CRCR Healthcare Compliance and Regulations 3

Question 1

A revenue cycle staff member accesses a celebrity patient's record out of curiosity without a treatment need. Which HIPAA rule is violated?

Accepted Answer

Privacy Rule minimum necessary standard

Answer

The HIPAA Privacy Rule's minimum necessary standard limits access to PHI to only what is needed for a legitimate job function.

Question 2

Under the Medicare Conditions of Participation, how long must hospitals generally retain medical records for adult patients?

Accepted Answer

5 years from date of discharge

Answer

Medicare Conditions of Participation require hospitals to retain patient medical records for at least 5 years from the date of discharge.

Question 3

Which element is NOT required for a valid HIPAA-compliant authorization for the release of PHI?

Accepted Answer

Patient's Social Security Number

Answer

A valid HIPAA authorization does not require the patient's Social Security Number; required elements focus on purpose, recipient, and patient rights.

Question 4

An exclusion from participation in federal healthcare programs is managed by which federal office?

Accepted Answer

Office of Inspector General (OIG)

Answer

The OIG maintains the List of Excluded Individuals/Entities (LEIE) and has authority to impose exclusions from federal healthcare programs.

Question 5

What is the primary purpose of a Corporate Integrity Agreement (CIA) entered with the OIG?

Accepted Answer

To outline compliance obligations as an alternative to exclusion

Answer

A CIA is a negotiated agreement requiring a healthcare entity to implement specific compliance measures in exchange for not being excluded from federal programs.

CRCR - Certified Revenue Cycle Representative Program Practice Test

CRCR - Certified Revenue Cycle Representative Program Practice Test

CRCR Healthcare Compliance and Regulations 3