Insurance/Billing
This insurance program is the primary focus of Accountable Care Organizations (ACOs) to improve patient care quality.
Medicare
Of the following medication routes — buccal, transdermal, intramuscular, sublingual — this one releases medication into the bloodstream the slowest.
Transdermal
In a SOAP note, vital signs are recorded in this section.
Objective section
These are the tiny air sacs in the lungs where gas exchange occurs.
alveoli
What is the appropriate action when removing staples from a wound?
A. Gently place the jaw of the staple remover on top of the staple
B. Carefully tilt the staple remover downward until the staple lifts out
C. Gently place the jaw of the staple remover under the staple
D. Dispose of staples in the wastebasket
Correct Answer: C
You do not want to place the remover on top or tilt it downward.
Always tilt upward to avoid pushing the staple further into the skin.
Staples must be disposed of in a sharps container, not a regular trash can.
The main goal of an Accountable Care Organization is to increase this aspect of patient care for Medicare beneficiaries.
Quality of care
A nitroglycerin patch is an example of this type of medication delivery method.
Transdermal
This section of a SOAP note contains the healthcare provider's diagnosis or clinical judgment about the patient’s condition.
Assessment
This word means difficulty swallowing.
Dysphagia
Which of the following requires prior authorization?
A. Urinalysis
B. Endoscopy
C. Pulmonary Function Test (PFT)
D. EKG
Correct Answer: B (Endoscopy)
Endoscopy is an invasive procedure often requiring anesthesia.
Requires prior authorization from insurance:
Submit diagnosis code (why it’s needed)
Submit CPT code (what procedure will be done)
You may receive an authorization number, but it doesn’t guarantee payment.
This type of insurance covers injuries that occur on the job.
Workers Compensation
This medication route involves placing a drug between the cheek and gum for absorption.
Buccal
In SOAP notes, this section outlines the healthcare provider's next steps, such as prescriptions, referrals, or tests.
Plan
This hormone helps regulate blood sugar levels
Insulin
Which of the following would violate HIPAA if included on a patient sign-in sheet?
A. Patient’s name
B. Name of provider
C. Reason for the visit
D. Appointment time
Correct Answer: C (Reason for the visit)
This is protected health information (PHI) and should not be publicly visible.
A patient’s name may appear on a sign-in sheet, but that is considered an incidental disclosure.
Newer sign-in sheets use peel-away stickers to prevent viewing previous entries.
This type of insurance helps cover low-income individuals and is managed at the state level.
Medicaid
What is the correct response if a parent calls and says their child ingested household cleaner?
A. Tell the parent to call back after taking the child’s vital signs
B. Direct the parent to manually induce vomiting
C. Contact the local Poison Control Center
D. Instruct the parent to administer syrup of ipecac
Correct Answer: C (Contact Poison Control)
Do not induce vomiting or delay emergency response.
Poison Control provides expert guidance tailored to the situation.
True or False: Abbreviations are acceptable in documentation as long as everyone understands them.
False — Only approved medical abbreviations should be used.
This large abdominal organ detoxifies chemicals and metabolizes drugs.
This abbreviation refers to a notice from Medicare that a service may not be covered.
What is an ABN (Advance Beneficiary Notice)?
These standardized codes are used for billing medical services and procedures in the U.S.
What are CPT codes (Current Procedural Terminology Codes)
Where should a patient be injected for a subcutaneous injection?
Fatty tissue under the skin. Back of upper arm, abdomen, thigh
Which part of a medical record would you find allergies, current medications, and past surgeries?
Medical history section
This organ stores bile but doesn't produce bile.
The gallbladder
Which setting provides holistic care for patients?
A. Home Healthcare
B. Skilled Nursing Facility
C. Assisted Living
D. Patient-Centered Medical Home (PCMH)
Correct Answer: D (Patient-Centered Medical Home)
Holistic care = treating the whole patient (physical, emotional, social needs).
PCMH involves a primary care provider coordinating overall care, including referrals to specialists.