MC 1100 medical front office procedure quiz revie

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A secondary health plan is noted in which Block

11d

The assignment of benefits is located in Block

13

The patient's name is found in Block

2

How are corrections made to the electronic health record

A new entry or addendum must be added close to the original entry with the correct information and then initialed

A review of individual cases by a committee to make sure that services are medically necessary and to study how providers use medical care resources is called a(n):

utilization review

The medical record should be released only with a

written release from the patient

When tracing "skips," which of the following is strictly forbidden by law?

Communicate with a third party more than once

If not handled properly, which of the following can decrease what is owed to the provider erroneously

Credit balances and refunds

Match block 14 with the appropriate content as it relates to completing the CMS 1500 form

Date of current illness injury or pregnancy

Match block 21 with the appropriate content as it relates to completing the CMS 1500 form

Diagnosis or nature of illness or injury

Medigap policies covers which of the following

Difference between Medicare reimbursement and the patient financial responsibilities

Which of the following is not accurate about correcting charting errors

Draw two clear lines through the error

The type of health-related information about a patient that conforms to nationally recognized interoperability standards that can be created managed and consulted by authorized clinicians and staff from more than one healthcare organization is an

EHR

A standard, nationwide rule must be followed in establishing a records retention schedule

False

Charge capture relates to charges for missed appointments

False

Claims that are done by direct billing first go to a clearinghouse.

False

Dirty claims cannot be resubmitted.

False

In the physicians office the accounts payable is the amount of money that all patients all the physician

False

The EMR relates to more than one healthcare organization.

False

The patient owns the medical record

False

Usually, more staff members are needed when an office uses an EMR system.

False

Very little statistical information can be gleaned from an EHR system

False

Which of the following MCO's typically has/have the lowest monthly premiums with their patient financial responsibility

HMOs

Which type of HMO model consists of physicians with separately owned practices who formally organize into a group but continue to practice in their own office

Independent Practice Association

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

It depends; the medical assistant must determine where the statement should be sent

Perhaps the most essential action for the medical assistant working with a patient and using an electronic record is to

Make frequent eye contact with the patient and smile

Match block 17 with the appropriate content as it relates to completing the CMS 1500 form

Name of referring provider

Which of the following should be considered when using a collection agency

Net back

Which of the following agreements for payment plans is not subject to TILA and does not require a signed Truth in Lending Statement

No specific agreement with more than four installments and no finance charge

Which of the following indirect filing systems is used by a majority of large clinics and hospitals

Numeric filing

The date in Block 14 is the date

Of the onset of illness

Which part of Medicare covers prescription drug services

Part D

The physical medical record belongs to the

Physician or provider

Which of the following referrals can be approved online when it is submitted through the providers web portal to the utilization review department

STAT referral

When completing the CMS 1500 form which section contains information about the patient and the insured

Section 2

Organizations that fund their own insurance programs offer their employees

Self-funded plans

Which of the following HMO models hires physicians and pays them a salary rather than contracting the physician to create a network

Staff model

Information that is gained by questioning the patient or that is taken from a form is called

Subjective information

Accounts receivable are moneys that are expected but not yet received. All invoices statements and operational expenses are included in accounts receivable.

The first statement is true the second is false

Many healthcare facilities find small claims court a satisfactory inexpensive means of collecting delinquent accounts. Parties to small claims actions are represented by an attorney to the hearing but many also send another person to court on their behalf to produce records supporting the claim.

The first statement is true the second is false

Which statement is not true regarding the reason for keeping accurate medical records

The patient's family may want to examine the records and correct errors

Black 1 of the CMS 1500 contains what information

Type of insurance coverage

Medical facilities should keep records on minors for how long?

Until the minor reaches the age of majority, plus 3 years

The advantages of the EHR system include

ability of the physician to see more patients in a day

Health insurance benefits are determined by

all of the above

The advantages of using the color coding filing system are the following

all of the above

Which of the following functions of an electronic record can store lists of billing codes and current procedural terminology

charge capture

The cash basis system of accounting used by most physicians means that

charges are recorded as income at the time they are received

Which of the following is a fixed amount per visit and is typically paid at the time of medical services

co-payment

A correction to a medical record can be made by

drawing a line through the entry and writing the correct information

The "E" entry in SOAPER charting method means

education

The TRICARE option that is similar to a preferred provider network is TRICARE:

extra

Which of the following is not objective information

family history

Which of the following pays the hospital surgical room fee

hospital

Continuity care means

medical attention that continues smoothly from one provider to another so that the patient receives the most benefit

Entities that make payment on an obligation or debt but are not parties of the contract that created the debt are called

third-party payers

If Mr. Jones insurance has a $500 deductible and a $50 surgery co-pay and then pays 80% of the charges how much will his policy P on his bill of $4359

$3047.20

If Mr. Jones insurance has a $500 deductible and a $50 surgery copay, how much will his insurance pay on his bill of $4359.00?

$3809

Match the PHR acronym with all the appropriate definitions

A. Electronic record of health related information B. Defined by the ONC D. Conforms to nationally recognized interoperability standards E. Can be drawn from multiple sources F. Managed shared and controlled by the individual

Match the EHR acronym with all the appropriate definitions

A. Electronic record of health related information C. Created and managed by authorize clinicians and staff from more than one healthcare organization D. Conforms to nationally recognized interoperability standards

Match the EMR acronym with all the appropriate definitions

A. Electronic record of health related information G. Created and managed by authorized clinicians and staff within a single healthcare organization

Which of the following is not an advantage of managed care

Access to specialized care and referrals is limited

Medical assistants can encourage other staff members during a conversation to an electronic health record system by

All of the above

The medical assistant should always verify which of the following prior to the patient's appointment

All of the above

Which of the following are special bookkeeping entries

All of the above

Which of the following managed-care plans require preauthorization for medical services such as surgery

All of the above

Which of the following needs to occur when a provider agrees to settle for a reduced fee

All of the above

Which of the following is not an advantage of color coded filing system

All of the above are advantages

The maximum amount of money third-party payers will pay for a specific procedure or service is called the

Allowable amount

Which of the following does not conform to the general rules of telephone collections

B. Make repeated telephone calls on the same day E. Leave a message at work revealing the nature of the call

Which of the following needs to occur when a check is returned from the bank for NSF

Both A and B

Which of the following plans require healthcare providers to become participating providers

Both A and B

Payments to the healthcare facility come as reimbursement from the insurance company only. Adjustments are made to a patient's account when it is necessary to add or subtract a patient payment from the balance.

Both statements are true

Veterans of the U.S. Armed Forces may be covered by

CHAMPVA

A payment method in which providers are paid for each individual enrolled in a plan Regardless of whether the person sees the provider that month it's called a

Capitation plan

Which of the following is a common reason why insurance claims are rejected

Claim was sent to the wrong insurance plan

Files for patients who have died moved away or otherwise terminated the relationship with the physician are called

Closed files

Which of the following are not reviewed by a utilization review committee

Fees for services provided

Which of the following is not an advantage of a numeric filing system

Filing activity is greatest when the system is initiated

How would you properly index the name "Jill Freeman, M.D." For filing if you had another patient with the same name but without the title

Freeman, Jill M.D

A policy that covers a number of people under a single master contract issued to the employer or to an association with which they are affiliated and that is not self-funded is usually called

Group Policy

HIPAA recommends that physicians keep the records on patients for at least

HIPAA does not recommend a number of years

Who is the legal owner of the information stored in a patient's record

The physician or agency where services were provided

How can the EHR function to best help improve a facility's appointment show rate?

The system can be programmed to initiate reminder and confirmation calls to patients

A provisional diagnosis is not a final diagnosis and usually is made before the test results are received

True

Electronic claims are submitted via electronic media

True

In Subtitle D of the HITECH Act, the privacy and security concerns related to the electronic submission of health information are addressed

True

Information contained in an electronic health record usually can be accessed from several different physical places

True

Insurance information should be collected on the first visit

True

Less storage space is needed for EHR systems

True

Outguides are heavy guides use to replace a folder that has been removed temporarily

True

The EHR allows access to patient information in an emergency

True

The EHR system can allow patients to set their own appointments using the Internet

True

The cafeteria style plan allows employees to choose the benefits they want for their respective employee

True

The purpose of the trial balance is to disclose any discrepancies between the journal and the ledger

True

The STARK law imposes restrictions on which of the following?

professional courtesy

Which of the following is not a method of organizing a medical record

progressively

The process of moving an active file to inactive status is called

purging

Which of the following health information exchanges allows Providers to find and or request information on a patient from other providers

query-based exchange

The "R" entry in SOAPER charting method means

response


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