The administration of financial transactions that result from the medical encountrers between a patient and a provider, facility, and/or supplier.

Revenue cycle management

Begins with patient registration and entering in the patients insurance information in the demographic section of the EHR

Revenue cycle

Statement received by the patient with the approved amount, a adjustment, and payment to provider.

Explanation of benefits

Sent to the practice with the approved amount and payment

remittance advice

Updated annually to reflect the amounts charged by providers for services.

fee schedule

sometimes called visit capture

charge entry

According to CMS, the provider or supplier who routinely waives Medicare deductibles and co-payments is misrepresenting the actual charge of the service or supply.

true

Waiver of Medicare deductibles is allowed under the anti-kickback statute.

false

There are no options for patients that do not have insurance.

false

Many commercial insurance companies prohibit waiving of copayments or deductibles.

true

A professional courtesy discount is an example of a(n)

adjustment

A(n)________ from lists the procedures performed in a medical office and their respective codes.

Encounter

As outlined in the Medicare desk reference for physicians. The routine waiver of Medicare deductibles and co-payments is unlawful for the following reason

It results in excessive utilization of Medicare items and services, it violates the anti-kickback statute, it results in false claims

Computerized accounting systems

automatically update records as information is entered into the system

Discounts must generally be authorized by the

provider

For many patients and staff members, discussing the subject of money owned is touchy and uncomfortable. Which of the following statements would not be considered a professional way to discuss collections

For the patient checking in at the front desk, “you have not paid your prior balance. Your account will be sent to collection if not paid in full today.”

Patients should be given a receipt

when they make payment in any form

The process of transferring information from one record to another is called

posting

When applying an insurance adjustment to a patient’s account, you are not typically required to post the

Name of the secondary insurance company that might be billed later

When claim form errors are identified by the third-party payers, the claim is then rehected. Which of the following is not considered an error

The correct place of service code

When following up on a delinquent claim, if the carrier tells you that it is still in process, you should

request an anticipated date of payment

When a patient’s health insurance plan supports the ability to check electronically the amount of co-payment a patient will be responsible for the amount of payment the insurance company will make

this is known as; real-time adjudication

Which form is also known as the UB-04 form

CMS-1450

Which of the following is not a common claim error

Use of correct international classification of diseases (ICD) codes or ICD codes that support the current procedural terminology (CPT) codes

Which of the following is not a fee usually charged by a clearinghouse

Customer service fee

Which of the following is not an advantage of using an electronic claims tracking (ECT) system

All claims are guaranteed to be paid if the forms are filled out correctly

Which of the following is not considered a true statement regarding the history of claims

Providers have never been paid using an exchange of services or bartering of goods.

_____ means that the doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services.

assignment

Electronically processing claim forms to insurance carriers

reduces the amount of preparation time for the claims processor

Information required to file a third-party claim on the CMS-1500 form includes all but?

the co-pay receipt given to patient at time of visit.

Information required to post on the patient account includes all of the following except the

date the claim was submitted

The CMS-1500 paper form when allowed is accepted by

medicare and various government insurers

The phone___ was coined to indicate payment of services rendered by someone other than the patient

Third-party reimbursement

The primary insurance information will be placed in _____ of the CMS-1500 form for secondary billing

block 9

The process of billing a secondary insurance company involves which of the following

After payment is received from the primary insurance, you must create a new bill with the secondary insurance information or perform the electronic task of submitting the claim to the secondary insurer

The steps to file a third-party claim and accurately complete the CMS-1500 form include

The insured's policy for FECA number, The patient’s or authorized person’s signature, checking the appropriate box regarding patient’s condition related to employment, auto accident, other accident, and claim codes

What is the first step in completing a claim form

check for a photocopy of the patients insurance card

When a third-party payer identifies an error on the claim form, the claim is

Rejected with a request to resubmit the form with corrections

Collection agencies may charge ____________ for their services

A percentage of the bill

Each state has laws (called statues of limitations) that establish the number of years during which legal procedures may be filled against a patient. If the statute of limitations is two years and the last date on the patient account was September 2021, it could be collected through

September 2023

If a patient's check is returned to the office by the bank and is marked ‘NSF” it means

There is not enough money in the patient’s account to cover the check

If you make collection calls before the legal hours in your state, you can be liable for

harassment

Money due to the practice is known as

accounts receivable

The account statement does not typically include which type of information

diagnosis information

The best collection opportunity after face-to-face contact is by

Telephone

The computer-generated statement is considered to be an efficient collection method for the office because it shows not only an itemized account of all transactions but the age of the account. The statement will show the portion of the amount due that is

Current, over 30 days, over 60 days.

The easiest and fastest method of searching for an account in practice management(PM) software is a(n) ____ search

Alpha

The specific provisions of the truth in lending act (TILA) that explains in great detail who and what is covered by the regulation and gives specific disclosure and other requirements that have to be met for open-end and closed-end credit transactions are implemented through

Regulation Z

The TILA specifies that when there is an agreement between the provider and a patient to accept payments in more than four installments, the provider is required to provide a disclosure of finance charges which must be kept on file for

2 years

The truth in lending act (TILA) requires the disclosure of finance charges if allowing a patient to pay in more than_____ installments

four

When composing collection letters, avoid words that tend to antagonize, such as

ignored

When processing a credit balance, if a refund is due to a patient you must

Verify that you have the patient’s current address

Where do aging dates usually on a patient statement

at the top or bottom

Accounts are considered current if within ______ days of the billing date

30

There are exceptions to the usual billing and collection procedures. Which of the following would not be considered an exception

A person who has disappeared or moved to avoid payment of bills ( the patient is a skip)

The check routing symbol is commonly ______ on a person check

hyphenated

The magnetic ink character recognition (MICR) numbers are numbers and symbols and contain the nine-digit___ number

routing

The process of performing banking transactions with a smartphone or personal digital assistant (PDA) is known as_____ banking

mobile

The process of verifying that the amount on the bank statement are consistent with the amounts in the check register is known as

reconciling

The use of checks become common

after world war II

The_____ is the amount in numbers that the check is written for

numeric amount

What is the correct way to write the numerical amount $5.62 as a written amount

five and 62/100

When completing a stub or register, you should

Bring forward the balance from the previous stub or entry

When preparing a deposit slip, if there are more checks than can be listed on the front of the slip, you should

Use the back, total the amount, and bring it forward to the correct line

When sorting currency, bills should be stacked

Portrait side up, in order from highest to lowest denomination

when writing a check, the date

can be written or numerical

You should not accept a check that is

Written for more than the amount due so the patient can have some cash in hand

Which of the following is not a type of savings account

personal checking

A bank statement obtained through an automated teller machine (ATM) usually contains the last _____ transaction made on an account

10

A check paid directly from a checking account through the internet is known as a(n)

electronic check

A check will be instantly returned by the bank if

the signature is missing

A(n) _____ check is a check paid directly from a checking account via the internet

electronic

All checks received in the office, whether in person or through the mail, should be protected by endorsement

Immediately at the time received

An overdraft is when

A check is more than the amount in the bank account

As soon as cash money is received in the office, it should be

Placed out of sight in a secure location

Deposits should always be delivered to the bank

At different times and days of the week

If a stop payment is placed on a check, the bank will

refuse to honor the check

Precautions must be taken when determining the banking procedures within a practice. Which of the following is an example of banking concerns

Possible loss of fluids, potential health insurance portability and accountability violations, identity if patients

When preparing a cover letter, you should not

make it long and involved

When you review your application, checking for missed or incorrectly information, checking for accuracy of spelling and general appearance, and making any necessary edit is a knowledge-based skill known as

Recognizing and using elements of fundamental writing skills

Which of the following is an example of a personal quality

positive attitude

Which of the following is the purpose of a practicum

To apply the skills you learned in the classroom

Which of the following would be considered an illegal interview question

Do you prefer to be called MS,MRS, or Miss

Which style of resume works best when there are no long periods of unemployment between jobs

chronological

Why should you send a follow up letter after an interview

To enhance your image, as an opportunity to address concerns or add related skills, out of courtesy

Your list of references should include _____ non family persons who know you well and can recommend you to an employer

three or four

A list of performance objectives for a practicum are complied by the

school coordinator

A resume should not

Contain information about your age

At a practicum, the student

is intended to have a learning experience

Because the job application will probably reach the personnel mangers office before you do, it must speak well for you; it must make a good first impression on the person who reads it. Which of the following steps would result in not making a good first impression

If the printed instructions on the form say to print all information in black ink, and you use blue ink

During an interview, it is recommended that you

Sit up straight and lean in a little toward your interviewer

Employers in the medical field are not commonly concerned with a prospective employee’s

history of personal relationships

On a resume, your contact information should be emphasized by

bolding

When interviewing for a job, you should not

act overconfident When listing experience on a functional style resume, you should enter the_____ first?

When listing experience on a functional style resume, you should enter the_____ first?

job title

The usual cause for an employee termination initiated by the employer is

Failure of the employee to satisfactorily perform job responsibilities

When relocating a medical facility, patient should be informed of the move

As soon as the date of the move is known

When should the office manager address the various office manuals with employees

During their orientation

Which of the following is an organization that may perform an inspection of the office/clinic

Insurance companies, drug enforcement agency (DEA), Fire department

Which of the following is not a fringe benefit that might be offered by an employer

salary

Which of the following is not a true statement regarding social media

There has to be malicious intent to violate HIPAA policy

Which of the following is not represented in Wisinski’s A-E-I-O-U model of communication

Assume others are hiding concerns

A great deal is learned from mistakes. If mistakes are not tolerated and go unreported, they are bound to be repeated. In a blameless culture, bringing mistakes to the forefront affords the best opportunity to find the root cause. This type of work environment is known as

nonpunitive

A probationary period is defined as

The period during which an employer test how suitable an applicant is for a job

Documentation requirement and directions for opening and closing an office are found in the

Office procedure manual

Employers commonly offer employees an average of ____ weeks of vacation time with pay after completing a year of full-time employment.

two

Every aspect of the medical assistant’s job requires training and can be used as a catalyst for change. Which would not be considered one of the simple steps that will improve outcomes of training

involving only a few select employees

in regard to HIPAA, what does PHI stand for

Protected health information