PAR - Patient Access Representative Regulatory and Compliance Standards Questions and Answers

Question 1

A patient arrives at the emergency department unconscious and without identification.
The hospital provides a medical screening exam and stabilizing treatment.
Which federal act requires these actions, regardless of the patient's ability to pay?

Accepted Answer

Emergency Medical Treatment and Labor Act (EMTALA)

Answer

Health Insurance Portability and Accountability Act (HIPAA)

Answer

Patient Self-Determination Act (PSDA)

Answer

False Claims Act (FCA)

Question 2

A Patient Access Representative is registering a new patient and provides them with a document detailing their rights to make healthcare decisions, including the right to formulate advance directives. This action is mandated by which of the following?

Accepted Answer

The Patient Self-Determination Act (PSDA)

Answer

The Health Information Technology for Economic and Clinical Health (HITECH) Act

Answer

The Consolidated Omnibus Budget Reconciliation Act (COBRA)

Answer

The Affordable Care Act (ACA)

Question 3

During an internal audit, it is discovered that a billing employee has been consistently using a billing code for a more complex procedure than the one actually performed to increase reimbursement from Medicare. This practice is a violation of which regulation?

Accepted Answer

False Claims Act (FCA)

Answer

Anti-Kickback Statute

Answer

Stark Law

Answer

Health Insurance Portability and Accountability Act (HIPAA)

Question 4

Which of the following scenarios represents a potential violation of the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule by a Patient Access Representative?

Accepted Answer

Discussing a patient's diagnosis in a crowded waiting room.

Answer

Informing a patient about their right to receive a copy of their medical records.

Answer

Asking a patient to provide their insurance information during registration.

Answer

Verifying a patient's appointment time over the phone.

Question 5

A patient asks for a copy of their medical records in an electronic format. According to HIPAA, which of the following is the most appropriate response from the Patient Access Representative?

Accepted Answer

Tell the patient to submit a request in writing and that a fee for labor and supplies may be charged.

Answer

Inform the patient that records can only be provided in paper format for security reasons.

Answer

Deny the request as patients are only allowed to inspect their records, not receive copies.

Answer

Explain that the hospital's policy prohibits the release of electronic health records directly to patients.

Question 6

Under the Emergency Medical Treatment and Labor Act (EMTALA), when is it appropriate for a hospital to transfer an unstable patient to another facility?

Accepted Answer

When a physician certifies that the medical benefits of the transfer outweigh the risks.

Answer

When the patient's insurance is not accepted by the initial hospital.

Answer

When the on-call specialist is unavailable to see the patient.

Answer

As soon as the patient's family requests a transfer to be closer to home.