RMA Pre-Test 2, Administrative

A patient refuses to follow medical advice, and the physician decides to terminate the relationship. The letter to the patient should state all of the following EXCEPT:

A referral to another physician. -The physician must notify the patient of his or her intention to terminate the relationship to protect the physician against abandonment. The physician is not required to refer to another physician.

A Tickler File is:

Future events arranged in chronological order. -A tickler file is a chronologic file used as a reminder that something must be done on a certain date. This type of file is frequently used as a follow-up method.

The federal insurance program that provides for the medically indigent is:

Medicaid. -Medicaid is a federally funded insurance program that was set up by the federal government in 1965 to provide for the medically indigent. It is regulated by each state.

Which of the following information provided by the patient on the patient registration form is considered to be demographic information?

Place of employment. -Demographic information is statistical information of a population. It is used to identify and provide necessary information about the patient. It includes name, age, address, occupation and place of employment, Social Security number, and name of closest relative.

An illness that existed before an insurance policy is written is known as a(n):

Preexisting Condition. -A preexisting condition is a physical condition of a person that existed before the insurance policy was issued.

When the medical office works on a fixed appointment schedule and a patient arrives without an appointment requesting to see the physician, the patient:

Should be squeezed in for a brief visit so the physician can decide what the next treatment step should be.

A credit balance on an account occurs when:

The patient pays in advance. -A credit balance is the amount of advance payment or overpayment on an account. The amount of receipts exceeds the amount charged.

How do insurance companies use procedure codes?

To decide whether the care being giving corresponds to the patient's disease. -Procedure codes are a means to classify the type of care given to patients. Procedure codes justify medical services by correlating procedures to diagnosis.

A provider who participates in Medicare performs a service for which she charges $250.00. How much should the provider charge Medicare?

$250.00. -A participating provider in the Medicare program must bill for the patient, accept assignment of benefits and accept Medicare's determination of allowable charges for the service.

When it is 4:00 PM in New York City, what time is it in Seattle, WA?

1:00 pm. -The United States is divided into four time zones: (1) Pacific Standard Time (WA, OR, NV, and CA), (2) Mountain Standard Time (MT, UT, ID, WY, CO, NM, AZ, and parts of ND, SD, NE, and KS), (3) Central Standard Time (MN, WI, IA, MO, AR, OK, TX, LA, MS, IL, AL, and parts of TN, KY, ND, SD, NE, and KS), and (4) Eastern Standard Time (all others). Central, Mountain, and Pacific Standard Time zones are 1 or more hours behind Eastern Standard Time. Pacific Standard Time is 3 hours behind Eastern Standard Time; when it is 1:00 Pacific Standard Time, it is 4:00 Eastern Standard Time.

Standard-size paper and envelope for business correspondence is:

8 1/2 x 11: no, 10 envelope. -A standard-size letter (8 1/2 x 11 inches) is used for general business and professional correspondence. Standard ways of folding and inserting letters are used so the letter fits properly and is easy to remove. A size no. 10 envelope is used for a standard-size letter.

Which of the following circumstances would waive the need for a written release of medical records?

A Subpoena. -A SUBPOENA DUCES TECUM is an order to provide records or documents to the court. Authority to release information from the medical record lies solely with the patient unless required by law.

An advantage of using the computer in the medical office is:

A computer has the ability tp process data according to a program to produce desired results. Computers perform tasks quickly and accurately, are versatile, and can perform the same task repeatedly while maintaining accuracy.

The notation c: Julia Jones, MD means:

A copy of the letter is sent to Dr. Jones. -The copy notation (c:) indicates that a copy of the document was sent to a third party or parties. The notation is placed one to two lines below the enclosure notation.

In the problem-oriented medical record (POMR) system, the initial database includes:

A numbered list of present problems. -The POMR system is designed to organize the patient's medical record and the information it contains. The system uses four parts: (1) database, (2) problem list, (3) treatment plan, and (4) progress notes. The database includes the chief complaint, present illness or illnesses, and the patient profile.

Open punctuation is characterized by:

Absence of punctuation after the salutation and a comma after the complimentary close. -Open punctuation style uses no punctuation at the end of any line outside of the body of the letter unless the line ends with an abbreviation. This type of punctuation is used with the simplified block letter style.

Under a managed care plan, the physician agrees to:

Accept predetermined fees. -Managed Care is a type of prepaid health plan. It was developed to provide health care services at a low cost. Managed care includes health maintenance organization (HMOs) and independent practice associations (IPAs). The traditional HMO builds a group of physicians who agree to be paid on a per-patient basis instead of a fee-for-service basis.

The term used to describe the bills the practice has to pay for rent, equipment rental and salaries is:

Account payable. -Accounts payable are the outstanding bills of a business.

Which group of patients should be escorted to the examination room and given instructions on what they are to do?

All patients should be escorted to the examination or treatment room. All patients are generally more cooperative and less anxious if they understand what is to be expected of them.

A numeric filing system requires the use of:

An Alphabetic Cross-Reference. -Numeric filing involves filing records, correspondence, or cards by number. It is an indirect filing system and requires the use of an alphabetic cross-reference to find a given file.

An electronic medical record software program can:

An electronic medical record software program creates, stores, edits, and retrieves patient data. If all data are entered correctly, the computer software can find the chart, store inputted information, and allow more than one person to access the information.

In an alphabetical file, which is filed first?

Andrew Stephen. -In alphabetic filing, a person's name is indexed with the surname as unit 1, the given name as unit 2, and the middle name as unit 3. Names are alphabetized according to the first unit letter by letter.

Which of the following calls require immediate transfer to the physician?

Another Physician. -The person answering the telephone is expected to screen all incoming calls. Good judgment in deciding whether to put through a call comes with experience. Calls from other physicians should be put through at once if the physician is available to take the call.

During a routine physical examination, the provider decides to perform spirometry on the patient. How should this be coded?

As a separate procedure. -The CPT code manual provides both a narrative description and a 5-digit code for each procedure or service a provider performs on the patient. The Medicine section of the CPT manual gives codes for noninvasive diagnostic and treatment services.

Patients who are always late or who habitually cancel appointments should be scheduled:

At the end of the day. -Patients who are habitually late for appointments should be scheduled at the end of the day so as not to disrupt the workflow.

After a patient is seen in the medical office, when is the first bill sent to the patient?

At the next scheduled billing after the insurance has paid. -If a patient has insurance, a bill is usually not sent until the insurance company has paid its portion of the bill. The statement for the balance would be sent with the next billing cycle.

This procedure protects against the loss of data:

Backing Up. -A backup is a tape or disk for storage of files to prevent their loss in the event of hard drive failure.

The smallest piece of information that the computer can process is a(n):

Bit. -A bit is a binary digit. It is the smallest piece of information that can be processed by a computer.

Most diseases or conditions are arranged in the tabular section of the ICD-10 manual:

By classification of disease or condition. -The Tubular List of the ICD-10-CM manual displays the actual codes, arranged in 21 chapters, according to classification of the disease or condition or factor influencing health status.

The universal claim form developed by Health Care Financing Administration (HCFA) is:

CMS-1500. -The CMS-1500 is a universal claim form developed by the HCFA that standardizes the data required by most insurance carriers to process insurance claims.

Which of the following is the purpose of records management?

Complete and accurate records are essential to a well-managed medical practice. Health information management includes not only the assembling of the record but also having an efficient system for saving, retrieving, protecting, transferring, storing, retaining, and destroying these records.

Which of the following is NOT included in a memorandum?

Complimentary Close. -A memorandum is a written communication among persons within an office or organization. It uses guide words that indicate the date, sender, receiver or receivers, and subject.

This type of call allows more than one person in more than one place to talk simultaneously:

Conference Call. -A conference call allows more than two people to participate in a conversation at one time. Each person can hear or talk to all others who are participating.

The portion of the fee that a patient with insurance must pay at the time of treatment is called the:

Copayment. -The copayment is payment of a specified amount required when seen by the provider. It is collected before the patient is seen.

Which of the following is demographic information included in a medical record?

Date of Birth. -Demographics relate to the statistical characteristics of a population. It includes the name, date of birth, marital status, children, occupation, education, and social information of the patient.

Which of the following DEMOGRAPHIC information is included in a medical recorded?

Date of Birth. -Demographic information is the routine personal data of the patient that includes name, gender, date of birth, marital status, home address and phone number, and occupation.

Which is correct for an inside address?

David Roberts, M.D. -The inside address includes the name, title, and address of the receiver. When addressing a letter to a physician, omit the courtesy title, and type the physician's name followed by his or her academic degree.

When money is placed in an account, which of the following documents is prepared?

Deposit slip. -Deposit slips are itemized documents of cash, checks, and other funds that a depositor presents to the bank with the items to be credited to an account. All deposits must be accompanied by a deposit slip. A copy of the slip is kept on file.

Which is NOT part of basic information obtained at the patient's first visit?

Diagnosis. -The patient's diagnosis may not be made at an initial visit. At the first visit, the patient may complete a patient information form that includes name, address, telephone number, insurance information, business information, and referral information.

All of the following would require a Current Procedural Terminology (CPT) code EXCEPT:

Diarrhea. - CPT is a listing of descriptive terms and identifying codes used for reporting medical services and procedures performed by the physician. All of the choices are procedures except diarrhea.

The index of files on a disk is the:

Directory. -The directory is the index of files on a disk. It shows the names of the documents that are saved on that disk. The operator can choose a file and open it.

An error was made in charting the patient's record. The method used to correct the error is to:

Draw a single line through the error, write the word "error," make the correction, and date and initial the entry. -Corrections are made in the medical record by drawing a single line through the error, writing the word "error" next to it, making the correction, and dating and initialing the correction (SLIDE rule).

Which of the following are Evaluation and Management (E&M) descriptors?

E&M descriptors include basic diagnostic and treatment services such as office visits and physical examinations. These descriptors are part of the CPT coding system.

EHR is an acronym for:

Electronic Health Record. -The patient's electronic health record (EHR) is a combination of multiple sources of patient records into one source.

When a shipment of supplies is received, the supplies should be checked against the:

Enclosed packing slip. -All orders received should be compared with the original purchase order and the invoice included with the shipment. The order should be checked for correct items, sizes, styles, and amounts.

The correct way to indicate an enclosure notation is:

Enclosure. -The enclosure notation identifies any material that may be accompanying the correspondence. The notation is placed two lines below the signature line. If more than one enclosure is included, specify the number (e.g., Enclosures 2).

A major advantage of using a computer for word processing is:

Extensive editing capability. -The computer, as a document production tool, permits efficient preparation and editing of written documents. Spell-check and column layout are simply added benefits. Storage capacity relates to the computer as a whole and is not specific to word processing.

Which letter style requires the complimentary closing and typed signature be placed in line with the left margin of the body of the letter?

Full Block style. -The full block style places all lines flush at the left margin. The other choices vary indentation of the margins.

Which of the following types of scheduling allows for the most efficient use of staff, materials, and facilities?

Grouping, -Grouping is the practice of scheduling patients with the same type of examination (e.g., complete physicals), conditions (e.g., pregnancy), or procedures (e.g., Papanicolaou [Pap] smears) within certain time frame.

The scheduling system based on scheduling similar appointments or procedures together is called:

Grouping. -Grouping or clustering allows the provider to make good use of time by seeing patients with the same needs at the same time. For example, a provider may perform complete physical examinations only on Wednesday mornings.

The file folder label for Jennie Holmes-Mathis should be:

Holmes-Mathis, Jennie. -Hyphenated elements of a name, whether first name, middle name, or surname, are considered as one unit.

Which of the following is an addition to the ICD-10 compared to ICD-9?

ICD-10-CM includes several new features compared to ICD-9-CM. These include more extensive information related to ambulatory care and managed care encounters, expansion of injury codes, combination of diagnosis and symptom codes which decreases the need for two codes, and more codes that allow for more precise coding of body parts and patient encounters.

The first thing the medical assistant should do when answering the telephone is:

Identify the practice and himself/herself. -The telephone is usually the first contact between the medical office and the patient. Identifying the office and one's self is a good telephone courtesy practice.

A claim may be rejected by an insurance company because of the omission of:

If a claim form is not sufficiently detailed, complete, and accurate, the insurance company may reject the claim. Reasons for claim rejection include missing or incomplete diagnosis; incorrectly coded diagnosis; charges not itemized; patient's group, member, or policy number missing; patient's signature missing; patient's date of birth missing; dates missing or incorrect; and physician's signature missing.

Which of the following must ALWAYS be completed on the insurance claim form?

If the physician accepts assignment of benefits. -Assignment of benefits is authorization for insurance reimbursement to be made to the provider of services rather than the insured individual.

If a patient calls to cancel his or her appointment:

Immediately offer a new appointment time. -An attempt should be made to reschedule the appointment while the patient is on the telephone. Patients with advance appointments may fill canceled appointments.

All checks received as payment for charges should be endorsed:

Immediately. -Endorsement is a signature or writing on the back of a check by which the endorser transfers all rights of the check to another party. All checks received as payments should be restrictively endorsed (for deposit only) immediately to safeguard against loss or theft.

A patient has not been seen in the office for 2 years. The patient's record would be found in the:

Inactive Files. -Inactive files generally are files of patients whom the provider has not seen for 6 months or longer. When the patient returns for care, his or her chart is moved to the active file.

Which of the following methods can be used to enter a health history into an electronic record?

Information must be entered into the electronic health record. This can be accomplished by the patient completing the questionnaire on a computer, the patient completing the history in paper form and the office staff scanning it into the computer, or the medical assistant entering the information directly into the computer while interviewing the patient.

Which is NOT an indexing rule?

Initials come after complete names. -Indexing rules are standardized and are based on current business practices. The rule that applies to initials states "that initials precede a name beginning with the same letter." For example, the chart for M. Johnson would be filed before the chart for Mary Johnson.

An encounter form/superbill provides which of the following?

Insurance claim. -A superbill is a combination charge slip, statement, and insurance reporting form. It is completed and given to the patient at each visit.

Which is NOT true of certified mail?

Insurance coverage is available. -Certified mail requires the receiver's signature as proof of delivery and receipt. Any mail in which first-class postage is paid can be accepted as certified mail.

When making an appointment, which of the following is NOT needed?

Insurance information. -The patient's insurance is obtained at the time of the first visit to the office. Necessary information includes the patient's name, telephone number, reason for coming to the office, and times available for the appointment.

Which coding system is NOT associated with medical procedures?

International Classification of Diseases, tenth edition Clinical Modification (ICD-10-CM). -ICD-10-CM is the coding system used to code diagnoses or disease conditions. CPT, HCPCS, RVS, and RBRVS are systems used to code medical procedures.

Patient information that is released without the patient's authorization might result in a legal charge of:

Invasion of privacy. -Invasion of privacy is the act of divulging patient information that has been acquired through privileged interaction (provider-patient communication) without the consent of the patient, which is an intentional tort. Information shared between the provider and the patient is confidential. A release of information form must be signed before this information can be shared.

Which of the following requires an ICD-10-CM code?

Irritable Bowel Syndrome. -ICD-9-CM assigns numeric codes to diseases, illnesses, injuries, and health-related conditions. The coding system is used to establish medical necessity to facilitate payment for health care services and to translate written terminology or descriptions into numbers to provide a universal common language.

A trial balance is a comparison of:

Ledger card totals and account-receivable balance. -A trial balance is a method of checking the accuracy of accounts. It should be done once a month after all posting has been completed and before preparing monthly statements. The purpose of a trial balance is to disclose any discrepancies between the ledger cards and account receivable. It does not prove the accuracy of the accounts.

Which of the following pieces of correspondence is best sent by certified mail with return receipt requested?

Letter informing a patient who has missed several appointments to find a new provider. -Certified Mail serves as a legal evidence that an item was mailed by the sender with a receipt.

A good telephone technique is a:

Low-pitched and expressive voice. -The telephone voice should be warm, friendly, and natural. Pronunciation and enunciation should be clear and distinct. A normal tone of voice carries best. Variance in tone brings out the meaning of words and adds vitality to what is said. The other choices present opportunities for disconcertion, confusion, or miscommunication.

Both paper and electronic medical records:

Medical records, whether paper or electronic, are a crucial part of a medical practice. They are legal documents that provide an ongoing record of patient treatment and care. They are a source of communication between members of the health care team.

The patient must pay a regular monthly premium for:

Medicare Part B. -Medicare Part A provides coverage of hospitalization services. Individuals age 65 or older are automatically enrolled in Part A with no premiums to pay. Part B covers physician and other provider services. It must be purchased.

Which is an example of a third-party payer?

Medicare, -A third-party payer is any person, insurance company, or government agent other than the patient or the patient's family who pays the patient's account.

The record of the proceedings of a meeting is referred to as the:

Minutes. -The record of the proceedings of a meeting is called the MINUTES. The minutes contain a record of what was done at a meeting, not what was said by the members. Minutes should be signed by the secretary and kept on file according to the procedure of the organization.

Dear Mrs. May: is an example of:

Mixed Punctuation. -Mixed (standard) punctuation is appropriate for use with block or modified block letter styles. It places a colon after the salutation and a comma after the complimentary closing. It is the most commonly used punctuation pattern.

The two-letter abbreviation for Nebraska is:

NE. -The use of standard two-letter abbreviations aids in the reading, coding, sorting, and canceling of all the mail. The U.S. Postal Service has issued a list of two-letter state abbreviations to be used with ZIP Codes. None of the other choices is a U.S. state abbreviation.

Which information is NOT essential for the surgery scheduler when requesting a surgery date?

Name of assisting physician. -Surgery is scheduled by type of procedure and availability of facilities. Important information includes the name of the procedure; expected length of the procedure in hours; type of anesthesia; and the patient's name, age, and telephone number.

The second page of a two-page letter contains which of the following in the heading?

Name, Page Number, and Date. -The second and continuous pages of a letter or report are placed on plain paper that matches the letterhead in weight, color, and fiber content. The heading of the subsequent pages must contain the name of the addressee, page number, and date.

A correctly addressed envelope includes:

Omission of all punctuation. -The U.S. Postal Service attempts to read, code, sort, and cancel all mail electronically. The success of this system depends on the correct format that can be read by the automatic equipment. This format includes all addresses typed in block format in the correct area of the envelope, everything in the address capitalized, all punctuation eliminated, states abbreviated using the standard two-letter code, and the ZIP Code must be included in the last line.

A master list of equipment inventory includes all of the following EXCEPT:

Operating Manuals. -An inventory of all capital items (equipment) should be prepared every year. For each item, the name, serial number, date of purchase, price, and any warranty information are included. Operating manuals should be kept separate and readily accessible.

HIPAA compliance in the medical front office refers to:

Patient Confidentiality. -HIPAA requires the adoption of privacy and security standards to protect an individuals identifiable health information.

An important consideration when deciding how to position the computer monitor at the reception desk is:

Patient Confidentiality. -The patient is entitled to complete confidentiality with regard to his or her medical records and release of information. Computer technology allows for the gathering and storage of vast amounts of information. The information can be accessible to a variety of individuals. The monitor displays information and should be positioned away from others who may be at the desk.

The most common color-coding system color codes the:

Patient's surname. -One system of color-coding files is the alphabetic color-coding system. This system uses different-colored tabs to represent a different segment of the alphabet. The chart is colored by the patient's last name (surname).

A fee profile is derived from:

Physician Charges. -A fee profile is established by compiling and averaging the usual charges for services of the physician over a given period. This profile is used to determine the amount of third-party liability.

Third-party participation in an office indicates the relationships among the:

Physician, patient, and insurance company. -A third-party payer is some entity other than the patient, spouse, or parent who is responsible for paying all or part of the patient's medical costs.

Which type of insurance organization uses the fee-for-services concept?

Preferred Provider Organization (PPO). -The preferred provider organization uses a fee-for-service concept. Providers agree on a predetermined list of charges for all services. Care is not prepaid. The patient must pay deductibles.

SOAP is an acronym for:

Problem-Oriented progress notes. -SOAP is an organized way of charting progress notes. SOAP stands for subjective, objective, assessment, and plan.

A direction to consider additional codes is:

See also. -SEE ALSO is the coding convention that gives the direction to the coder to consider another code.

The bank statement is reconciled with:

The Checkbook. -A bank statement is periodically sent by the bank to the customer. It shows the status of the account on a given date. The bank statement balance and the checkbook balance should be the same, or they need to be reconciled (disclosure of any errors in the checkbook or bank statement).

A Medicare claim for a deceased beneficiary may be paid directly to the physician if:

The estate is billed. -Estate claims are made against the estate of a deceased patient. When the office receives notification of the patient's death, the office must submit a claim for the unpaid balance to the administrator of the estate. Each state has different rules and regulations concerning the filing of estate claims.

On arrival to the medical office, the established patient informs the medical assistant of a change in insurance coverage. Which of the following computer screens should be accessed?

The patient record. -The patient record screen shows the patient information such as demographics and insurance information.

When a patient has managed care insurance, who is the gatekeeper to authorize consultations with specialists?

The primary care provider. -In a managed care system, the patient selects a primary care provider. The provider is considered to be the gatekeeper and must provide a referral for specialist care.

Which of the following characteristics of a receptionist might make an impression on a patient?

The receptionist is usually the first person in the medical office with whom the patient has contact. The appearance, professionalism, attitude, and manners of the receptionist as well as the appearance of the reception area as a whole can influence the patient's perception of the entire practice.

The appointment system of the office should take into account the needs of the:

The scheduling system chosen by the facility must be individualized for each specific practice. Important factors that determine the best system include patient need, physician preferences and habits, and facilities available.

Ideally, a telephone should be answered before the:

Third Ring. -If possible, the telephone should be answered on the first ring and always by the third ring.

When preparing the appointment matrix, the first action is to indicate:

Times not available. -To develop the matrix in the appointment book, block out the times the physician or physicians will be unavailable. All else revolves around physician availability.

If a patient's account has been turned over to a collection agency and the patient calls about the bill, the patient should be told:

To deal with the collection agency. -After an account has been released to a collection agency, the medical office makes no further attempts at collection. No more statements are sent. The patient's ledger is marked so that the office knows it is in the hands of an agency. The patient should be referred to the agency if he or she contacts the office in regard to the account. Any payments should be reported to the agency.

The complimentary close of a letter is typed how many lines below the last line of the body?

Two. -The complimentary close is placed on the second line below the last line of the body of the letter.

The most formal of complimentary closings is:

Very truly yours. -The complimentary close is the writer's way of saying "good-bye." The words used are determined by the formality used in the salutation.

A new employee must complete which of the following?

W-4 forms. -The W-4 form is the Employee's Withholding Allowance Certificate. It is filled out by the employee and allows him or her to determine the number of withholding allowances.

The entry, editing, manipulation, and storage of text using the computer is:

Word Processing. -Word processing is the system used to process written communications. It is a document production tool. Telecommunications involve verbal communication; documentation, interfacing, and formatting are not types of computer systems.