Med 131 final exam
The process of transferring information from one record to another is called
Posting
Which of the following demonstrates why it is important to explain patient financial obligations for services rendered?
It allows the patient to concentrate on getting well, it assists the patient in planning a reasonable payment schedule, it presents an opportunity to explain why the charges are as stated.
The process of the insurance company determining benefits and amounts for a patient claim/ visit
Adjudication
Sometimes called charge entry
visit capture
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