ch 1 Flashcards
In what year was the AAPC founded?
1988
What type of health insurance provides coverage for low-income families?
medicaid
Which of the following choices is NOT a benefit of an active compliance plan?
Eliminates risk of an audit.
What will the scope of a compliance program depend on?
The size and resources of the provider’s practice
What is the value of a remittance advice?
It states what will be paid and why any changes to charges were made
What does the abbreviation MAC stand for?
Medicare Administrative Contractor
According to the AAPC Code of Ethics, which term is NOT listed as an ethical principle of professional conduct?
Efficiency
If an NCD does not exist for a particular service/procedure performed on a Medicare patient, who determines coverage?
Medicare Administrative Contractor (MAC)
What is the purpose of National Coverage Determinations?
To explain CMS policies on when Medicare will pay for items or services.
Healthcare providers are responsible for developing ____ ____ and policies and procedures regarding privacy in their practices.
Notices of Privacy Practices
Which coding manuals do outpatient coders focus on learning?
CPT®, HCPCS Level II and ICD-10-CM
Who is responsible for enforcing the HIPAA security rule?
The Office for Civil Rights (OCR)
The Medicare program is made up of several parts. Which part covers provider fees without the use of a private insurer?
part b
In what year was HITECH enacted as part of the American Recovery and Reinvestment Act?
2009
The OIG releases a ____ outlining its priorities for the fiscal year ahead and beyond.
work plan
The Medicare program is made up of several parts. Which part is affected by the Centers for Medicare & Medicaid Services - Hierarchical Condition Categories (CMS-HCC)?
part c
Which provider is NOT a mid-level provider?
Anesthesiologist
HITECH provides a ____ day window during which any violation not due to willful neglect may be corrected without penalty.
30
What is PHI?
Protected health information
which of the following is a BENEFIT of electronic transactions?
Timely submission of claims
According to AAPC’s Code of Ethics, an AAPC member shall use only ____ and ____ means in all professional dealings.
legal and ethical
What form is used to submit a provider’s charge to the insurance carrier?
CMS-1500
The minimum necessary rule is based on sound current practice that protected health information should NOT be used or disclosed when it is not necessary to satisfy a particular purpose or carry out a function. What does this mean?
Providers should develop safeguards to prevent unauthorized access to protected health information
