AAPC Official CPC Certification Study
Guide Notes 2023
"hold harmless clause" - ANS-* found in some non-Medicare health plan contracts
* prohibits billing to patient for anything beyond deductibles and co-pays.
A compliance plan may offer several benefits, including: - ANS-* more accurate
payment of claims
* fewer billing mistakes
* improved documentation and more accurate coding
* less chance of violating self-referral and anti-kickback status
A healthcare clearing house is a - ANS-entity that processes nonstandard health
information they receive from another entity into a standard format
A key provision in HIPAA is the Minimum Necessary requirement. this means - ANSonly the minimum necessary protected health information should be shared to satisfy a
particular purpose.
A medically necessary service is the - ANS-least radical service/procedure that allows
for effective treatment of the patients' complaint or condition
A patient sustaining an injury to her great saphenous vein would have sustained injury
to which of anatomical site? - ANS-Leg
APC - ANS-Ambulatory Payment Classification
ARRA - ANS-American Recovery and Reinvestment Act (of 2009)
ASC - ANS-Ambulatory Surgical Centers
Abuse consists of - ANS-payment for items or services that are billed by providers in
error that should not be paid for by Medicare.
An ABN protects the provider's financial interest by - ANS-creating a paper trail that
CMS requires before a provider can bill the patient for payment if Medicare denies
coverage for the stated service or procedure.
An entity that processes nonstandard health information they receive from another
entity into a standard format is considered what? - ANS-Clearinghouse
As a part of Health Care Reform, the Affordable Care Act of 2010 amended the
definition of fraud to remove the __________ requirement - ANS-intent
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