FINAL EXAM 2025 QUESTIONS
AND ANSWERS AAPC CPB
,Medicare was passed into law under the title XVIII of what Act?
a. HIPAA
b. Stabilization Act
c. HMO
d. Social Security Act
d. Social Security Act
A new radiology company opens in town. The manager calls your practice and offers to pay $20 for
every Medicare patient you send to them for radiology services. What does this offer violate?
a. Anti-Kickback law
b. Stark Laws
c. HIPAA
d. Qui Tam
a. Anti-Kickback law
A practice agrees to pay $250,000 to settle a lawsuit alleging that the practice used X-rays of one patient
to justify services on multiple other patients' claims. The manager of the office brought the civil suit.
What type of case is this?
a. HIPAA
b. Stark case
c. Anti-Kickback
d. Qui Tam
d. Qui Tam
A private practice hires a consultant to come in and audit some medical records. Under the Privacy
Rule, what is this consultant considered?
a. A covered entity
b. A business associate
c. An employee
d. A clearinghouse
b. A business associate
What is the standard time frame established for record retention?
a. Seven years
b. The life of the patient c
.Five years
d. There is no single standard record retention, it varies by state and federal regulation
d. There is no single standard record retention, it varies by state and federal regulation
What entities are exempt from HIPAA and not considered to be covered entities?
a. Workers' compensation
,b. Employers with less than 100 employees c .Church-
sponsored plans
d. Sponsored group plans
a. Workers' compensation
A patient is seen in your clinic. Her husband calls later in the day to ask for information about the
visit. The practice pulls the patient's privacy authorization to see if they can speak to the husband.
What act does this action fall under?
a. Health Information Act
b. HIPAA
c. Social Security Act
d. ADA
b. HIPAA
When a patient is enrolled in an HMO, which options below are the responsibilities of the primary
care physician (PCP)?
I. Manage the member's treatment
II. Be the only provider for all of the patient's healthcare
III. Provide referrals to specialists
IV. Approve emergency department visits
V. Provide referrals for inpatient admissions
a. I, II, III
b. I, III, IV
c. I, III, V
d. I, II
b. I, III, IV
What is the benefit of using NPI numbers for payers?
I. It is a single identifier for all payers
II. It contains the providers' birthdates to allow certain identification
III. Each payer can make their own number
IV. It has no personal identifying information in the number
a. I, II
b. I, II, IV
c. III, IV
d. I, IV
d. I, IV
A group contracts with a third-party administrator to manage paperwork. This group pays for the
operation of the insurance plan and the costs of administration. What type of plan does this
represent?
a. Association Group
, b. Management Service Organization
c. Self-Funded ERISA
d. Fully Insured Employer Group
c. Self-Funded ERISA
AND ANSWERS AAPC CPB
,Medicare was passed into law under the title XVIII of what Act?
a. HIPAA
b. Stabilization Act
c. HMO
d. Social Security Act
d. Social Security Act
A new radiology company opens in town. The manager calls your practice and offers to pay $20 for
every Medicare patient you send to them for radiology services. What does this offer violate?
a. Anti-Kickback law
b. Stark Laws
c. HIPAA
d. Qui Tam
a. Anti-Kickback law
A practice agrees to pay $250,000 to settle a lawsuit alleging that the practice used X-rays of one patient
to justify services on multiple other patients' claims. The manager of the office brought the civil suit.
What type of case is this?
a. HIPAA
b. Stark case
c. Anti-Kickback
d. Qui Tam
d. Qui Tam
A private practice hires a consultant to come in and audit some medical records. Under the Privacy
Rule, what is this consultant considered?
a. A covered entity
b. A business associate
c. An employee
d. A clearinghouse
b. A business associate
What is the standard time frame established for record retention?
a. Seven years
b. The life of the patient c
.Five years
d. There is no single standard record retention, it varies by state and federal regulation
d. There is no single standard record retention, it varies by state and federal regulation
What entities are exempt from HIPAA and not considered to be covered entities?
a. Workers' compensation
,b. Employers with less than 100 employees c .Church-
sponsored plans
d. Sponsored group plans
a. Workers' compensation
A patient is seen in your clinic. Her husband calls later in the day to ask for information about the
visit. The practice pulls the patient's privacy authorization to see if they can speak to the husband.
What act does this action fall under?
a. Health Information Act
b. HIPAA
c. Social Security Act
d. ADA
b. HIPAA
When a patient is enrolled in an HMO, which options below are the responsibilities of the primary
care physician (PCP)?
I. Manage the member's treatment
II. Be the only provider for all of the patient's healthcare
III. Provide referrals to specialists
IV. Approve emergency department visits
V. Provide referrals for inpatient admissions
a. I, II, III
b. I, III, IV
c. I, III, V
d. I, II
b. I, III, IV
What is the benefit of using NPI numbers for payers?
I. It is a single identifier for all payers
II. It contains the providers' birthdates to allow certain identification
III. Each payer can make their own number
IV. It has no personal identifying information in the number
a. I, II
b. I, II, IV
c. III, IV
d. I, IV
d. I, IV
A group contracts with a third-party administrator to manage paperwork. This group pays for the
operation of the insurance plan and the costs of administration. What type of plan does this
represent?
a. Association Group
, b. Management Service Organization
c. Self-Funded ERISA
d. Fully Insured Employer Group
c. Self-Funded ERISA
