The Health Insurance Portability and Accountability Act (HIPAA) regulates protected health information while allowing appropriate use by all of the following entities EXCEPT:
providers.
health plans.
clearinghouses.
employers.
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Q. 2) Penalties or interest charges can be billed to a beneficiary by a physician due to TRICARE's failure to make payment on a timely basis.
Indicate whether this statement is true or false.
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Q. 3) A physician may bill a Medicaid patient for services if the:
service was not medically necessary.
patient signed an advance beneficiary notice (ABN).
claim was not filed in a timely manner.
necessary preauthorization was not obtained.
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Q. 4) Where can a medical office specialist find the annually established Medicare conversion factor (MCF)?
What will be an ideal response?
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Q. 5) The number one reason that appeals of Medicare Part B claims are returned is for not:
filing within the specified time limit.
including a valid signature.
including necessary documentation.
having patient consent.
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Q. 6) If a Veteran's Administration (VA) facility cannot provide necessary medical care for a veteran, an authorization for services will specify all of the following EXCEPT the:
provider the patient must see.
medical services that the VA approves.
length of period of treatment.
amount the VA will pay.
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Q. 7) In 1994, the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) program name was changed to:
the Defense Enrollment Eligibility Reporting System (DEERS).
the Veteran's Administration (VA) Health Administration Center.
TRICARE.
CHAMPVA.
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Q. 8) The coding system used to report procedures and services for Medicare patients is the __________ Coding System.
Fill in the blank with correct word.
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Q. 9) Examples of standard code sets recognized under HIPAA include:
CPT codes.
HCPCS codes.
ICD-9(10)-CM codes.
all of the above.
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Q. 10) Nonparticipating providers who collect amounts from patients in excess of the limiting charge are subject to financial penalties.
Indicate whether this statement is true or false.
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