1|Page
NHA Billing and Coding Specialist Exam
Newest / NHA Billing and Coding Specialist
Exam Preparation / NHA Billing and Coding
Specialist Practice Exam With Complete 200
Questions And Correct Detailed Answers
|Already Graded A+(Newest Version!)
record of clinical observations and care a pt receives at a health care
p p p p p p p p p p p p
pfacility
must be detailed, current and accurate -
p p p p p p
..........ANSWER.......documentation
p
include insurance companies, Medicare and Medicaid -
p p p p p p
p..........ANSWER.......third party payers p p
pcp explains medical or diagnostic procedures, surgical intervetions
p p p p p p p
and the benifits and risks involved, giving an oportunity for pts to ask
p p p p p p p p p p p p p
questions before intervention is provided -
p p p p p p
..........ANSWER.......informed consent
p p
pt presents for treatment, such as extending an arm to allow a blood
p p p p p p p p p p p p p
draw
goes voluntarily - ..........ANSWER.......implied consent
p p p p
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Any information about health status, provision of health care, or pay
p p p p p p p p p p
ment for health care that can be linked to an individual. This is interpr
p p p p p p p p p p p p p
eted rather broadly and includes any part of a patient's medical recor
p p p p p p p p p p p
d or payment history. -
p p p p
..........ANSWER.......Protected Health Information (PHI)
p p p p
agency that converts clains into a standardized electronic format, lo
p p p p p p p p p
oks for errors and formats them according to HIPAA and insurance s
p p p p p p p p p p p
tandards - ..........ANSWER.......clearinghouse
p p
documents that identify the person or provide enought info so that th
p p p p p p p p p p p
e person coud be identified -
p p p p p
..........ANSWER.......individiually identifiable
p p
pts permission evidenced by signature -
p p p p p
..........ANSWER.......consetn
p
permission granted by the pt or the pts representative to release info
p p p p p p p p p p p
rmation for reasons other than treatment, pyment, or health care op
p p p p p p p p p p
erations - ..........ANSWER.......authorization
p p
payment for services rendered by third party payer -
p p p p p p p p
..........ANSWER.......reimbursement
p
review of claims for accuract and completeness -
p p p p p p p
p..........ANSWER.......auditing
,3|Page
making falso statements of representations of material facts to obtai
p p p p p p p p p
n some benifit or payment for which no entitlement would otherwise
p p p p p p p p p p p
exist - ..........ANSWER.......fraud
p p
assigning diagnosis/procedure code at a higher level than the docu
p p p p p p p p p
mentation supports - ..........ANSWER.......upcoding
p p p
using multiplr codes that describe different components of a treatme
p p p p p p p p p
nt instead of using a single code that describes all the steps -
p p p p p p p p p p p p
..........ANSWER.......unbundling
p
practices that directly or indirectly result in unnecessary costs to the
p p p p p p p p p p p
medicare program - ..........ANSWER.......abuse
p p p
business associates must ensure that PHI remains sucure, and they
p p p p p p p p p
are expected to report any breaches in security -
p p p p p p p p p
..........ANSWER.......final rule
p p
pcps are not allowed to refer pts to a pcp with whom they have a fina
p p p p p p p p p p p p p p p
ncial relationship with - ..........ANSWER.......stark law
p p p p p
has oversight responsibilities to stark law -
p p p p p p
..........ANSWER.......CMS
p
, 4|Page
protects the government from being overcharges for services provid
p p p p p p p p
er or sold, or substandard goos or services -
p p p p p p p p
..........ANSWER.......false claims act
p p p
has the authority to exclude individuals and entities who have engag
p p p p p p p p p p
es in fraud and abuse from participating in Medicare, Medicaid, and
p p p p p p p p p p p
other federal helath care programs -
p p p p p
..........ANSWER.......Office of the Inspector General (OIG)
p p p p p p
complete recors of the servics provided by the health care professio
p p p p p p p p p p
nal, along with appropriate insurance info -
p p p p p p
..........ANSWER.......claim
p
sending required info to third party payers for reimbursement -
p p p p p p p p p
..........ANSWER.......transmitting claims
p p
claims must be recieved within 1 calander year of the claim's date of
p p p p p p p p p p p p p
service - ..........ANSWER.......filing claims for medicare
p p p p p
determines which insurance plan is primary and which is secondary
p p p p p p p p p p
- ..........ANSWER.......coordination of benifits
p p p
medicare payment that is recovered after primary insurance pays -
p p p p p p p p p
..........ANSWER.......conditional payment
p p
NHA Billing and Coding Specialist Exam
Newest / NHA Billing and Coding Specialist
Exam Preparation / NHA Billing and Coding
Specialist Practice Exam With Complete 200
Questions And Correct Detailed Answers
|Already Graded A+(Newest Version!)
record of clinical observations and care a pt receives at a health care
p p p p p p p p p p p p
pfacility
must be detailed, current and accurate -
p p p p p p
..........ANSWER.......documentation
p
include insurance companies, Medicare and Medicaid -
p p p p p p
p..........ANSWER.......third party payers p p
pcp explains medical or diagnostic procedures, surgical intervetions
p p p p p p p
and the benifits and risks involved, giving an oportunity for pts to ask
p p p p p p p p p p p p p
questions before intervention is provided -
p p p p p p
..........ANSWER.......informed consent
p p
pt presents for treatment, such as extending an arm to allow a blood
p p p p p p p p p p p p p
draw
goes voluntarily - ..........ANSWER.......implied consent
p p p p
,2|Page
Any information about health status, provision of health care, or pay
p p p p p p p p p p
ment for health care that can be linked to an individual. This is interpr
p p p p p p p p p p p p p
eted rather broadly and includes any part of a patient's medical recor
p p p p p p p p p p p
d or payment history. -
p p p p
..........ANSWER.......Protected Health Information (PHI)
p p p p
agency that converts clains into a standardized electronic format, lo
p p p p p p p p p
oks for errors and formats them according to HIPAA and insurance s
p p p p p p p p p p p
tandards - ..........ANSWER.......clearinghouse
p p
documents that identify the person or provide enought info so that th
p p p p p p p p p p p
e person coud be identified -
p p p p p
..........ANSWER.......individiually identifiable
p p
pts permission evidenced by signature -
p p p p p
..........ANSWER.......consetn
p
permission granted by the pt or the pts representative to release info
p p p p p p p p p p p
rmation for reasons other than treatment, pyment, or health care op
p p p p p p p p p p
erations - ..........ANSWER.......authorization
p p
payment for services rendered by third party payer -
p p p p p p p p
..........ANSWER.......reimbursement
p
review of claims for accuract and completeness -
p p p p p p p
p..........ANSWER.......auditing
,3|Page
making falso statements of representations of material facts to obtai
p p p p p p p p p
n some benifit or payment for which no entitlement would otherwise
p p p p p p p p p p p
exist - ..........ANSWER.......fraud
p p
assigning diagnosis/procedure code at a higher level than the docu
p p p p p p p p p
mentation supports - ..........ANSWER.......upcoding
p p p
using multiplr codes that describe different components of a treatme
p p p p p p p p p
nt instead of using a single code that describes all the steps -
p p p p p p p p p p p p
..........ANSWER.......unbundling
p
practices that directly or indirectly result in unnecessary costs to the
p p p p p p p p p p p
medicare program - ..........ANSWER.......abuse
p p p
business associates must ensure that PHI remains sucure, and they
p p p p p p p p p
are expected to report any breaches in security -
p p p p p p p p p
..........ANSWER.......final rule
p p
pcps are not allowed to refer pts to a pcp with whom they have a fina
p p p p p p p p p p p p p p p
ncial relationship with - ..........ANSWER.......stark law
p p p p p
has oversight responsibilities to stark law -
p p p p p p
..........ANSWER.......CMS
p
, 4|Page
protects the government from being overcharges for services provid
p p p p p p p p
er or sold, or substandard goos or services -
p p p p p p p p
..........ANSWER.......false claims act
p p p
has the authority to exclude individuals and entities who have engag
p p p p p p p p p p
es in fraud and abuse from participating in Medicare, Medicaid, and
p p p p p p p p p p p
other federal helath care programs -
p p p p p
..........ANSWER.......Office of the Inspector General (OIG)
p p p p p p
complete recors of the servics provided by the health care professio
p p p p p p p p p p
nal, along with appropriate insurance info -
p p p p p p
..........ANSWER.......claim
p
sending required info to third party payers for reimbursement -
p p p p p p p p p
..........ANSWER.......transmitting claims
p p
claims must be recieved within 1 calander year of the claim's date of
p p p p p p p p p p p p p
service - ..........ANSWER.......filing claims for medicare
p p p p p
determines which insurance plan is primary and which is secondary
p p p p p p p p p p
- ..........ANSWER.......coordination of benifits
p p p
medicare payment that is recovered after primary insurance pays -
p p p p p p p p p
..........ANSWER.......conditional payment
p p
