AAPC CPB Final Exam with Verified Answers
1. d. Social Security Act: Medicare was passed into law under the title XVIII of what
Act?
a. HIPAA
b. Stabilization Act
c. HMO
d. Social Security Act
2. a. Anti-Kickback law: A new radiology company opens in town. The manager
calls your practice an...
AAPC CPB Final Exam with Verified Answers
1. d. Social Security Act: Medicare was passed into law under the title XVIII of what
Act?
a. HIPAA
b. Stabilization Act
c. HMO
d. Social Security Act
2. a. Anti-Kickback law: 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. Anti-Kickback law
b. Stark Laws
c. HIPAA
d. Qui Tam
3. d. Qui Tam: A practice agrees to pay $250,000 to settle a lawsuit alleging that
the practice used X-rays of one patient to justify services on multiple other patients'
claims. The manager of the office brought the civil suit. What type of case is this?
a. HIPAA
b. Stark case
c. Anti-Kickback
d. Qui Tam
4. b. A business associate: A private practice hires a consultant to come in and
audit some medical records. Under the Privacy Rule, what is this consultant consid-
ered?
a. A covered entity
b. A business associate
c. An employee
d. A clearinghouse
5. d. There is no single standard record retention, it varies by state and federal
regulation: What is the standard time frame established for record retention?
a. Seven years
b. The life of the patient
c .Five years
d. There is no single standard record retention, it varies by state and federal
regulation
, AAPC CPB Final Exam with Verified Answers
6. a. Workers' compensation: What entities are exempt from HIPAA and not con-
sidered to be covered entities?
a. Workers' compensation
b. Employers with less than 100 employees
c .Church-sponsored plans
d. Sponsored group plans
7. b. HIPAA: A patient is seen in your clinic. Her husband calls later in the day to ask
for information about the visit. The practice pulls the patient's privacy authorization
to see if they can speak to the husband. What act does this action fall under?
a. Health Information Act
b. HIPAA
c. Social Security Act
d. ADA
8. b. I, III, IV: When a patient is enrolled in an HMO, which options below are the
responsibilities of the primary care physician (PCP)?
I. Manage the member's treatment
II. Be the only provider for all of the patient's healthcare
III. Provide referrals to specialists
IV. Approve emergency department visits
V. Provide referrals for inpatient admissions
a. I, II, III
b. I, III, IV
c. I, III, V
d. I, II
9. d. I, IV: What is the benefit of using NPI numbers for payers?
I. It is a single identifier for all payers
II. It contains the providers' birthdates to allow certain identification
III. Each payer can make their own number
IV. It has no personal identifying information in the number
a. I, II
b. I, II, IV
c. III, IV
d. I, IV
10. c. Self-Funded ERISA: A group contracts with a third-party administrator to
manage paperwork. This group pays for the operation of the insurance plan and the
, AAPC CPB Final Exam with Verified Answers
costs of administration. What type of plan does this represent?
a. Association Group
b. Management Service Organization
c. Self-Funded ERISA
d. Fully Insured Employer Group
11. c. Medicaid: A patient presents for an immunization. When the patient pays his
bill, he asks for a receipt so that he may turn it in to meet his spenddown. What type
of coverage does this patient have?
a. Commercial insurance
b. Medicare
c. Medicaid
d. TRICARE
12. a. HMO: What is an insurance plan that provides a gatekeeper to manage the
patient's healthcare?
a. HMO
b. IPO
c. PPO
d. Medicaid
13. c. File a claim with Medicaid, a refund will be completed when the EOB is
received showing the patients responsibility: A patient presenting for care does
not have an insurance card and is billed CPT code 99213 for $100. The patient
pays $100 to the provider. A week later, the patient presents verification of coverage
through Medicaid for this date of service. What process should be followed?
a. Nothing needs to be done
b. File a claim to Medicaid and refund the $100 to the patient
c. File a claim with Medicaid, a refund will be completed when the EOB is received
showing the patients responsibility
d. None of the above
14. b. Physician's request for privileges: Which of the following is NOT evaluated
in the credentialing process?
a. Physician's residency
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