Claims
Which item does not go on the patient encounter form?
a) Patient address b) Date of service c) Insurance d) Previous services
What are Previous services?
Carol and her husband, Greg, just had a baby. Carol is laid off from her job and Greg works part-time at a gas station. They are without insurance coverage. The administrative medical assistant should supply Carol and Greg with information to contact:
a) Medicare b) Medicaid c) TRICARE d) CHAMPVA
What is Medicaid?
Dr. Rodriguez receives payment from BCBS for services rendered to patients covered by the plan. This is known as:
a) Assignment of benefits b) Accepting assignment c) Balance billing d) Preauthorization of services
What is Assignment of benefits?
The Evaluation and Management section of procedure codes falls within which range of CPT codes?
a) 90281-99607 b) 70010-79999 c) 80047-89398 d) 99201-99480
What is 99201-99480?
Statutes of limitations for collecting debt:
a) Are mandated by the federal government. b)May exceed 15 years. c) Are set state to state and may vary. d) Are not relevant to the office collection policy.
What is Are set state to state and may vary?
Which of these are prepared on a computer and transmitted electronically to an insurance carrier for processing to receive reimbursement?
a) Patient statements b) Superbills c) Electronic claims d)Encounter forms
What are Electronic claims?
What health insurance covers the expenses of the families of veterans with total, permanent, or service-related disabilities?
a) DEERS b) TRICARE c) CHAMPVA d) HIPAA
What is CHAMPVA?
Which type of payment is made in advance?
a) Co-pay b) Capitation c) Fee-for-service d) Deductible
What is Capitation?
Which type of code is used for reporting each procedure and service that the physician has documented in treating the patient?
a) Diagnostic b) Procedural c) HCPCS d) Medical
What is Procedural?
Which of these shows the professional services rendered to the patient, the charge for each service, payments made, and the balance owed?
a) Encounter form b) Fee schedule c) Routing slip d) Patient statement
What is Patient statement?
A claim form without errors is known as what type of claim?
a) Clearinghouse b) HIPAA c) CMS d) Clean
What is clean?
What part of Medicare is also known as medical insurance?
a) A b) B c) C d) D
What is B?
What is the name for a list of usual procedures the office performs and the corresponding charges?
a) encounter form b) collection list c) fee schedule d) routing slip
What is fee schedule?
CPT-4 stands for ______________________________.
a) Contemporary Procedural Terminology, 4th Edition
b) Current Practice Terminology, 14th Edition
c) Current Processing Terminology, 14th Edition
d) Current Procedural Terminology, 4th Edition
What is Current Procedural Terminology, 4th Edition?
What is it called when bills are sent once a month and are timed to reach the patient no later than the last day of the month?
a) Monthly billing cycle b) Guarantor billing c) Third-party liability billing d) Collection billing cycle
What is Monthly billing cycle?
A(n) _______________ is a service bureau that collects electronic claims from many different medical practices and forwards the claims to the appropriate insurance carriers.
a) Clearinghouse b) Collection agency c) Reimbursement agency d) Insurance company
What is a Clearinghouse?
Adult children covered under a patient's policy may continue being covered under the parent's medical insurance policy up to the age of
a) 18 b) 21 c) 26 d) 30
What is 26?
When speaking with a patient regarding their bill, the administrative medical assistant ______ use medical words to explain the balance.
a) Should b) Should not c) Is required to d) May
What is Should not?
The CPT-4 manual is published by the ________________________________.
a) WHO b) AMA c) HIPAA d) DRG
Who is the AMA?
A terminated account may result when the physician finds it impossible to
a) diagnose the patient's condition b) extract payment from a patient c) contact the patient's insurance provider d) estimate the cost of a patient's procedure.
What is extract payment from a patient?
If handwritten, what color ink should be used to complete the CMS-1500 form?
a) Black b) Green c) Red d) Blue
What is black?
Typically, where are the insurance telephone numbers listed on an insurance card?
a) Front of card b) Back of card c) Not listed on the card d) Both on the front and back of the card
What is on Back of card?
A listing of medical procedures/services and usual charges is called a __________.
a) Fee Schedule b) Encounter Form c) Patient Statement d) Collection List
What is a Fee Schedule ?
During Michael's sick visit a CBC was performed. Which type of code(s) should be used for the service?
a) Unbundled code b) E codes c) Bundled code d) Medicine code
What are Bundled code?
A daily report, called a __________, lists all charges, payments, and adjustments entered during that day.
a) Encounter form b) Collection list c) Day sheet d) Superbill
What is a Day sheet?