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TELE 5
100

Which of the following best describes the state or regional organization that handles Medicare claims?

FISCAL INTERMEDIARY

100

Which of the following terms is applied when more than one policy covers an individual?

COORDINATION OF BENEFITS

100

Which of the following applies to a method of containing hospital costs that is based on an average cost for treatment of a patient’s condition?

Diagnostically related groups

100

A patient is called about an NSF check. He states he is very sorry and asks what he can do. Which of the following types of checks would the medical assistant ask him to bring to the office as a guaranteed payment for the returned check?

Cashier’s

100

Which of the following is NOT a requirement for the ABN form?

Must include the final cost

200

If the employer operates its own health plan instead of purchasing a plan from an insurance company to cover its employees, what type of plan are they utilizing?

Self-Funded Health Care

200

Which of the following is the most likely cause of the deposits not agreeing with the credits on the day sheet or the patient ledgers?

Payment is misplaced

200

Which of the following best describes insurance policies that provide coverage on a fee-for-service basis?

Traditional

200

Which of the following is known as the fee system that defines allowable charges that will be accepted by insurance carriers?

UCR

200

What is the name of the form given to Medicare patients explaining that the cost of a procedure is the responsibility of the patient?

Advanced beneficiary notice

300

Which of the following best classifies the adjustment column in the accounting process and its effect on the balance due?

Credit column; DECREASE balance

300

Which of the following best describes a network of providers and hospitals who have a contract with insurance companies to provide discounted health care?

PREFERRED PROVIDER ORGANIZATION(PPO)

300

Which of the following best describes the managed care organization model having the freedom of obtaining medical services from an HMO provider or by self-referral to a non-HMO provider?

Point-of-service plan

300

WHAT IS THE ENCOUNTER FORM KNOWN AS? 

CHARGE SLIP

MULTIPURPOSE BILLING FORM 

SUPERBILL

300

Which of the following is the type of endorsement that should be used in a clinic?

RESTRICTIVE 

400

The amount of money that the insured must incur for medical services before the policy begins to pay is known as what?

DEDUCTIBLE

400

Which of the following is NOT a procedural step when disbursing the petty cash funds?

Add receipts to original petty cash amount

400

Which of the following is the first rule of purchasing?

Nothing is ordered or paid for without a purchase order.

400

Which of the following is NOT a part of the pegboard system?

BANK DEPOSITS 

400

The statement mailed to the patient summarizing how the insurance carrier determined the reimbursement is known as what?

(EOB) explanation of benefits

500

Which of the following is the most appropriate action when balancing a petty cash account?

ADD AN AMOUNT EQUAL TO THAT SPENT 

500

Which of the following applies to the cash that is usually kept in a locked change drawer and used for transactions with patients who pay in cash and need change?

CASH ON HAND

500

Which of the following terms means an insurance policy pays a percentage of the balance after application of the deductible?

Co-insurance

500

On the ledger card, which column is used for entering payments?

Credit column

500

Which of the following best describes policies that are supplementary to Medicare insurance?

MEDIGAP

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