Chapter 13 Quiz Questions CMAA

Smart cards can be used: a. for electronic cash b. for government identification c. to purchase goods and services d. to access medical and financial records e. all of the above are correct

e. all of the above are correct

Generally, copayment waivers are: a. offered as a form of courtesy discount to patients who are insured b. offered to hardship cases in order to reduce the patient's responsibility for the 20% owed that the insurance company will not pay c. offered today to colleagues in the medical practice d. a matter of routine offered in many situations e. banned by both government and private insurers

e. banned by both government and private insurers

Per HIPAA, the _______form is part of the financial record.The ledger card that is used in a paper-based financial system contains the same information as a computerized _______.Within an EHR system, a(n) _____ provides a breakdown of the amounts that are due or delinquent, and how many days they are delinquent.

Per HIPAA, the encounter form is part of the financial record.The ledger card that is used in a paper-based financial system contains the same information as a computerized bill .Within an EHR system, a(n) aging analysis provides a breakdown of the amounts that are due or delinquent, and how many days they are delinquent.

Quantum merit means: a. "as much as he deserves" b. "the value of something" c. "a portion of the fee" d. "the quality of the care received" e. "as much as is fair

a. "as much as he deserves"

When interviewing a collection agency, what collection rate would be considered realistic and good? a. 30% to 60% b. 60% to 80% c. 50% to 75% d. 25% to 45% e. 75% or above

a. 30% to 60%

Antifraud and abuse provisions in the Medicare and Medicaid programs consider "fee-splitting" a felony and punishable by: a. 5-year imprisonment and a $25,000 fine b. 5-year imprisonment and a $10,000 fine c. 3-year imprisonment and a $10,000 fine d. 1-year imprisonment and a $5000 fine e. 3-year imprisonment and a $25,000 fine

a. 5-year imprisonment and a $25,000 fine

Select the correct statement regarding collections. a. The longer an account remains delinquent, the harder it will be to collect. b. Collection letters to obtain payment are better than telephone calls. c. The best times to make collection calls are prior to and after regular working hours. d. Use a public telephone to make collection calls. e. Be flexible about interruptions when making collection calls.

a. The longer an account remains delinquent, the harder it will be to collect.

What is a fee schedule that is determined by the following called? A fee that is normally charged for a professional service and that is in the range of usual fees charged by physicians with similar training and experience in the same type of socioeconomic area, considering any special circumstances. a. UCR b. RVS c. Participating fee d. DRG e. RBRVS

a. UCR

Breaking down accounts into lengths of time that money is owed is called: a. aging accounts b. analyzing accounts c. account divisions d. maturation of accounts e. separating accounts

a. aging accounts

While writing his collections letter to the patient, the medical assistant in the video should avoid using which of the following words? a. ignored b. forgotten c. overlooked d. missed

a. ignored

Which is the most effective method for the medical assistant to discuss an outstanding balance with a patient? a. in person b. via e-mail c. by telephone d. by postal mail

a. in person

The revenue cycle: a. includes the life of all patient accounts from creation to payment b. starts when an insurance company is billed and ends when the insurance company pays c. starts when a patient is first seen and completes when the patient no longer sees the physician d. is another term for the "money wheel" e. includes the life of the patient account from creation to collection action

a. includes the life of all patient accounts from creation to payment

When a physician accepts all patients but refuses to accept reimbursement from any third-party, private, or government program and instead bills patients directly, this is referred to as: a. individual responsibility program b. nonparticipating physician contract c. concierge medicine d. value-based reimbursement e. fee-for-service

a. individual responsibility program

Garnishment is: a. limited to 25% of disposable earnings in any workweek b. limited to 30% of disposable earnings in any workweek c. limited to 15% of disposable earnings in any workweek d. limited to 10% of disposable earnings in any workweek e. unlimited on the amount that can be garnished

a. limited to 25% of disposable earnings in any workweek

After a judgment is made in favor of the medical practice in small-claims court: a. the physician still has to pursue the money b. the court follows up to make sure payment is made c. a court representative follows up to make sure payment is made d. the court, if necessary, attaches the patient's wages to ensure payment in full e. the money is always exchanged in the courtroom and turned over to the physician

a. the physician still has to pursue the money

If a physician denies credit to a patient, according to the Equal Credit Opportunity Act, how many days does the patient have to request the reason in writing? a. 120 days b. 60 days c. 90 days d. 30 days e. 10 days

b. 60 days

The most common types of bankruptcy filed by patients are: a. Chapter 7 and Chapter 11 b. Chapter 7 and Chapter 13 c. Chapter 11 and Chapter 12 d. Chapter 12 and Chapter 13 e. Chapter 7 and Chapter 12

b. Chapter 7 and Chapter 13

Certain hospitals have received federal construction grants to enlarge their facilities in exchange for caring for indigent patients; this obligation falls under the: a. Medicare program b. Hill-Burton Act c. Indigent-Care Act of 1946 d. federal Medicaid program e. state Medicaid program

b. Hill-Burton Act

A fee schedule that weights each procedure code with a unit value is called a: a. limiting charge b. RVS system c. DRG system d. nonparticipating fee schedule e. participating fee schedule

b. RVS system

Breaking down accounts into lengths of time that money is owed is called: a. account divisions b. aging accounts c. analyzing accounts d. maturation of accounts e. separating accounts

b. aging accounts

When a physician "opts out" of insurance programs and instead charges patients a monthly or annual fee for services, this is referred to as: a. nonparticipating fees b. concierge fees c. value-based medicine d. fee-for-service e. participating fees

b. concierge fees

The medical assistant in the video needs to call Mrs. Witherspoon, a patient about an overdue payment. During the call, the medical assistant should: a. share personal details about his own financial struggles. b. demonstrate empathy for Mrs. Witherspoon's situation. c. keep the conversation brief and impersonal. d. tell Mrs. Witherspoon that the physician will no longer treat her.

b. demonstrate empathy for Mrs. Witherspoon's situation.

When offering a sliding fee schedule: a. discounts need to apply to all services provided by the doctor's office b. household gross income, employment status, and special circumstances need to be considered c. the schedule needs to be offered to all patients, regardless of income d. only federally funded programs can participate. e. both a and b

b. household gross income, employment status, and special circumstances need to be considered

A charge slip, encounter form, superbill, and transaction slip are other names for a: a. ledger card b. multipurpose billing form c. daysheet d. pegboard e. service sheet

b. multipurpose billing form

What percentage of the nonpar allowable fee can a physician collect? a. 40% b. 80% c. 20% d. 60%

c. 20%

A physician who does not participate in the Medicare program may bill Medicare beneficiaries: a. 80% of the nonparticipating allowable fee b. 80% of the participating allowable fee c. 20% of the nonparticipating allowable fee plus the difference between the allowable fee and the limiting charge d. 20% of the nonparticipating allowable fee e. 20% of the participating allowable fee plus the difference between the allowable fee and the limiting charge

c. 20% of the nonparticipating allowable fee plus the difference between the allowable fee and the limiting charge

When interviewing a collection agency, what collection rate would be considered realistic and good? a. 60% to 80% b. 50% to 75% c. 30% to 60% d. 25% to 45% e. 75% or above

c. 30% to 60%

According to the Fair Credit Billing Act, a patient has _____ days from the date the statement is mailed to complain about an error, and the provider has _____ days to acknowledge it and _____ days to correct the error if it occurred. a. 30, 60, 90 b. 30, 30, 30 c. 60, 30, 90 d. 60, 90, 120 e. 60, 60, 90

c. 60, 30, 90

Medicare pays participating physicians: a. 100% of the Medicare fee b. 80% of the fee charged c. 80% of approved charges d. 20% of approved charges e. 20% of the fee charged

c. 80% of approved charges

Statements are not sent to patients who have: a. private insurance b. Medicare c. Medicaid d. TRICARE e. all of the above are correct

c. Medicaid

In which of the following situations would it be necessary to send a collection letter to a patient who has an unpaid bill? a. The patient's check is returned by the bank with insufficient funds. b. The patient forgets to bring her checkbook to her appointment. c. Several months have elapsed and the patient cannot be reached by phone. d. Two weeks have gone by since the patient received his first statement.

c. Several months have elapsed and the patient cannot be reached by phone.

Payment at the time services are rendered is: a. only applicable for the collection of insurance copayments b. not a reasonable expectation c. an opportunity not to be missed d. only applicable for cash-paying patients e. no longer applicable since all Americans are mandated to have insurance coverage

c. an opportunity not to be missed

Mr. Townsend, a patient with an overdue balance, would like to discuss making a financial agreement with the medical practice. When discussing these arrangements with the patient, the medical assistant should: a. find out how much Mr. Townsend would like to pay and how long he needs. b. provide Mr. Townsend with a Truth in Lending form if he requires more than five installments. c. discuss an installment plan with Mr. Townsend that includes an initial down payment. d. ask Mr. Townsend if he would like to make annual installments.

c. discuss an installment plan with Mr. Townsend that includes an initial down payment.

Once he has completed and printed the collections letter, the medical assistant should do all of the following except: a. make sure the patient's name and address are correct. b. check that the amount owed in the letter matches the past due date. c. sign the letter and place it in the outgoing mail. d. double check the letter to make sure the account information is accurate.

c. sign the letter and place it in the outgoing mail.

The most important collection practice to increase collections, improve public relations, and reduce patient complaints, business-office turnover, accounts receivable, and write-off amounts is: a. sending friendly collection letters b. telephoning patients who have overdue accounts c. stating fee-for-service and collecting fees at the time services are given d. sending timely billing statements every 30 days e. utilizing a collection agency early in the collection process

c. stating fee-for-service and collecting fees at the time services are given

Which of the following statements about office collections is true? a. Most medical offices use collection agencies to handle overdue payments. b. A physician may decide to extend credit to some patients and not to others. c. All medical offices within a state follow the same policies and procedures regarding collections. d. Each medical office has its own policies and procedures regarding collections.

d. Each medical office has its own policies and procedures regarding collections.

What is the name of the credit law that states, "Collectors must identify themselves and the medical practice they represent; they must not mislead the patient?" a. Truth in Lending Consumer Credit Cost Disclosure b. Federal Truth in Lending Act c. Equal Credit Opportunity Act d. Fair Debt Collection Practices Act e. Fair Credit Billing Act

d. Fair Debt Collection Practices Act

A medical assistant who is attempting to reach a patient by phone about an overdue balance is unsuccessful. This is the second time the medical assistant has tried to call the patient at home, and this time the phone rings unanswered. When notating the dun message in the patient's record, the assistant should include which abbreviations? a. NLE, NR b. POW, LMVM c. T, OOW d. TR, NA

d. TR, NA

To what does the "allowed amount" on the explanation of benefits (EOB) refer? a. The amount of monies received from the insurance carrier, plan, or program b. The amount the patient is responsible for after insurance payment c. A flat fee that the patient owes prior to services being rendered d. The amount the insurance company will pay under contract with the physician

d. The amount the insurance company will pay under contract with the physician

Select the correct statement regarding collections. a. The best times to make collection calls are prior to and after regular working hours. b. Collection letters to obtain payment are better than telephone calls. c. Be flexible about interruptions when making collection calls. d. The longer an account remains delinquent, the harder it will be to collect. e. Use a public telephone to make collection calls.

d. The longer an account remains delinquent, the harder it will be to collect.

Jonas, a medical assistant, needs to call a patient to discuss the collection of an outstanding unpaid fee. Jonas should do all of the following except: a. inform the patient of the amount of the debt. b. call the patient after 9:00 a.m. c. identify himself and the name of the medical practice. d. call the patient more than once each day.

d. call the patient more than once each day.

Regulation Z of the Federal Truth in Lending Act applies to: a. patients who decide to pay (on their own) their debt in more than four installments b. patients who do not pay all of their debt in one payment but spread it out over time c. patients who offer to pay in installments d. patients who agree to pay in more than four installments e. all of the above are correct

d. patients who agree to pay in more than four installments

Regulation Z of the Federal Truth in Lending Act applies to: a. patients who decide to pay (on their own) their debt in more than four installments b. patients who do not pay all of their debt in one payment, but spread it out over time c. patients who offer to pay in installments d. patients who agree to pay in more than four installments e. all of the above are correct

d. patients who agree to pay in more than four installments

The accounts receivable is: a. the total amount of money collected b. the amount of money received in a day, week, month, and/or year c. the total amount of money billed and collected d. the total amount of money owed to the medical practice e. both a and b

d. the total amount of money owed to the medical practice

Select the correct statement regarding fee schedules. a. Some practices may have more than one fee schedule. b. The doctor may charge for something that is not on the fee schedule. c. Multiple fee schedules are not allowed. d. A fee schedule is typically organized alphabetically by type of service. e. Both a and b.

e. Both a and b.

Select the correct statement regarding physicians giving cash discounts. a. Discounts can only be offered to patients with insurance coverage. b. The physician has the right to determine who he or she can offer cash discounts to. c. Cash discounts can only be offered to patients without insurance coverage. d. Cash discounts should never be offered in a medical practice. e. If cash discounts are offered, they must be offered to all patients.

e. If cash discounts are offered, they must be offered to all patients.

Hospitals base payment for Medicare patients on the: a. RVS system b. RBRVS system c. UCR system d. fee-for-service system e. MS-DRG systemq

e. MS-DRG systemq

The Centers for Medicare and Medicaid Services basis Medicare fees on the: a. DRG system b. RVS system c. CMS system d. UCR system e. RBRVS system

e. RBRVS system

Collection letters may be in the form of a/an: a. form letter b. letter with checklist c. personally composed letter d. email e. a, b, and c are all correct

e. a, b, and c are all correct

Office policy for the collection of fees is based on whether the patient is insured, enrolled in a manage care plan, not insured, and: a. specialty of the physician b. amount of the average bill c. the patient load d. how many insurance contracts the physician has e. a, b, and c are all correct

e. a, b, and c are all correct

A credit bureau may: a. issue noninvestigative consumer credit reports to someone who applies for credit b. issue consumer investigative reports requested by insurance companies, employers, credit grantors, and so forth c. operate as a collection department to receive delinquent accounts d. issue information about a consumer over the telephone e. all of the above are correct

e. all of the above are correct

In the billing and collection process, the patient registration form: a. is used to collect vital information to help ensure payment b. is a tool used to effectively collect on accounts c. is used to trace a person who have moved d. needs to be filled out accurately and completely e. all of the above are correct

e. all of the above are correct

Cycle billing: a. allows billing at certain times of the month based on alphabetical breakdown, account number, insurance type, or date of first service b. allows continuous cash flow, relieves mailing statements all at once, and distributes billing telephone calls c. distributes statements during the month based on dollar amounts; those with the highest amount due are billed first d. is not recommended for the medical office e. both a and b

e. both a and b

Garnishment is: a. unlimited on the amount that can be garnished b. limited to 10% of disposable earnings in any workweek c. limited to 30% of disposable earnings in any workweek d. limited to 15% of disposable earnings in any workweek e. limited to 25% of disposable earnings in any workweek

e. limited to 25% of disposable earnings in any workweek

The value-based reimbursement (VBR) model is centered around: a. the number of hospital admission a provider delivers b. the number of patients seen c. the amount of testing, procedures, and treatment performed d. the volume and intensity of service e. providing the minimum number of services necessary to improve a patient's condition

e. providing the minimum number of services necessary to improve a patient's condition

For tracing purposes, a patient who owes a balance and moves, leaving the physician's office with no forwarding address, is called a: a. deadbeat b. defaulter c. run-away d. looser e. skip

e. skip