AAPC CPB Study guides, Class notes & Summaries

What does the acronym PHI stand for? a. Patient Healthcare Information b. Patient History of Illness c. Protected Health Information d. Protected Healthcare Index Answer c. Protected Health Information 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. Stark Laws b. HIPAA c. Anti-Kickback law d. Qui Tam Answer c. Anti-Kickback law Which ...

What is the term for the total amount of covered medical expenses a policyholder must pay each year out-of-pocket before the health insurance company begins to pay any benefits? Answer A deductible is the amount a policyholder pays for health care services before the health insurance begins to pay. Which type of insurance covers physicians and other healthcare professionals for liability as to claims arising from patient treatment? Answer Medical malpractice insurance is a type of liability i...

Managed care organization were created to manage benefits and to develop participating provider networks. Managed care can now be categorized according to six models. Which model below listed below is not considered managed care? A. Triple Option Plan (TOP) B. Integrated Delivery System (IDS) C. Health Maintenance Organization (HMO) D. Value-added Network (VAN) Answer D. Value-added Network (VAN) Medicare Part ______ helps pay for inpatient care in a hospital, skilled nursing facility, ...

A practice agrees to pay $250,000.00 to settle a lawsuit alleging that the practice used x-rays of one patient to justify services on multiple other patients' claims. The office manager brought the civil suit. What type of case is this? Answer Qui Tam In which of the following circumstances may PHI not be disclosed without the patient's authorization or permission? Answer An office receives a call from the patient's husband asking for information about his wife's recent office visit. A...

What is the term for the total amount of covered medical expenses a policyholder must pay each year out-of-pocket before the health insurance company begins to pay any benefits? A. Copayment B. Deductible C. Secondary Payment D. Coinsurance Answer B. Deductible Which type of insurance covers physicians and other healthcare professionals for liability as to claims arising from patient treatment? A. Business liability B. Bonding C. Medical malpractice D. Workers' compensati...

A 6 year-old is seen in the pediatrician office for the first time. He has insurance coverage through both his mother (DOB: 02/08/86 and his father (DOB: 05/15/85). Whose insurance is primary? A. Mother's insurance plan B. Father's insurance plan C. The policy that has the best benefits D. Either mother's or father's insurance plan depending who brings the child in for medical care. Answer A. Mother's insurance plan Which managed care plan has the patient receiving care from pa...

AAPC CPB FINAL EXAM 2021 WITH CORRECT RATIONALES fraud - answer-making false statements or misrepresenting facts to obtain an undeserved benefit or payment from a federal healthcare program inadequate med recd - answer-All the following are considered Fraud, EXCEPT: breach - answer-A hospital records transporter is moving medical records from the hospital to an off-site building. During the transport, a chart falls from the box on to the street. It is discovered when th...

AAPC CPB VERSION 1-5 EXAM ALREADY GRADED A+ 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 balanc...

AAPC CPB VERSION 1-5 EXAM ALREADY GRADED A+ 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 balanc...

AAPC CPB VERSION 1-5 EXAM ALREADY GRADED A+ 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 balanc...