AAPC CPB Chapter 1-5/ 477 Q&A/ Already
Graded A+/ 2024-2025
Eight standard transactions were adopted for Electronic Data Interchange (EDI)
under HIPAA. Which of the following is NOT included as a standard transaction?
a. Payment and remittance advice
b. Eligibility in a health plan
c. Coordination of benefits
d. Physician unique identifier number - Answer: d. Physician unique identifier
number
A physician received office space at a reduced rate for referring patients to the
hospital's out- patient physical therapy center. What Law does this violate?
a. Anti-Kickback Statute
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,b. Stark Law
c. False Claims Act
d. Truth in Lending Act - Answer: a. Anti-Kickback Statute
One of the most severe penalties that can be associated with violations of the
Social Security Act is exclusion from federal health care plans. Which of the
following statements is true of excluded individuals?
a. Physicians that have been excluded can bill the patient for services but cannot
bill federal health plans.
b. Physicians that have been excluded can refer their patients to other facilities for
treatment.
c. Physicians that have been excluded are prohibited from billing for any services
to a federally administered health plan.
d. Physicians that have been excluded are exempt from billing for services but are
allowed to write prescriptions and order tests. - Answer: c. Physicians that have
been excluded are prohibited from billing for any services to a federally
administered health plan.
A claim is received by a payer that subsequently requests the medical records for
the date of service on the claim. What procedure should be followed by the
practice?
a. Only the date of service on the claim should be sent to the payer. The records
can be sent as part of HIPAA based on treatment, payment, and operations (TPO).
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,b. The records for the claim can be sent after authorization is received from the
patient.
c. The entire patient record should be sent as part of HIPAA based on treatment,
payment, and operations.
d. The payer is required to provide authorization signed from the patient prior to
requesting the medical records. - Answer: a. Only the date of service on the claim
should be sent to the payer. The records can be sent as part of HIPAA based on
treatment, payment, and operations (TPO).
HIPAA requires that privacy practice notices be provided in several circumstances.
Which if the following is NOT required?
a. Must be available on any website the practice maintains
b. Must be provided upon request
c. Must be presented to all patients
d. Must be placed into the patient's file - Answer: d. Must be placed into the
patient's file
The regulation of finance charges or interest applied to outstanding balances in
the medical practice is under what law?
a. Truth in Lending Act
b. Criminal Health Care Act
c. HIPAA
d. Conditions of Participation - Answer: a. Truth in Lending Act
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, Federal healthcare plans include what payers?
a. Blue Cross, Medicare, Humana
b. Medicare, Medicaid, TRICARE
c. Medicare, TRICARE, Blue Cross
d. Humana, VA, TRICARE - Answer: b. Medicare, Medicaid, TRICARE
HIPAA of 1996 includes a Security Rule that is established to provide what national
standards for protecting and transmitting patient data. Which of the following is
NOT true.
a. The Security rule applies to health care providers, health plans, and any covered
entity involved in the care of the patient.
b. The Security Rule applies only to the entity that initiates the release of
protected health information.
c. Standards for storing and transmitting patient data in electronic form includes
portable electronic devices.
d. The Security Rule states that safeguards must be in place to prevent unsecured
release of information. - Answer: b. The Security Rule applies only to the entity
that initiates the release of protected health information.
All entities are responsible for the protected health information, including the
entity receiving the information. Portable electronic devices such as tablets and
smart phones are to be made secure with passwords that are not shared between
staff.
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Graded A+/ 2024-2025
Eight standard transactions were adopted for Electronic Data Interchange (EDI)
under HIPAA. Which of the following is NOT included as a standard transaction?
a. Payment and remittance advice
b. Eligibility in a health plan
c. Coordination of benefits
d. Physician unique identifier number - Answer: d. Physician unique identifier
number
A physician received office space at a reduced rate for referring patients to the
hospital's out- patient physical therapy center. What Law does this violate?
a. Anti-Kickback Statute
Page 1 of 122
,b. Stark Law
c. False Claims Act
d. Truth in Lending Act - Answer: a. Anti-Kickback Statute
One of the most severe penalties that can be associated with violations of the
Social Security Act is exclusion from federal health care plans. Which of the
following statements is true of excluded individuals?
a. Physicians that have been excluded can bill the patient for services but cannot
bill federal health plans.
b. Physicians that have been excluded can refer their patients to other facilities for
treatment.
c. Physicians that have been excluded are prohibited from billing for any services
to a federally administered health plan.
d. Physicians that have been excluded are exempt from billing for services but are
allowed to write prescriptions and order tests. - Answer: c. Physicians that have
been excluded are prohibited from billing for any services to a federally
administered health plan.
A claim is received by a payer that subsequently requests the medical records for
the date of service on the claim. What procedure should be followed by the
practice?
a. Only the date of service on the claim should be sent to the payer. The records
can be sent as part of HIPAA based on treatment, payment, and operations (TPO).
Page 2 of 122
,b. The records for the claim can be sent after authorization is received from the
patient.
c. The entire patient record should be sent as part of HIPAA based on treatment,
payment, and operations.
d. The payer is required to provide authorization signed from the patient prior to
requesting the medical records. - Answer: a. Only the date of service on the claim
should be sent to the payer. The records can be sent as part of HIPAA based on
treatment, payment, and operations (TPO).
HIPAA requires that privacy practice notices be provided in several circumstances.
Which if the following is NOT required?
a. Must be available on any website the practice maintains
b. Must be provided upon request
c. Must be presented to all patients
d. Must be placed into the patient's file - Answer: d. Must be placed into the
patient's file
The regulation of finance charges or interest applied to outstanding balances in
the medical practice is under what law?
a. Truth in Lending Act
b. Criminal Health Care Act
c. HIPAA
d. Conditions of Participation - Answer: a. Truth in Lending Act
Page 3 of 122
, Federal healthcare plans include what payers?
a. Blue Cross, Medicare, Humana
b. Medicare, Medicaid, TRICARE
c. Medicare, TRICARE, Blue Cross
d. Humana, VA, TRICARE - Answer: b. Medicare, Medicaid, TRICARE
HIPAA of 1996 includes a Security Rule that is established to provide what national
standards for protecting and transmitting patient data. Which of the following is
NOT true.
a. The Security rule applies to health care providers, health plans, and any covered
entity involved in the care of the patient.
b. The Security Rule applies only to the entity that initiates the release of
protected health information.
c. Standards for storing and transmitting patient data in electronic form includes
portable electronic devices.
d. The Security Rule states that safeguards must be in place to prevent unsecured
release of information. - Answer: b. The Security Rule applies only to the entity
that initiates the release of protected health information.
All entities are responsible for the protected health information, including the
entity receiving the information. Portable electronic devices such as tablets and
smart phones are to be made secure with passwords that are not shared between
staff.
Page 4 of 122
