Quiz 2

How does the life cycle of a medical bill begin? A. The physician's diagnosis B. Making an appointment C. A completed questionnaire D. Printing an encounter form

A complete questionnaire

Which is a false statement? A. Being complete in every detail pertains to being thorough. B. Accuracy has no effect on reimbursement. C. Being accurate and thorough are necessary for proper reimbursement.

Accuracy has no effect on reimbursement.

When an insurance carrier pays for medical treatment based on a policy, it is paying _____. A. benefits B. the HMO C. the premium D. a copayment

Benefits

Which claim form is usually submitted for services performed in a physician's office? A. UB-04 B. CMS-1500

CMS-1500

Codes that identify the physician's opinion about what's wrong with a patient are what type of codes? A. HCPCS Level II B. Procedure C. Diagnosis

Diagnosis

Which coding manual contains five-digit alphanumeric codes? A. UB-04 B. CMS-1500 C. ICD-10-CM D. HCPCS Level II

HCPCS level II

What does Medicare Part A pay for? A. Hospital services B. Pharmaceuticals C. Medical expenses D. Outpatient hospital treatment

Hospital services

Diagnosis codes are found in which manual? A. CPT B. ICD-10-CM C. ICD-10-PCS

ICD-10-CM

Which coding manual contains three to seven character codes with a decimal after the third character? A. CPT B. HCPCS C. ICD-10-CM D. ICD-10-PCS

ICD-10-CM

What is another term for insurance carrier? A. Patient B. Health insurance C. Insurance company D. Physician, clinic or hospital

Insurance company

If preauthorization is required, but the insurance company is not notified, the insurance company _____. A. pays more B. might reduce reimbursement C. bills the doctor for the cost of the extra paperwork involved D. all of the above

Might reduce reimbursement

Who is the first-party? A. Patient B. Health insurance C. Insurance company D. Physician, clinic or hospital

Patient

Who is the second party? A. Patient B. Health insurance C. Insurance company D. Physician, clinic or hospital

Physician clinic hospital

This process includes notifying the insurance company for approval prior to a procedure. A. Reimbursement B. Visitation limits C. Preauthorization D. Allowable charge

Preauthorization

Which type of codes do the CPT and HCPCS Level II manuals contain? A. CMS B. Diagnosis C. Procedure

Procesure

This is the process of paying someone for services already performed. A. Reimbursement B. Claims processing C. Completing an encounter D. None of the above

Reimbursement

What is the total amount of bills at which point the copayment is dropped called? A. Deductible B. Policy limit C. Threshold limit D. Allowable amount

Threshold limit

This is the healthcare program for the Department of Defense. A. Medicaid B. TRICARE C. CHAMPVA D. Workers' compensation

Tricare

A program that pays the medical bills for people with job-related injuries or illnesses is called what? A. PPO B. Medicaid C. Managed care D. Workers' compensation

Worker's compensation