Billing / Coding 2

Question 1

person who makes an accusation of fraud or abuse.

Answer 1

relator

Question 2

Electronic health records are considered to have significant advantages, including all of the following except

Answer 2

reduced costs.

Question 3

When protected health information is shared, which of the following should be observed?

Answer 3

minimum necessary standard

Question 4

Which of the following laws prohibits submitting a fraudulent claim?

Answer 4

FCA

Question 5

Which of the following is required for releasing protected health information for reasons other than treatment, payment, or health care operations?

Answer 5

patient’s signed authorization

Question 6

The ACA requires the adoption of __________ for each of the HIPAA Standard transactions.

Answer 6

operating rules

Question 7

What make(s) it possible for physicians and health plans to exchange electronic data using a standard format.

Answer 7

HIPAA Electronic Transactions and Code Sets

Question 8

The responsibility of licensed health care professionals to observe state medical standards of care is called

Answer 8

medical professional liability.

Question 9

The document notifying an individual of a breach is called a

Answer 9

breach notification.

Question 10

For release of PHI for treatment, payment, and health care operations

Answer 10

no authorization is required from the patient.

Question 11

For release of PHI for treatment, payment, and health care operations

Answer 11

no authorization is required from the patient.

Question 12

Which of the following require(s) CEs to establish safeguards to protect PHI?

Answer 12

HIPAA Security Rule

Question 13

HIPAA identifies three types of covered entities

Answer 13

health plans, clearinghouses, and providers.

Question 14

NPI is the abbreviation for

Answer 14

National Provider Identifier.

Question 15

The Health Care Fraud and Abuse Control Program was created by

Answer 15

HIPAA

Question 16

Which of the following conditions requires a specific authorization from the patient other than for TPO?

Answer 16

alcohol abuse

Question 17

are numbers of predetermined length and structure, such as people’s Social Security numbers.

Answer 17

Identifiers

Question 18

E/M is the abbreviation for

Answer 18

evaluation and management.

Question 19

Which of the following acts contains additional provisions concerning the standards for electronic transmission of health care data?

Answer 19

HITECH

Question 20

The electronic equivalent of a business document is called a(n)

Answer 20

transaction

Question 21

CE is the abbreviation for

Answer 21

covered entity

Question 22

Which of the following are organizations that work for covered entities but are not themselves covered entities?

Answer 22

business associates

Question 23

How many Americans are currently part of the Medicare and Medicaid programs?

Answer 23

more than 90 million

Question 24

DRS is the abbreviation for

Answer 24

designated record set.

Question 25

TPO is an abbreviation for

Answer 25

treatment, payment, and health care operations.

Question 26

HIPAA is the abbreviation for the

Answer 26

Health Insurance Portability and Accountability Act.

Question 27

The federal agency that runs Medicare and Medicaid is

Answer 27

CMS

Question 28

HIPAA contains how many provisions (titles) that focus on various aspects of health care?

Answer 28

5

Question 29

What group is charged with detecting health care fraud and abuse?

Answer 29

OIG

Question 30

Which of the following is an action that misuses money that the government has allocated?

Answer 30

abuse

Question 31

regulate(s) the use and disclosure of patients' protected health information.

Answer 31

HIPAA Privacy Rule