Chapter 4
Which of the following methods of scheduling appointments would be beneficial for established patients in Dr. Larsen's practice who have been diagnosed with ovarian cancer and need frequent follow-up appointments and medication checks?
shared medical appointments
wave scheduling
open appointment scheduling
new patient scheduling
shared medical appointments
Faith called the office to schedule an annual exam with Dr. Larsen. Her last visit was four years ago. Faith should be scheduled as a(n)
established patient.
no-show patient.
new patient.
returning patient.
new patient.
Dr. Abrams receives payment from BCBS for services rendered to patients covered by the plan. This is known as
assignment of benefits.
coordination of benefits.
balance billing.
preauthorization of services.
assignment of benefits.
While opening mail for a medical office, the administrative medical assistant scans the correspondence and places a sticky note on items needing the physician's attention. This is called
first-class mail handling.
date-stamping the mail.
annotating.
reading the mail with an optical character reader.
annotating.
Patient A had a CBC and a PFT performed. Which type of insurance will cover the services?
major medical
surgical
basic
disability
basic
A claim was submitted with a diagnosis code for a Stage 4 ulcer on the left foot and a procedure code for a hernia repair. Payment was denied. Which of the following is a reason for the denial?
using outdated codes
upcoding the procedure code
not submitting the proper modifier
lack of medical necessity
lack of medical necessity
While triaging a patient over the phone, the AMA learned the patient had “a really deep cut on the inside of the upper thigh and there was blood everywhere.” The patient stated he was not able to stop the bleeding. The patient should be advised to
come to the office, since the wound may become infected.
go immediately to the emergency department because the patient may have cut into an artery.
elevate the leg above his heart and see if the bleeding decreases.
schedule an appointment for the following morning.
go immediately to the emergency department because the patient may have cut into an artery.
Noelle's insurance policy states she has a coinsurance of 90/10 of covered services. When she received her notice from the insurance carrier, it stated that the charges for her last office visit were not allowed. How much of the charges is Noelle responsible for?
90 percent
10 percent
0 percent
100 percent
100 percent
What are some of the elements of Telephone Etiquette
•Use a pleasant tone that conveys self-assurance, along with a genuine desire to be understanding and helpful.
•Promptness: courtesy begins with promptness in answering the call.
Greeting and identifying
When faxing PHI, which of the following should the medical office assistant do prior to faxing the documents?
Send a release of information with the fax cover document.
Contact the entity to whom the transmitted information is to be faxed.
Request a signed return receipt of the faxed information.
All of these.
All of these.
Under his insurance plan, Tyler is required to have prior approval for his upcoming knee replacement. Before the surgery, the surgeon must have which approval document from the insurance plan for the surgery?
informed consent
expressed consent
patient encounter form
preauthorization/precertification approval
preauthorization/precertification approval
Double Jeopardy!!!
The term ______ payer is used if the patient has a policy with an insurance company in which the insurance company agrees to carry the risk of paying for the medical services rendered.
first-party
second-party
third-party
fourth-party
third-party
Alianna has missed four consecutive appointments with Dr. Larsen without notifying the office or rescheduling. Documentation in Alianna's chart should show a(n) _____________ notation.
no-show
new patient
established patient
triaged patient
no-show
Michelle and her husband, Drew, just had a baby. Michelle is laid off from her job and Drew works part-time at a gas station. They are without insurance coverage. The administrative medical assistant should supply Michelle and Drew with the contact information for
Medicare.
Medicaid.
TRICARE.
CHAMPVA.
Medicaid.
What does CC stand for?
Chief Complaint