Question 1

To give, release, or transfer information to another entity is called consent.

Accepted Answer

A) True 
 B)False  False

Question 2

The focus on the health care practice setting and reducing administrative costs and burdens are the goals of

Accepted Answer

A)  HIPAA Title I Insurance Reform. 
B)  HIPAA Title II Administrative Simplification. 
C)  HIPAA Security Rule Administrative Safeguard. 
D)  HIPAA Security Rule Technical Safeguard. 
A)  HIPAA Title I Insurance Reform. 
B)  HIPAA Title II Administrative Simplification. 
C)  HIPAA Security Rule Administrative Safeguard. 
D)  HIPAA Security Rule Technical Safeguard. B

Question 3

Determine whether the following statements are cases of insurance (a) abuse or (b) fraud. You may use the two choices as many times as needed.

-Calling patients back for repeated and unnecessary follow-up visits.

Accepted Answer

A) Abuse 
B) Fraud 
A) Abuse 
B) Fraud A

Question 4

Stealing money that has been entrusted to one's care is known as ___________________.

Accepted Answer

The answer of Stealing money that has been entrusted to...

Question 5

The HITECH Act replaced the HIPAA privacy laws.

Accepted Answer

A) True 
 B)False

Question 6

Nonprivileged information about a patient consists of the patient's

Accepted Answer

A)  city of residence. 
B)  diagnosis. 
C)  illness. 
D)  treatment. 
A)  city of residence. 
B)  diagnosis. 
C)  illness. 
D)  treatment.

Question 7

Match the positions below with the description of that person or entity.

-Individual who is designated to help a provider remain in compliance by setting policies and procedures in place, train staff regarding HIPAA Privacy guidelines, and act as the contact person for questions and complaints.

Accepted Answer

A) Health care provider 
B) Clearinghouse 
C) Covered entity 
D) Business associate 
E) Privacy officer, privacy official 
A) Health care provider 
B) Clearinghouse 
C) Covered entity 
D) Business associate 
E) Privacy officer, privacy official

Question 8

A health care organization must not conduct business with any health care provider who has been listed as an __________________ by OIG.

Accepted Answer

The answer of A health care organization must not conduct...

Question 9

Nonprivileged information consists of ordinary ____________________ unrelated to the treatment of the patient.

Accepted Answer

The answer of Nonprivileged information consists of ordinary ____________________ unrelated...

Question 10

What is the goal of the Medicare Integrity Program (MIP)?

Accepted Answer

Identify a

Question 11

Submitting a claim for services that is not medically necessary is a violation of the False Claims Act.

Accepted Answer

A) True 
 B)False

Question 12

Employees should be aware of what is expected from them and the consequences of misconduct through well-publicized ____________ guidelines.

Accepted Answer

disciplina

Question 13

What is the correct response when a relative calls asking about a patient?

Accepted Answer

A)  Document the name of the relative and his or her relationship to the patient before disclosing any information. 
B)  Ask the relative to put the request in writing and include the patient's signed authorization. 
C)  Have the physician return the telephone call. 
D)  None of the above. 
A)  Document the name of the relative and his or her relationship to the patient before disclosing any information. 
B)  Ask the relative to put the request in writing and include the patient's signed authorization. 
C)  Have the physician return the telephone call. 
D)  None of the above.

Question 14

Determine whether the following statements are cases of insurance (a) abuse or (b) fraud. You may use the two choices as many times as needed.

-Failure to make required refunds when services are not reasonable and necessary.

Accepted Answer

A) Abuse 
B) Fraud 
A) Abuse 
B) Fraud

Question 15

Telephone conversations by providers in front of patients should be _____________________.

Accepted Answer

The answer of Telephone conversations by providers in front of...

Question 16

List the seven basic components of a compliance plan.

Accepted Answer

Conducting internal monitoring and audit

Question 17

Stark laws prohibit the submission of claims for "designated services" if the referring physician has a __________________ with the entity that provides the service.

Accepted Answer

financial

Question 18

Billing for services or supplies not provided is __________________.

Accepted Answer

The answer of Billing for services or supplies not provided...

Question 19

Notes, papers, and memos regarding patient information should be disposed of using a shredding device.

Accepted Answer

A) True 
 B)False

Question 20

The HIPAA amendments to the Criminal "FALSE" Claims Act cover what four areas?

Accepted Answer

Theft or embezzlement; incorre

To give, release, or transfer information to another entity is called consent.

The focus on the health care practice setting and reducing administrative costs and burdens are the goals of

Determine whether the following statements are cases of insurance (a) abuse or (b) fraud. You may use the two choices as many times as needed. -Calling patients back for repeated and unnecessary follow-up visits.

Stealing money that has been entrusted to one's care is known as ___________________.

The HITECH Act replaced the HIPAA privacy laws.

Nonprivileged information about a patient consists of the patient's

Match the positions below with the description of that person or entity. -Individual who is designated to help a provider remain in compliance by setting policies and procedures in place, train staff regarding HIPAA Privacy guidelines, and act as the contact person for questions and complaints.

A health care organization must not conduct business with any health care provider who has been listed as an __________________ by OIG.

Nonprivileged information consists of ordinary ____________________ unrelated to the treatment of the patient.

What is the goal of the Medicare Integrity Program (MIP)?

Submitting a claim for services that is not medically necessary is a violation of the False Claims Act.

Employees should be aware of what is expected from them and the consequences of misconduct through well-publicized ____________ guidelines.

What is the correct response when a relative calls asking about a patient?

Determine whether the following statements are cases of insurance (a) abuse or (b) fraud. You may use the two choices as many times as needed. -Failure to make required refunds when services are not reasonable and necessary.

Telephone conversations by providers in front of patients should be _____________________.

List the seven basic components of a compliance plan.

Stark laws prohibit the submission of claims for "designated services" if the referring physician has a __________________ with the entity that provides the service.

Billing for services or supplies not provided is __________________.

Notes, papers, and memos regarding patient information should be disposed of using a shredding device.

The HIPAA amendments to the Criminal "FALSE" Claims Act cover what four areas?

Role of an Insurance Billing Specialist

Basics of Health Insurance

Medical Documentation and the Electronic Health Record

Diagnostic Coding

Procedural Coding

The Paper Claim: Cms-1500 02-12

The Electronic Claim

Receiving Payments and Insurance Problem Solving

Office and Insurance Collection Strategies

The Blue Plans, Private Insurance, and Managed Care Plans

Medicare

Medicaid and Other State Programs

Tricare and Veterans Health Care

Workers Compensation

Disability Income Insurance and Disability Benefit Programs

Hospital Billing

Seeking a Job and Attaining Professional Advancement

Filters

Exam 2: Compliance, Privacy, Fraud, and Abuse in Insurance Billing

To give, release, or transfer information to another entity is called consent.

The focus on the health care practice setting and reducing administrative costs and burdens are the goals of

Determine whether the following statements are cases of insurance (a) abuse or (b) fraud. You may use the two choices as many times as needed. -Calling patients back for repeated and unnecessary follow-up visits.

Stealing money that has been entrusted to one's care is known as ___________________.

The HITECH Act replaced the HIPAA privacy laws.

Nonprivileged information about a patient consists of the patient's

Match the positions below with the description of that person or entity. -Individual who is designated to help a provider remain in compliance by setting policies and procedures in place, train staff regarding HIPAA Privacy guidelines, and act as the contact person for questions and complaints.

A health care organization must not conduct business with any health care provider who has been listed as an __________________ by OIG.

Nonprivileged information consists of ordinary ____________________ unrelated to the treatment of the patient.

What is the goal of the Medicare Integrity Program (MIP)?

Submitting a claim for services that is not medically necessary is a violation of the False Claims Act.

Employees should be aware of what is expected from them and the consequences of misconduct through well-publicized ____________ guidelines.

What is the correct response when a relative calls asking about a patient?

Determine whether the following statements are cases of insurance (a) abuse or (b) fraud. You may use the two choices as many times as needed. -Failure to make required refunds when services are not reasonable and necessary.

Telephone conversations by providers in front of patients should be _____________________.

List the seven basic components of a compliance plan.

Stark laws prohibit the submission of claims for "designated services" if the referring physician has a __________________ with the entity that provides the service.

Billing for services or supplies not provided is __________________.

Notes, papers, and memos regarding patient information should be disposed of using a shredding device.

The HIPAA amendments to the Criminal "FALSE" Claims Act cover what four areas?

Role of an Insurance Billing Specialist

Basics of Health Insurance

Medical Documentation and the Electronic Health Record

Diagnostic Coding

Procedural Coding

The Paper Claim: Cms-1500 02-12

The Electronic Claim

Receiving Payments and Insurance Problem Solving

Office and Insurance Collection Strategies

The Blue Plans, Private Insurance, and Managed Care Plans

Medicare

Medicaid and Other State Programs

Tricare and Veterans Health Care

Workers Compensation

Disability Income Insurance and Disability Benefit Programs

Hospital Billing

Seeking a Job and Attaining Professional Advancement

Filters