NHA EXAM WITH ALL CORRECT & VERIFIED ANSWERS
(UPDATED TO PASS)
Describe the difference between informed and implied consent? Correct answer-Informed consent
is required in writing after explanation of a procedure, with time to ask questions, while implied
consent is assumed
What is documentation? Correct answer-Documentation is a complete, accurate, up-to-date
record of the care a patient receives at a health care facility.
Disclosure refers to the way health information is: Correct answer-given to an outside person or
organization.
What is the difference between consent and authorization? Correct answer-**Authorization** is
permission granted by the patient or the patient's representative to release information for reasons
*other than* treatment, payment, or health care operations.
**Consent** is used only when the permission is for treatment, payment, or health care operations.
True or False: Physicians have the option to decide whether to explain privacy rules to their patients.
Correct answer-False
Auditing refers to which of the following?
(choose one)
*Writing claims
*Signing off on claims
*sending claims to third-party payers
*Reviews claims for accuracy and completeness Correct answer-Reviews claims for accuracy and
completeness
True or False: Fraud is intentional misrepresentation of information for the purposes of receiving
higher payments, while abuse happens unintentionally, often because of poor business practices.
Correct answer-true
define upcoding Correct answer-Assigning a code that will deliberately result in a higher payment
The Stark Law states that:
(choose one)
*debt collection agencies can't use abusive or unfair practices to collect payments.
*the government can't be charged for substandard goods or services.
*physicians can't refer patients to practitioners with whom they have a financial relationship.
*private health information must be kept secure. Correct answer-physicians can't refer patients to
practitioners with whom they have a financial relationship.
The Office of the Inspector General is responsible for: Correct answer-fighting fraud.
,What is a claim? Correct answer-A claim is a complete record of all the services provided to a
patient.
Identify two items of information that need to be on a claim. Correct answer-Possible answers
include the patient's name, health record number, account number, and demographic information,
the subscriber number, group or plan number, and the provider's name.
Which of the following describes a clean claim?
(choose one)
All the data elements are completed.
All the data elements are written on a white piece of paper.
Almost all the data elements are right.
All the necessary data elements are completed. Correct answer-All the necessary data elements
are completed.
True or False: In 2012, the Administration Simplification Compliance Act (ASCA), part of HIPAA,
mandated that health care claims be submitted electronically, with some exceptions. Correct
answer-true
The primary insurance plan does which of the following? (choose one)
Pays for everything
Pays first
Pays second
Has the option of paying first or second Correct answer-Pays first
What is an NPI number? Where does it go on CMS-1500? Correct answer-the NPI is a unique
identification number for all HIPAA-covered entities, including individuals, organizations, home
health agencies, clinics, long-term care facilities, residential treatment centers, laboratories,
ambulances, group practices, and health maintenance organizations (HMOs).
It is block 17b on the CMS-1500 form.
True or False: Misspelling a patient's name is a common processing error. Correct answer-true
Nicknames and hyphenated last names can complicate the task of getting the patient's name correct.
, True or False: You are allowed to use both six- and eight-digits for the date on one claim. Correct
answer-False
You need to pick one style and use it throughout the claim.
Describe when Medicare is the secondary insurance for a patient. Correct answer-Medicare is the
secondary insurance for a patient when she has a group health insurance plan, is covered by workers'
compensation, or is on disability.
By signing block 12 on the CMS-1500 form, a patient is doing which of the following?
(choose one)
Authorizing the release of funds to a provider
Authorizing the provider to perform a procedure
Authorizing the release of medical information needed to process a claim
Authorizing hospice care Correct answer-Authorizing the release of medical information needed to
process a claim
Name three kinds of insurance information that needs to be collected from the patient. Correct
answer-Among the correct responses are the correct policy number and group number, if applicable;
policy effective dates; and type of policy.
Coordination of benefits involves which of the following? (Choose one)
Double-checking each patient's insurance information
Collecting demographic information
Determining which insurance is primary and which is secondary
Submitting a claim Correct answer-Determining which insurance is primary and which is secondary
The coordination of benefits process, which determines primary and secondary insurance, ensures
that there is no duplication in the payment of benefits. The primary insurance pays first, up to its
coverage limits, and the secondary insurance pays second.
True or False: The birthday rule is a way to mark how long a patient has had his insurance policy.
Correct answer-False
(UPDATED TO PASS)
Describe the difference between informed and implied consent? Correct answer-Informed consent
is required in writing after explanation of a procedure, with time to ask questions, while implied
consent is assumed
What is documentation? Correct answer-Documentation is a complete, accurate, up-to-date
record of the care a patient receives at a health care facility.
Disclosure refers to the way health information is: Correct answer-given to an outside person or
organization.
What is the difference between consent and authorization? Correct answer-**Authorization** is
permission granted by the patient or the patient's representative to release information for reasons
*other than* treatment, payment, or health care operations.
**Consent** is used only when the permission is for treatment, payment, or health care operations.
True or False: Physicians have the option to decide whether to explain privacy rules to their patients.
Correct answer-False
Auditing refers to which of the following?
(choose one)
*Writing claims
*Signing off on claims
*sending claims to third-party payers
*Reviews claims for accuracy and completeness Correct answer-Reviews claims for accuracy and
completeness
True or False: Fraud is intentional misrepresentation of information for the purposes of receiving
higher payments, while abuse happens unintentionally, often because of poor business practices.
Correct answer-true
define upcoding Correct answer-Assigning a code that will deliberately result in a higher payment
The Stark Law states that:
(choose one)
*debt collection agencies can't use abusive or unfair practices to collect payments.
*the government can't be charged for substandard goods or services.
*physicians can't refer patients to practitioners with whom they have a financial relationship.
*private health information must be kept secure. Correct answer-physicians can't refer patients to
practitioners with whom they have a financial relationship.
The Office of the Inspector General is responsible for: Correct answer-fighting fraud.
,What is a claim? Correct answer-A claim is a complete record of all the services provided to a
patient.
Identify two items of information that need to be on a claim. Correct answer-Possible answers
include the patient's name, health record number, account number, and demographic information,
the subscriber number, group or plan number, and the provider's name.
Which of the following describes a clean claim?
(choose one)
All the data elements are completed.
All the data elements are written on a white piece of paper.
Almost all the data elements are right.
All the necessary data elements are completed. Correct answer-All the necessary data elements
are completed.
True or False: In 2012, the Administration Simplification Compliance Act (ASCA), part of HIPAA,
mandated that health care claims be submitted electronically, with some exceptions. Correct
answer-true
The primary insurance plan does which of the following? (choose one)
Pays for everything
Pays first
Pays second
Has the option of paying first or second Correct answer-Pays first
What is an NPI number? Where does it go on CMS-1500? Correct answer-the NPI is a unique
identification number for all HIPAA-covered entities, including individuals, organizations, home
health agencies, clinics, long-term care facilities, residential treatment centers, laboratories,
ambulances, group practices, and health maintenance organizations (HMOs).
It is block 17b on the CMS-1500 form.
True or False: Misspelling a patient's name is a common processing error. Correct answer-true
Nicknames and hyphenated last names can complicate the task of getting the patient's name correct.
, True or False: You are allowed to use both six- and eight-digits for the date on one claim. Correct
answer-False
You need to pick one style and use it throughout the claim.
Describe when Medicare is the secondary insurance for a patient. Correct answer-Medicare is the
secondary insurance for a patient when she has a group health insurance plan, is covered by workers'
compensation, or is on disability.
By signing block 12 on the CMS-1500 form, a patient is doing which of the following?
(choose one)
Authorizing the release of funds to a provider
Authorizing the provider to perform a procedure
Authorizing the release of medical information needed to process a claim
Authorizing hospice care Correct answer-Authorizing the release of medical information needed to
process a claim
Name three kinds of insurance information that needs to be collected from the patient. Correct
answer-Among the correct responses are the correct policy number and group number, if applicable;
policy effective dates; and type of policy.
Coordination of benefits involves which of the following? (Choose one)
Double-checking each patient's insurance information
Collecting demographic information
Determining which insurance is primary and which is secondary
Submitting a claim Correct answer-Determining which insurance is primary and which is secondary
The coordination of benefits process, which determines primary and secondary insurance, ensures
that there is no duplication in the payment of benefits. The primary insurance pays first, up to its
coverage limits, and the secondary insurance pays second.
True or False: The birthday rule is a way to mark how long a patient has had his insurance policy.
Correct answer-False
