INSURANCE
OFFICE LOGISTICS
PATIENT SCHEDULING
WORKFORCE
MEDICATIONS
100

A process required by some insurance carriers in which the provider obtains permission to perform certain procedures or services is

Preauthorization/ Precertification 
100

For practices that do not use e-prescribing, where should extra prescription pads be stored?

Locked Cabinets

100

What type of scheduling allows for patients to schedule 24 hours per day and reduces calls to the office?

Self-Scheduling 

100

TRUE OR FALSE: If a manager does not make a habit of writing formal reprimands to employees not performing as expected, insufficient evidence may be available to terminate their employment.

True!


Without adequate documentation to support a manager's claims it will be difficult to terminate an employee

100

The use of a drug eliminates the disease

Cure 

200

Provide the name of 2 different Government Insurance programs

Medicare

Medicaid

TriCare

ChampVA

200

Money owed by a company to other companies for services and goods.

Accounts Payable 

200

A person who fails to keep an appointment and gives no prior warning or notice is known as what?

No-Show

200

Which of the following resume formats are customized to a specific job and includes detail key skills and how the applicant has demonstrated those skills?

Targeted

200

Service provided to stop certain conditions from occurring or to lead to an early diagnosis are considered

Preventative 

300
True or False: Claims that are done by direct billing first go to a clearinghouse

False!

Direct billing is completed when the claim is submitted directly to the insurance company for payment and processing 

300

True or False: The duty of care is the level and type of care an ordinary, prudent healthcare professional having the same training and experience in a similar practice would have provided under a similar situation.

True 

300

For legal purposes, what needs to occur when a patient fails to keep an appointment?


Document in the patient's chart and schedule book/system 


300

TRUE OR FALSE: Personal websites indicated on the resume should be professional and contain a professional image of the person.

True!

Personal websites that are highlighted on a resume should contain a professional picture of the potential employee as well professional material

300

This can occur when a medication is taken routinely, and the prior dose is not completely metabolized and excreted before the next dose is given.

Cumulative Effect 

400
True or False: TriCare is insurance provided for military members and their families of those who served and suffered a permanent disability and/or death

FALSE!

ChampVA is a military backed insurance program that is designed for former military members and their families if the member sustained a permanent disability and/or death 

400

Services and/or supplies used to treat the patient's diagnosis meet the accepted standard of medical practice is the definition of:

Medical Necessity 

400
TRUE OR FALSE: It is the responsibility of the diagnostic/testing facility to determine if they are in fact INN with a member's insurance?

False!

Diagnostic and testing facilities do not verify insurance information of patients, that is the job of the ordering provider 

400

TRUE OR FALSE: Employee morale should not be a consideration when company decisions are made

False!

Employee morale and wellbeing should always be considered when company changes will have impacts on the employees

400

Provide 4 examples of the uses of drugs

  • Prevention: Drugs used to prevent diseases. Example: vaccines are given, and the body creates antibodies to protect against specific diseases.
  • • Treatment: Drugs that relieve the symptoms while the body fights off the disease. Example: acetaminophen brings down a fever (antipyretic), while the body fights off a viral infection.
  • • Diagnosis: Drugs used to diagnose or monitor a condition. Example: contrast medium (radiopaque dye) is given to highlight organs on x-rays.
  • • Cure: Drugs that eliminate the disease. Example: amoxicillin, an antibiotic, is used to cure strep throat.
  • • Contraceptive: Drugs used to prevent pregnancy. Example: Depo-Provera is a contraceptive injectable medication.
  • 292• Health maintenance: Medications used to maintain or enhance health. Examples: vitamins and minerals.
  • • Palliative: Drugs that do not cure or treat the disease but improve the quality of life. Example: Morphine, an analgesic, is commonly used by patients with cancer.
  • • Replacement: Drugs used to increase the blood levels of naturally occurring substances in the body. Example: levothyroxine is used for patients with hypothyroidism.
500
Provide 2 items (insurance related) that are found on a patient's EOB
Patient's deductible

Co-payment information

Co-insurance information

500

Please define the following:

Fraud

Waste 

Abuse 

Fraud: Intentional deception

Waste: Extravagant, needless spending

Abuse: Unintentional, improper use of resources 

500
Please provide 3 different types of scheduling

Wave

Modified Wave

Stream

Cluster 

500

Provide 3 ways that management can avoid problems in the workplace

Careful definition of the areas of responsibility for each staff member.

Maintaining appropriate boundaries with employees

Acting fair in all situations

Encouraging staff to come and speak with them with issues 

500

Who is financially responsible for a minor seeking treatment for STD without parental consent?

Parent/ Legal Guardian