Chapter 7 Quiz

About how many data elements are represented by the 837P

1054

How many data elements are represented by the CMS-1500?

150

Which of the following claim forms allow for more data to be included?

837P

Which of the following would be considered a clean claim?

A claim has the correct information for the patient and the encounter

What menu in Medisoft is used to access the Claim Management dialog box?

Activities menu

What choices is/ are available in the select claims for only section of the list only claims that match dialog box?

All Secondary Tertiary All of these are correct

What chart numbers will be included if the Chart Numbers boxes are left blank in the Create Claims dialog box?

All chart numbers

Which of these actions may be performed in the claim management dialog box?

All of these are correct

You are working at a practice and have been asked to create a claim for services performed between the 15th of the month and at the end of the month. What feature of Medisoft may be used?

Apply a filter to the data in Medisoft

What radio buttons may be selected in the provider box of the creat claims dialog box?

Assigned and attending

How is the Claim Management dialog box displayed in Medisoft ?

By clicking claim management on the activities menu or the shortcut on the toolbar

Which of the following invariance claims can be prepared in the practice management program?

CMS-1500 HIPPA Equivalent Encounter Informatijn (837P) HIPPA X 12 837 All of these are correct

Which of the tabs on the claim dialog box displays information about claims being submission to a patients primary insurance carrier?

Carrier 1 tab

Which of the tabs on the claim dialog box display information about claims being submitted to a patients secondary and tertiary insurance carrier?

Carrier 2 and carrier 3 tabs

Which of the boxes on the lay only claims that match dialog box utilizes the MMDDCCYY?

Claim created

What dialog box is displayed after the desired boxes in the laid only claims that match dialog box have been filled in and the apply button is clicked?

Claim management dialog box

What type of claims can be created using a filters in Medisoft?

Claims for specific patients Claim for specific insurance All of these all correct

More than one insurance carrier code can be entered in the primary insurance box if claims are being sent to a

Clearing house

You have been asked to make some changes to a claim before it is sent to an insurance carrier. How would you accomplish that task?

Click edit button to open the claim and correct the data

Which method is used to restore the list only claims that match dialog box to its original settings once it has been reopened ?

Click the Defaults button, then click the apply button

How are the selected filters applied to the claims data once the desired boxes have been filled in on the list only claims that match dialog box?

Click the apply button

You have made a mistake entering claim information in the claim management dialog box and want to redo your work. Which action would you take?

Click the delete button to delete the elected claim and release the transactions bound to the claim

Which of the following is the percentage of charges that insured pays for the payment of the deductible amount?

Coinsurance

What just be placed in between insurance carrier codes in the primary insurance field of the create claim dialog box?

Commas

Which of the tabs in the claim dialog box provides a place to include specific notes or comments about the claim?

Comment tab

Claims that are prepared for submission to an insurance carrier must be reviewed for ___ after they are selected

Completeness and accuracy

What button is clicked to creat the claims once all necessary information has been entered on the create claims dialog box?

Create

In what dialog box are claims created in Medisoft

Create claims

What is the next step once the services patient has received from a provider have been entered into the practice management program

Creating insurance claims

This amount is usually due from the insured before benefits begin

Deductible

What information do claims communicate to a payer about a patient?

Diagnosis Charges Procedures All of these are correct

Insurance claims may be ___ within the Claim Management area of Medisoft

Edited Submitted Created All of these are correct

How are almost all claims sent today?

Electronically

You have been asked to create claims for all the cases have charged totaling at least $500. What filter would you use?

Enter amount

What box is the list only claims that match dialog box is clicked to exclude claims that have been billed and accepted from a search?

Exclude done

In Medisoft, what is a condition that data just meet to be selected?

Filter

How many navigator buttons are contains in the upper right corner of the Claim Management ?

Five

Which of the following source claims are created in Medisoft?

From transactions previously entered in Medisoft

Which of the following do the letters HMO stand for

Health Maintenance organization

By what characteristic may claims in the list only claims that match dialog box be sorted?

Insurance carrier Billing method Claim status All of these are correct

How does the dollar amount entered in the enter amount box of the create claims dialog box?

It acts as the minimum total amount required for a case before a claim can be created.

What happens to a claim if it contains an error?

It may denied Delayed Rejected All of these are correct

What's button in the claim management dialog box makesthe next claim and the list active?

Last claim button

What do the filters in the List Only Claims that match dialog box do with the existing claims that meet the specified criteria?

List them

You have been asked to create a claim for all the procedures that were performed at a specific hospital. What filter would you use from the Create Claim dialog box?

Location

Which of the following is a type of health insurance in which organizations control both financing and the delivery healthcare to policyholder

Managed care

How many insurance carrier codes may be entered in the primary Insurance box if claims are being sent to a clearing house ?

More than one

Which buttons simplify the task of moving from one entry to another in claim management ?

Navigator buttons

Which button on the claim management dialog box makes the next claim in the list active ?

Next claim button

What boxes need to be filled in the List Only Claims That Match dialog box to select the desired claims?

Only the boxes that will be used to select the desire claims need to be filled in

Which of the following entries are allowed in the Frequency Type field of the Carrier 1 tab?

Original entries Replacement entries Void entries All of these are correct

What radio button choice exists in the Billing Method box of the Lost Only Claim That Match dialog box?

Paper Electronic All All of these are correct

Medical insurance represents an agreement between the___ and a health plan

Policy holder

Payments made to the health plan by the policyholder for insurance coverage are called

Premiums

Which button in the claim management dialogbox reactivated the claim that was most recently active?

Previous claim button

You have been asked to create a claims for all the cases for patients who are covered by BCBS. What filter would you use ?

Primary insurance

Which button in the claim management dialog box begins the process of sending electronic claim or printing paper claims?

Print/Send

By what characteristic can claims in the List only claims that match NOT sorted ?

Procedure code

Which button in the claim management dialog box is used to restored data when necessary ?

Refresh data button

Which button in the claim Management dialog box reprints a claim that has already been printed?

Reprint claim

If a claim is rejected by an insurance carrier, it should be___ before resubmission

Reviewed

Which of the following claims is made active when the next claim button is clicked in the claim management dialog box?

The next claim in the list

Who does the Assigned radio button in the Provider box indicate

The patient's regular physician

Claims that are not paid in full can have a negative effects on___

The practices bottom line

What can be done with claims after they are created a Medisoft

They can be printed and mailed or transmitted electronically

Which of the following as a result that can happen with rejected claims

They may cause the practice twice as much as clean claim and can result in reduced cash flow

Which of the following statements describes the advantage of navigator buttons?

They simplify the task of moving from one entry to another

Which type of the following data can be used in a filter ?

Transaction dates Billing codes Chart numbers All of these are correct

Which of the tabs on the claim dialog box lists information about the transaction included in a claim?

Transactions tab