorization or permission?
According to the Privacy Rule, what A contract
must a Business Associate and a
Covered Entity have in order to do
business?
,HMO plans require the enrollee to: To have referrals to see a specialist that is
generated by the patient's primary care provider.
Which of the following is NOT a Require the enrollee to maintain a Primary Care
component of the PPO payer Provider.
model?
Under the Privacy Rule a health Covered entity
plan, clearinghouses, and any entity
transmitting health information is
considered?
A request for medical records is Release the requested records to the insurance
received for a specific date of company.
service from a patient's insurance
company with regards to a
submitted claim. No authorization
for release of information is
provided. What action should be
taken?
Which of the following situations Workers' Compensation
allows the release of PHI without
authorization from the patient?
HIPAA mandated what entity to HHS
adopt national standards for
electronic transactions and code
sets?
What is the standard time frame There is no single standard for record retention; it
established for record retention? varies by state and federal regulations.
, CMS defines _______ as billing for a Fraud
lower level of care than is
supported in documentation,
making false statements to obtain
undeserved benefits or payment
from a federal healthcare program,
or billing for a service that was not
performed.
A claim is submitted for a patient on Abuse
Medicare with a higher fee than a
patient on Insurance ABC. What is
this considered by CMS?
A person that files a claim for a False Claims Act
Medicare Beneficiary knowing that
the service is not correctly
reported is in violation of what
statute?
Which of the following actions is Up-coding or unbundling services
considered under the False Claims
Act?
A practice sets up a payment plan Truth in Lending Act
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?
Medicare was passed into law Social Security Act
under the title XVIII of what Act?
