Finance
The job of creating and implementing the practice's collections policies is done by:
a) the collections specialist
b) the bookkeeper
c) the billing/collections manager
d) the physician assistant
What is the billing/collections manager?
In submitting paper claims, the best practice is to
a) check the NUCC instructions
b) check with each payer for specific information required on the form as well as the NUCC notes
c) check with HIPAA for specific instructions regarding a payer
d) check with the employer on payer requirements
What is check with each payer for specific information required on the form as well as the NUCC notes?
Which of these is the best method for determining if a patient is eligible for services?
a) check the monthly enrollment list
b) check the provider patient listing
c) verify the patient's insurance coverage
d) check the patient roster
What is verify the patient's insurance coverage?
What term refers to the stealing of funds?
a) fraud
b) embezzlement
c) collections
d) cash flow
What is embezzlement?
Under the Federal Trade Commission's rules, it is not legal to:
a) discuss the patient's balance during collection calls
b) identify the practice where the debt was incurred
c) contact a patient via mail
d) contact a patient who wants calls to be made to an attorney
What is contact a patient who wants calls to be made to an attorney?
When a practice accepts a credit card payment in advance for payments billed after treatment, what does the practice send the patient?
a) day sheet
b) zero-balance statement
c) patient statement
d) walkout receipt
What is zero-balance statement?
Name the condition code you would apply to an abortion performed due to social or economic reasons.
a) AE
b) AF
c) AG
d) AH
What is AG?
How often do open enrollment periods usually occur?
a) once per month
b) twice per year
c) once per year
d) every other year
What is once per year?
Patients may agree to a(n)____________ for expensive procedures before the date of service.
a) annual percentage rate calculation
b) prepayment plan
c) payment schedule
d) truth-in-lending form
What is a prepayment plan?
Which of the following is the cost of a borrower's credit calculated as an annual rate?
a) annual percentage rate
b) finance charge
c) amount financed
d) payment schedule
What is annual percentage rate?
__________ is after an account is determined to be uncollectible and is removed from the practice's expected accounts receivable.
a) credit reporting
b) bad debt
c) skip tracing
d) means test
What is bad debt?
Physicians identify their medical specialty by using:
a) administrative codes
b) taxonomy codes
c) place of service codes
d) diagnosis codes
What are taxonomy codes?
BlueCross and BlueShield companies also offer a consumer-driven health plan called
a) BlueFlex
b) BlueCDHP
c) Flexible Blue
d) FlexiBlue
What is Flexible Blue?
The day sheet in a medical office summarizes:
a) all the charges and payments from the start of the month to the current date
b) all the transactions that were posted to all patient ledgers on a particular business day
c) all the payments received from insurance on that day
d) all the payments received from patients on that day
What is all the transactions that were posted to all patient ledgers on a particular business day?
The abbreviation NA stands for:
a) no arrangements
b) no answer
c) no awareness
d) no assignment
What is no answer?
When patients are scheduled to have major, expensive procedures, the practice's policy may be to set up:
a) postpayment plans
b) prepayment plans
c) deductibles
d) coinsurance plans
What are prepayment plans?
Name the POS code used to indicate a procedure occurred in a skilled nursing facility.
a) 11
b) 12
c) 31
d) 81
What is 31?
Which type of consumer-driven health plan funding option is set up by individuals rather than employers?
a) a health reimbursement account (HRA)
b) a health savings account (HSA)
c) a flexible savings account (FSA)
d) a medical home model
What is a health savings account (HSA)?
Bad debt includes all collections that are:
a) over 30 days on the aging report
b) over 60 days on the aging report
c) over 90 days on the aging report
d) all uncollectible accounts
What is all uncollectible accounts?
Under guarantor billing, which of the following is true?
a) the insured, instead of the patient if they are not the same person, receives a practice's bill for services
b) the patient received a practice's bills for services
c) the insurance company will send out a bill to the guarantor
d) the guarantor has to request whom the bill is sent to
What is the insured, instead of the patient if they are not the same person, receives a practice's bill for services?
Which of the following requires a practice to follow a specific series of steps before an account can be written off?
a) Medicaid
b) Medicare
c) both Medicaid and Medicare
d) neither Medicaid nor Medicare
What is both Medicaid and Medicare?
What are the five sections on a claim?
a) provider, clearinghouse, payer, claim details, diagnosis
b) provider, claim details, diagnosis, procedure, payer
c) provider, payer, diagnosis, clearinghouse, subscriber
d) provider, subscriber, payer, claim details, services
What are provider, subscriber, payer, claim details, services?
Define parity as it relates to medical insurance.
a) concept of a network system that reimburses more for quality, cost-effective healthcare
b) concept of diversity in the quality of medical service
c) concept of equality with medical/surgical benefits
d) concept of impartiality in selecting a PCP
What is concept of equality with medical/surgical benefits?
A _______________ may be used to fairly determine a patient's ability to pay for medical services.
a) credit reporting
b) bad debt
c) skip tracing
d) means test
What is a means test?
Who is responsible for regulating the hours during which collection calls may be made?
a) FDCPA
b) Telephone Consumer Protection Act
c) both the FDCPA and the Telephone Consumer Protection Act
d) there is not any regulation on what hour collection calls can occur
Who are both the FDCPA and the Telephone Consumer Protection Act?