CMC Compliance & Regulatory Knowledge

Question 1

What does HIPAA primarily regulate?

Accepted Answer

Patient health information privacy

Answer

Medical billing fees

Answer

Healthcare provider licensing

Answer

Insurance reimbursement rates

Question 2

Which federal agency enforces HIPAA regulations?

Accepted Answer

OCR

Answer

CDC

Answer

FDA

Answer

NIH

Question 3

What is considered a violation of patient confidentiality?

Accepted Answer

Sharing patient data without authorization

Answer

Providing general advice

Answer

Discussing treatment options with a provider

Answer

Entering data into an EHR system

Question 4

What does the OIG do in relation to medical coding?

Accepted Answer

Monitors healthcare fraud and abuse

Answer

Issues diagnostic codes

Answer

Manages insurance premiums

Answer

Provides continuing education

Question 5

What is upcoding in medical billing?

Accepted Answer

Billing for a more complex service than provided

Answer

Using outdated codes

Answer

Submitting duplicate claims

Answer

Failing to code all procedures

Question 6

What must be obtained before releasing a patient's medical records?

Accepted Answer

Patient’s authorization form

Answer

Verbal confirmation

Answer

Doctor’s note

Answer

Medical assistant approval

Question 7

What document outlines an organization’s policies for handling PHI?

Accepted Answer

Privacy policy

Answer

Coding manual

Answer

Patient intake form

Answer

Clinical protocol

Question 8

Which law protects against healthcare fraud and abuse?

Accepted Answer

False Claims Act

Answer

HIPAA

Answer

Affordable Care Act

Answer

Medicare Modernization Act

Question 9

What is the primary goal of compliance programs in healthcare facilities?

Accepted Answer

Prevent legal and ethical violations

Answer

Increase patient visits

Answer

Monitor physician performance

Answer

Create billing statements