CVAE NHA CEHRS Study
Material from student share
questions with 100% correct
answers
Medical Ethics - answer standards of conduct based on moral
principles
HIPAA - answer Health Insurance Portability and Accountability Act
of 1996
2 provisions of HIPAA - answer 1) Insurance Reform
2) Administrative Simplifications
Insurance Reform (provision of HIPAA) - answer provide continuous
insurance coverage for workers & their dependents when they
change or lose their job
Administrative Simplifications (provision of HIPAA) - answer focus
health care practice setting to reduce administrative costs &
burdens.
FCA - answer False Claims Act
False Claims Act - FCA - answer Federal law prohibits submitting a
fraudulent claim or making a false statement or representation in
connection with a claim
NCCI - answer National Correct Coding Initiative
,Possible consequences of incorrect coding - answer 1) delay of
processing/payment claims reduced payment
2) denied claims
3) fines/imprisonment
4) exclusion from payer's programs
5) loss of physician's license to practice medicine
National Correct Coding Initiative - NCCI - answer developed my the
CMS to promote national correct coding methodologies & control
improper coding that leads to inappropriate payment of Part B
health insurance claims
2 types of edits - answer 1) Column 1/Column 2 (previously called
Comprehensive/Component) Edits
2) Mutually Exclusive Edits
OIG - answer Office of Inspector General
Office of Inspector General - OIG - answer has the task to investigate
and prosecute health care fraud & abuse
Fraud - answer knowingly & intentionally deceiving or
misrepresenting information that may result in unauthorized
benefits
Abuse - answer incidents or practices, not usually considered
fraudulent, that are inconsistent with the accepted medical
business or fiscal practices in the industry
Patient Confidentiality - answer All patients have a right to privacy
& all information should remain privileged. Discuss patient
,information only with the patient's physician or office personnel that
need certain information to do their job. Obtain a signed consent
from to release medical information to the insurance company or
other individual
Employer Liability - answer physicians are legally responsible for
their own conduct and any actions of their employees performed
within the context of their employment.
Employer Liability as known as - answer VICARIOUS LIABILITY or
RESPONDENT SUPERIOR
Medical Record - answer documentation on the patient's social &
medical history, family history, physical examination findings,
progress notes, radiology & lab results, consultation reports &
correspondence to patient
Medical Report - answer part of the medical record - permanent
legal document that formally states the consequences of the
patient's examination or treatment in letter or report form. this is
the part required to complete the insurance claim form.
DOS - answer Date of Service
POS - answer Place of Service
TOS - answer Type of Service
DX - answer diagnosis
What is required when billing the insurance company? - answer Date
of Service, Place of Service, Type of Service, diagnosis & procedures
, Reasons for Documentation - answer 1) Avoidance of denied or
delayed payments by insurance carriers investigating the medical
necessity of services
2) Enforcement of medical record-keeping rules by insurance
carriers requiring accurate documentation that supports procedure
& diagnostic codes
3) Subpoena of medical records by the state investigators or the
court for review
4) defense of professional liability claim
Retention of Medical Records - answer 1) governed by the state &
local laws - vary from state to state
2) most are required to retain records indefinitely; deceased for at
least 5 years
Multigravida - answer a pregnant woman who has had at least one
previous pregnancy
Rib Case - answer 12 pairs of ribs,
True Ribs - answer numbers 1-7, attached directly to the sternum in
the front of the body
False Ribs - answer numbers 8-10, attached to the sternum by
cartilage
Floating Ribs - answer 11 & 12 are not attached at all
ROM - answer Range of Motion
Material from student share
questions with 100% correct
answers
Medical Ethics - answer standards of conduct based on moral
principles
HIPAA - answer Health Insurance Portability and Accountability Act
of 1996
2 provisions of HIPAA - answer 1) Insurance Reform
2) Administrative Simplifications
Insurance Reform (provision of HIPAA) - answer provide continuous
insurance coverage for workers & their dependents when they
change or lose their job
Administrative Simplifications (provision of HIPAA) - answer focus
health care practice setting to reduce administrative costs &
burdens.
FCA - answer False Claims Act
False Claims Act - FCA - answer Federal law prohibits submitting a
fraudulent claim or making a false statement or representation in
connection with a claim
NCCI - answer National Correct Coding Initiative
,Possible consequences of incorrect coding - answer 1) delay of
processing/payment claims reduced payment
2) denied claims
3) fines/imprisonment
4) exclusion from payer's programs
5) loss of physician's license to practice medicine
National Correct Coding Initiative - NCCI - answer developed my the
CMS to promote national correct coding methodologies & control
improper coding that leads to inappropriate payment of Part B
health insurance claims
2 types of edits - answer 1) Column 1/Column 2 (previously called
Comprehensive/Component) Edits
2) Mutually Exclusive Edits
OIG - answer Office of Inspector General
Office of Inspector General - OIG - answer has the task to investigate
and prosecute health care fraud & abuse
Fraud - answer knowingly & intentionally deceiving or
misrepresenting information that may result in unauthorized
benefits
Abuse - answer incidents or practices, not usually considered
fraudulent, that are inconsistent with the accepted medical
business or fiscal practices in the industry
Patient Confidentiality - answer All patients have a right to privacy
& all information should remain privileged. Discuss patient
,information only with the patient's physician or office personnel that
need certain information to do their job. Obtain a signed consent
from to release medical information to the insurance company or
other individual
Employer Liability - answer physicians are legally responsible for
their own conduct and any actions of their employees performed
within the context of their employment.
Employer Liability as known as - answer VICARIOUS LIABILITY or
RESPONDENT SUPERIOR
Medical Record - answer documentation on the patient's social &
medical history, family history, physical examination findings,
progress notes, radiology & lab results, consultation reports &
correspondence to patient
Medical Report - answer part of the medical record - permanent
legal document that formally states the consequences of the
patient's examination or treatment in letter or report form. this is
the part required to complete the insurance claim form.
DOS - answer Date of Service
POS - answer Place of Service
TOS - answer Type of Service
DX - answer diagnosis
What is required when billing the insurance company? - answer Date
of Service, Place of Service, Type of Service, diagnosis & procedures
, Reasons for Documentation - answer 1) Avoidance of denied or
delayed payments by insurance carriers investigating the medical
necessity of services
2) Enforcement of medical record-keeping rules by insurance
carriers requiring accurate documentation that supports procedure
& diagnostic codes
3) Subpoena of medical records by the state investigators or the
court for review
4) defense of professional liability claim
Retention of Medical Records - answer 1) governed by the state &
local laws - vary from state to state
2) most are required to retain records indefinitely; deceased for at
least 5 years
Multigravida - answer a pregnant woman who has had at least one
previous pregnancy
Rib Case - answer 12 pairs of ribs,
True Ribs - answer numbers 1-7, attached directly to the sternum in
the front of the body
False Ribs - answer numbers 8-10, attached to the sternum by
cartilage
Floating Ribs - answer 11 & 12 are not attached at all
ROM - answer Range of Motion
