midterm 150
How many characters maximum can be used in an ICD-10-CM code?
7 characters are the maximum.
What is a beneficiary?
A designated person who receives funds from an insurance policy.
What is an explanation of benefits (EOB)?
A document sent by the insurance company to the provider and the patient explaining the allowed charges, the amount reimbursed for services, and the patient's financial responsibility.
What is a claim?
A formal request for payment from an insurance company for services provided.
Define "in situ".
A malignant neoplasm site as the absence of invasion of surrounding tissue.
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.
What is a co-insurance?
A percentage of the allowed amount that the policy holder is responsible for.
What is a preauthorization?
A process required by some insurance carriers in which the provider obtains permission to perform certain procedures or services.
What is a security risk analysis?
A safety measure that identifies potential threats of network breaches and the action plans that are initiated to prevent the breaches.
What is a co-pay?
A set dollar amount that a patient must pay for each office visit.
What is the definition of "policy"?
A written agreement between two parties, where one party agrees to pay another party if certain specified circumstances occur.
What is the term for the collecting of important information from the health record?
Abstract
What part of the computer contains logic circuitry interprets instructions from a program?
CPU
How often should an EHR system be backed up?
Daily
What is the term for the health providers determination of the cause of a condition, illness, disease, injury or congenital defect?
Diagnosis
What should the medical assistant be aware of doing if there are toys in the office?
Disinfect the toys on a routine basis.
How can a correction be made in a medical record?
Drawing a line through the entry and writing the correct information.
What are some typical ways a medical assistant can avoid fires?
Ensure power strips are not overloaded. Turn off equipment that appears to be overheating or malfunctioning. Follow manufacturer's guidelines when storing potentially flammable chemicals. Check electrical cords for cracks or fraying.
What is the term for the articulations of sound?
Enunciation
What is the study of the causes or origin of diseases?
Etiology
What are "closed" files?
Files for patients that have died, moved away, or otherwise terminated their relationship with the provider.
Who approves the referrals to a specialist in some managed care plans?
Gatekeeper
What is the type of policy that covers a number of people under a single contract issued to an employer?
Group Policy
Which MCO typically has the lowest monthly premium with lower patient financial responsibility?
HMO
Which managed care plans require preauthorization for medical services such as surgery?
HMOs, PPOs, EPOs,
When is an answering service used?
If all staff members need to be away at the same time and to accept after hours calls.
What is the term for Continuity of Care?
Medical attention that continues smoothly from one provider to another so that the patient receives the most benefit.
What is the term for healthcare services appropriate for the evaluation and treatment of a disease, condition, illness, or injury and consistent with the applicable standard of care?
Medically necessary
What does a Medigap policy cover?
Medicare Deductible, Medicare c0-insurance and services not covered under Medicare
What part of Medicare covers Physician's office visits?
Medicare Part B
What is the security measure that monitors if hackers are attempting to break into the network and accounts can be locked?
Monitoring log-in activity
What is the term for the relative frequency of deaths in a specific population?
Mortality
What is the most commonly used input device that allows the computer operator to select commands by interfacing with the monitor screen?
Mouse
What is the abbreviation that is the equivalent of "unspecified"?
NOS
What form is a provider legally obligated to provide the patient?
NPP
What is the term that describes a series of computers that are linked, allowing them to share information?
Network
What is not considered email etiquette in the ambulatory care facility?
Never use all capital letters or abbreviations and emoticons to make the message friendlier.
If a patient has a large cut on their hand that has stopped bleeding, is this considered and emergency?
No
Can Insurance Information be included on a sign-in registration. Explain why or why not.
No because it is in violation of HIPAA
Can a code for HIV be used if there is no definitive HIV present?
No, the HIV code can only be used if HIV is present.
What is the term for a patient who fails to keep an appointment without advance notice ?
No-show
What is the typical business envelope size?
No. 10
What type of device would a printer be?
Output device
Define what an application software is designed to do.
Perform a variety of tasks, such as word processing, database functions, and patient billing.
What is the term for the depth of sound?
Pitch
What type of treatment is used to stop certain conditions from occurring or leads to an early diagnosis?
Preventive
What does "PHI" stand for?
Protected Health Information
What are the steps in using a fire extinguisher?
Pull the pin, Aim the nozzle at the base of the fire, Squeeze the handle to release the extinguisher agent, Sweep the nozzle from side to side of the fire.
What is the term for an order from a primary care provider for the patient to see a specialist?
Referral
What is the term for a repayment made for expenses or loss incurred?
Reimbursement
What are some of the typical necessities when taking the chief complaint?
Remedies the patient has tried to relieve symptoms, the duration of pain, symptoms and when they first appeared, reason for seeing the doctor.
What device transfers paper files to a computerized system without inputting all the data using the keyboard.
Scanner
What is the term for an abnormal condition resulting from a previous disease?
Sequela
What spacing is used in business letter?
Single space
How would you describe an indigent?
Someone who is poor, needy or impoverished.
What methods are used to organize a medical record?
Source-Oriented, Problem-oriented, Chronological
What is one strategy that a Medical Assistant could use to help an angry caller calm down?
Speaking in a lower tone of voice
What are the advantages to using a laser printer?
Speed, Quality of printing, Efficiency
What keyboards help reduce repetitive strain injuries by minimizing muscle strain?
Split-key layout and Waved or curvy key layout
How would you properly index the name "Amanda M. Stiles-Duncan?
Stilesduncan, Amanda M.
What must be done when vaccines are stored in a refrigerator?
Store at the ideal temperature of 40F, leave 2-3 inches between vaccine containers and refrigerator walls, post "Do Not Unplug signs, be certain to shut the refrigerator door.
If the doctor is unsure of the diagnosis, what will the medical assistant use to code?
Symptoms
Where do you find an Essential Modifier?
The Essential Modifiers are indented under the main term and must be included in the diagnostic statement.
What is a deductible?
The amount of money a policy holder pays per claim before the insurance company will pay on the claim.
Explain insurance premium.
The amount of money paid to keep an insurance policy active.
What should a medical assistant do when unpacking an order that arrives?
The medical assistant should compare the contents of the package to the packing slip found in the package.
What is a "Participating Provider"?
The physician who enters into a contract with an insurance company and agrees to certain rules and regulations.
What is "capitation"?
The provider is paid for each individual enrolled in a plan, regardless of whether the person sees the provider that month.
Define manifestations.
The signs and symptoms of disease.
How do the main terms appear in the Alphabetic Index?
The terms are in bold
How are burns coded?
They are coded by site, degree and the body surface involved.
What is considered proper body mechanics when lifting or carrying an object?
When lifting and carrying heavy items, keep the item directly in front of you to avoid rotating your spine. Keep your movements smooth. When reaching for an object your feet should face the object. Prevent reaching and straining to get an object
What is the purpose of a firewall?
used to help prevent access to private networks
What is the term for a filing system that uses a combination of letters and numbers?
Alphanumeric
What is a provider network?
An approved list of physicians, hospitals, and other providers.
What is a third-party administrator?
An organization that processes claims and provides administrative services for another organization.
What are some common network security procedures?
Authentication, using strong passwords with eight characters, privacy filters, and logging out of network before leaving the computer.
When using speaker phone, what is one thing that a medical assistant do to remain HIPAA compliant?
Be certain that the conversation cannot be overheard.
What is the insurance that covers veterans of the US Armed Forces?
CHAMPVA
Where should you begin your search for a diagnostic code?
In the ICD-10-CM manual in the Alphabetic Index
What needs to be verified by a medical assistant prior to a patient appointment?
Insurance eligibility, benefits and exclusions, and effective date of insurance
What is the principal advantage of using the wave method when designing the scheduling process?
It allows flexibility to accommodate the unpredictable.
Would a call about an animal bite be urgent or emergent?
It is considered urgent.
Define "carcinoma in situ"
It is the absence of invasion of surrounding tissues.
What is the purpose of utilization review?
It is to review individual cases by a committee to determine that the services are medically necessary.
What is the purpose of a matrix in the schedule?
It prevents booking of patients during meetings and hospital rounds
What is involved in active listening?
Listening to what the speaker is saying, interpreting what the message is, Restating the message to make sure that you have received the intended message.
What types of outpatient procedures might be scheduled by the physician's office?
MRI's, CT Scans, Blood work
What is the name of the federally funded government insurance program that covers the indigent?
Medicaid
What are some typical infection control products that should be available in the reception area?
Tissues, waste containers, hand sanitizer, masks.
Why was diagnostic coding originally developed?
To document mortality.
What health insurance model offers the most flexibility for patients?
Traditional health insurance.
What is the healthcare insurance provided to military dependents and retires military personnel?
Tricare
What are the duties that a medical assistant should perform each day prior to patient arrival?
Turn on the lights in all examination rooms, make sure each room is fully stocked with supplies, Turn on all equipment that will be used throughout the day.
What letter in the ICD-10-CM is reserved by the World Health Organization to assign new diseases with uncertain etiology?
U
What is the type of insurance that protects workers from loss of wages after an industrial accident that happened on the job?
Worker's Compensation
What organization developed the International Classification of Disease?
World Health Organization
What is needed in order to release medical records?
Written release from the patient
Describe indirect filing.
a filing system that requires the use of alphabetic cross-reference to ;ocate specific files.
How would a medical assistant tell the receiver that a copy/duplicate of the letter was sent to Dr. Adams?
c:Alice Adams, M.D. at the bottom of the letter