MC 1100 medical front office procedure quiz revie
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
