Final Exam - Chapters 16, 17, 18, 19, and 20

Which of the following terms applies to the accounting system in which outstanding accounts such as office expenses and services are paid for?

Accounts payable

Which of the following must collect the money from the patient if the medical office purses payment through small claims court?

Clinic

What applies to codes as used supplements to basic CPT system and are required reporting services and procedures to Medicare and Medicaid Pateints?

HCPCS

Which of the following is NOT an advantage of a computerized system?

Increases the time needed to train personnel

How can the medical assistant help prevent collection problems?

Inform the patient of payment at the first visit or call.

Providers who accept assignment with Medicare and Medicaid are mandated to charge every patient:

The same amount for similar services rendered

Which section of the CPT book includes coding of lacerations?

Surgery

Which of the following applies to medical insurance for dependents of active duty or retired military personnel and their dependents?

TRICARE

Which type of check has a stub attached that is used to indicate date and invoice numbers?

Voucher

Which of the following questions would NOT be helpful in developing a credit and collection policy?

What is the most convenient time of the month for patients to make a payment?

Total monthly receipts are $50,000 and total monthly charges are $60,000 for the same month. Which of the following percents is the collection ratio?

83%

A patient's check is returned for insufficient funds. Which of the following applies to the patient account balance after the amount of the NSF check is posted and an entry is made in the adjustment column?

Account balance is increased.

Which of the following accounts is debited when a check is written to pay invoices?

Accounts payable

Which of the following is an unwritten promise to pay for credit purchases or services?

Accounts payable

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

The encounter form is also known as the:

All of the above

When collecting a payment from the patient, what is considered the best time?

At the time of service

Which of the following is medical insurance for the spouse and unmarried dependent of a veteran with permanent total disability resulting from a service-related injury?

CHAMPVA

What is completed using data from the patients electronic health record in most offices today?

CMS 1500

What applies to the coding book used for specifying services and procedures performed in the medical office?

CPT

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

What is not included in the recommended procedure for researching CPT code numbers using the index?

Choose a modifier for all diagnoses and procedures

Which of the following is used to gauge the effectiveness of the clinic's billing procedures?

Collection ratio

When completing the patient and insured Information section on the CMS-1500 form you should use what to separate parts of the name?

Commas

What information in not included in coding?

Counseling

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

Credit column

Which of the following is a recommended method used to figure the accounts receivable ratio?

Divide the current accounts receivable balance by the average monthly gross charges.

Which of the following is NOT a common problem affecting collections?

Divorces

What the are codes applied to an injury or poisoning?

E codes

On completion of the processing of the claim the insruance company sends what to the insured person?

EOB

What are diagnosis codes used primarily with cancer registries?

M Codes

Which section of the CPT book includes coding of immunizations and chemotherapy?

Medicine

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

Medigap

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

Must include the final cost

Which of the following is the first rule of purchasing?

Nothing is ordered or paid for without a purchase order.

Which of the following is NOT a service offered by collection agencies?

Obtain funds from bankruptcy accounts.

Which of the following applies to Medicare coverage that pays for outpatient services?

Part B

Which of the following applies to Medicare coverage that pays for prescription drug coverage?

Part D

Which of the following best describes the use of a charge slip?

Provides a patient with account activity for the day of service

Which of the following applies to persons who are eligible for Medicare?

Receive disability income

Which of the following is NOT a true statement about a computerized accounting system?

Replaces all other systems immediately

Which collection technique is used as a last resort in the collection of unpaid balances?

Sending to collection agency.

Why is it important for the medical assistant to understand medical insurance coding?

Serves as a basis for the information on the claim form

How many major sections are in the Current Procedural Terminology reference book?

Seven

The ICD-CM 10th revision will utilize alpanumeric codes that will consist up to how many characters?

Seven

The new CMS-1500 form is distinguishable from the old form in that the 1500 symbol and date are located where?

Top Left Margin

What insurance plan has an annual deductible? Traditional or Managed?

Traditional

Which of the following best describes insurance policies that require policyholders to select a primary care provider?

Traditional

What organization developed ICD-9-CM?

World Health Organization

The amount of charges the provider would have to write off if insurance didn't cover it, is know as what?

an adjustment

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

explanation of benefits (EOB)

Which of the following traditional insurance coverage covers specific dollar amounts for provider's fees, hospital care, and surgery?

indemnity

Capitation payment

managed care

Preventative treatment provided

managed care

Usually must stay inside the provider network

managed care

Considering the amount that Medicare reimburses for medical care, what amount does the patient and Medicare pay?

patient $12, medicare $48

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 non-HMO providers?

point-of-service plan

Before certain procedures or visits can be made, some insurance policies require which of the following?

preauthorization

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

Which is the most common type of referral used by managed care?

regular

Large companies, non-profit organizations, and governments frequently use what kind of insurance to reduce costs and gain more control of their finances?

self-insurance

Payment fee for service

traditional

Usually can go outside provider network

traditional

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

traditional

Which of the following best describes insurance policies that require policy holders to select a primary care provider?

traditional

Which of the following is the purpose of screening new patients for insurance coverage?

verify patient has coverage and obtain vital billing information.

Each time a patient comes to the clinic, the medical assistant must verify which of the following insurance information?

whether insurance covers the procedure, what the patient's insurance plan is, and whether a referral is required. (ALL OF THE ABOVE)

Which of the following is a type of insurance coverage for persons injured on the job?

worker's compensation

Dr. Chad is a participating provider in Medicare. Does this mean Dr. Chard will accept assignment and what percentage of the allowed amount?

yes, 100%