Medicare Parts
A private health insurance plan that combines Part A, Part B, and often Part D (prescription drug coverage) into one plan.
PART C (MEDICAL ADVANTAGE)
System in which the only information needed for filing and retrieval is a patient's name.
Direct Filing System
Documents that provides detailed information about charges, payments, and remaining amounts owed to a provider
Accounts receivable ledger
As a medical administrative assistant, how long should you wait before falling up on a pending insurance authorization for a patient's procedure?
A. 120 days.
B. 90 days.
C. 60 days.
D. 30 days.
D. 30 days.
System that provides national uniform payments after adjustments across all practices throughout the country.
Resource-Based Relative Value Scale (RBRVS)
Covers doctor's services, outpatient care, medical supplies, and preventive services.
PART B
Reference to corresponding information in a separate location
Cross-reference
A chronological record of bills received, bills paid, and payments and reimbursements received.
Daily journal
4. Which of the following describes the birthday rule that designates who holds the primary insurance for a dependent child?
A. The parent with the higher income always holds the primary insurance
B. The parent whose insurance policy has been active the longest holds primary coverage
C. The parent whose date of birth occurs earlier in the calendar year holds the primary insurance
D. The older parent automatically holds primary insurance regardless of birth month
C. The parent whose date of birth occurs earlier in the calendar year holds the primary insurance
A small amount of cash available for expenses such as postage, parking fees, small contributions, emergency supplies, and miscellaneous small items.
Petty cash fund
Covers inpatient hospital stays, skilled nursing care, hospice care, and home health services.
PART A
True or False: Cross-reference sheets are needed for numeric filing systems.
True, because the patient is not identified by name, the cross reference sheet is needed to match the name with the number.
A daily record of financial transactions and services rendered.
Day sheet
5. What is the term for a form of cost-sharing that begins after the deductible has been met?
A. Premium
B. Copayment
C. Coinsurance
D. Out-of-pocket maximum
C. Coinsurance
2. What is a general journal?
A. A summary of financial ratios used for decision-making
B. A document used only for recording cash transactions
C. Document where transactions are entered.
D. A report showing year-end inventory balances
Document where transactions are entered.
Covers prescription drugs.
PART D
Files are arranged by name, business, institution, or topic, following the alphabetical order of letters.
Alphabetic
Document consisting of proof of posting sections, month-to-date accounts receivable proof, and year-to-date accounts receivable proof.
End-of-day Summary
6. Using standard indexing rules, in which section of the filing system would a medical assistant place the record of a patient named Ann Mary Jensen Davis?
A. A
B. D
C. M
D. J
D. J
1. What is a subsidiary journal?
A. A financial statement that shows a company's profit or loss at the end of the year
B. A document where transactions are summarized and later recorded in a general ledger
C. A record of employee work hours used for payroll processing
D. A chart used to compare budgeted and actual expenses
B. A document where transactions are summarized and later recorded in a general ledger
3. Who is the guarantor in a medical or financial context?
A. The person who provides medical treatment to the patient
B. The insurance company paying for the services
C. The person or entity responsible for the remaining payment of services after insurance has paid
D. The organization that manages healthcare records
C. The person or entity responsible for the remaining payment of services after insurance has paid
Files are arranged by numbers, which can be straight numeric, terminal digit, or middle digit.
Numeric
A method of bookkeeping that relies on a one-sided accounting entry to maintain financial information.
Single-entry system
7. When the patient completes the Assignment of Benefits form, they are agreeing that the payment for the services provided will go to the:
A. Patient
B. Pharmacy
C. Insurance company
D. Healthcare provider
D. Healthcare provider
What is a document that describes items purchased or services rendered and shows the amount due?
A. Receipt
B. Invoice
C. Purchase order
D. Packing slip
Invoice