Question 1

What must patients who are members of CDHPs do before their health plan makes a payment?

Accepted Answer

A)  Self-bill their health plan. 
B)  Meet a large deductible. 
C)  Pay their coinsurance. 
D)  Allow the provider to accept assignment. 
A)  Self-bill their health plan. 
B)  Meet a large deductible. 
C)  Pay their coinsurance. 
D)  Allow the provider to accept assignment. B

Question 2

Which of these documents will the patient not complete?

Accepted Answer

A)  medical history 
B)  encounter form 
C)  assignment of benefits 
D)  patient information form 
A)  medical history 
B)  encounter form 
C)  assignment of benefits 
D)  patient information form B

Question 3

A patient presents for an appointment and you must locate the information about their health plan. Determine where this information should be located.

Accepted Answer

A)  patient's health survey and patient information form 
B)  patient's information form and insurance card 
C)  patient's signed Acknowledgment of Receipt of Notice of Privacy Practices 
D)  patient's insurance card only 
A)  patient's health survey and patient information form 
B)  patient's information form and insurance card 
C)  patient's signed Acknowledgment of Receipt of Notice of Privacy Practices 
D)  patient's insurance card only B

Question 4

What type of information is included in a patient's social history?

Accepted Answer

A)  exercise habits and referring physician name and number 
B)  alcohol use and social security number 
C)  insurance information and patient address 
D)  smoking, alcohol use, and exercise habits 
A)  exercise habits and referring physician name and number 
B)  alcohol use and social security number 
C)  insurance information and patient address 
D)  smoking, alcohol use, and exercise habits

Question 5

Which of the following is gathered via the patient information form?

Accepted Answer

A)  the patient's progress notes 
B)  the patient's examination results 
C)  the patient's personal and insurance information 
D)  the patient's discharge summary 
A)  the patient's progress notes 
B)  the patient's examination results 
C)  the patient's personal and insurance information 
D)  the patient's discharge summary

Question 6

You are working at a practice and have been asked to document some payer communications. Determine where the communications should be recorded.

Accepted Answer

A)  medical record 
B)  financial record 
C)  clinical record 
D)  encounter form 
A)  medical record 
B)  financial record 
C)  clinical record 
D)  encounter form

Question 7

Who should the front desk at a medical office ask about whether any of their pertinent personal or insurance information has changed?

Accepted Answer

A)  direct provider 
B)  established patients 
C)  referring providers 
D)  new patients 
A)  direct provider 
B)  established patients 
C)  referring providers 
D)  new patients

Question 8

NonPAR stands for

Accepted Answer

A)  nonparticular. 
B)  nonparticipating. 
C)  noncovered. 
D)  participating. 
A)  nonparticular. 
B)  nonparticipating. 
C)  noncovered. 
D)  participating.

Question 9

What information must be documented in the patient's financial record when communicating with payers?

Accepted Answer

A)  nothing should be documented in the financial record 
B)  the date of communication and the outcome 
C)  the representative's name, date of communication, and outcome 
D)  the representative name and date of communication 
A)  nothing should be documented in the financial record 
B)  the date of communication and the outcome 
C)  the representative's name, date of communication, and outcome 
D)  the representative name and date of communication

Question 10

Which of the following is used to send necessary data to payers for a claim?

Accepted Answer

A)  X12 270 
B)  X12 278 
C)  X12 837 
D)  X12 271 
A)  X12 270 
B)  X12 278 
C)  X12 837 
D)  X12 271

Question 11

When the practice can get answers quickly from insurance plans, it will benefit from

Accepted Answer

A)  quicker payment for services. 
B)  more payments for services. 
C)  all of these are correct. 
D)  larger payment for services. 
A)  quicker payment for services. 
B)  more payments for services. 
C)  all of these are correct. 
D)  larger payment for services.

Question 12

Describe what should be done when incorrect or conflicting data are discovered on encounter forms.

Accepted Answer

A)  Double-check the documentation and communicate with physician. 
B)  Send in without correcting and then appeal when rejected. 
C)  Nothing needs to be done. 
D)  Call the health plan. 
A)  Double-check the documentation and communicate with physician. 
B)  Send in without correcting and then appeal when rejected. 
C)  Nothing needs to be done. 
D)  Call the health plan.

Question 13

Sometimes the use of a third payer is necessary after two health plans have made payments on a claim. This type of insurance is known as

Accepted Answer

A)  secondary insurance. 
B)  supplemental insurance. 
C)  primary insurance. 
D)  tertiary insurance. 
A)  secondary insurance. 
B)  supplemental insurance. 
C)  primary insurance. 
D)  tertiary insurance.

Question 14

Which of the following entities would be given a referral number by the patient?

Accepted Answer

A)  the health plan 
B)  the referred physician 
C)  the referring physician 
D)  the medical insurance specialist 
A)  the health plan 
B)  the referred physician 
C)  the referring physician 
D)  the medical insurance specialist

Question 15

What can be used to verify insurance company information?

Accepted Answer

A)  portal 
B)  TPO 
C)  notice of privacy practice 
D)  patient information form 
A)  portal 
B)  TPO 
C)  notice of privacy practice 
D)  patient information form

Question 16

In what order are benefits typically determined when the parents do not have joint custody arrangements?

Accepted Answer

A)  plan of custodial parent, plan of spouse of custodial parent, plan of parent without custody 
B)  plan of custodial parent and then plan of spouse of custodial parent only 
C)  plan of parent without custody, plan of custodial parent, plan of spouse of custodial parent 
D)  plan of parent without custody only 
A)  plan of custodial parent, plan of spouse of custodial parent, plan of parent without custody 
B)  plan of custodial parent and then plan of spouse of custodial parent only 
C)  plan of parent without custody, plan of custodial parent, plan of spouse of custodial parent 
D)  plan of parent without custody only

Question 17

For unassigned claims, the payment for services rendered is expected

Accepted Answer

A)  after the patient receives a statement. 
B)  after the insurance is billed. 
C)  at the time of service. 
D)  when the claim is sent. 
A)  after the patient receives a statement. 
B)  after the insurance is billed. 
C)  at the time of service. 
D)  when the claim is sent.

Question 18

Under what rule is a child's primary coverage under the father's plan when both parents have coverage?

Accepted Answer

A)  birthday rule 
B)  gender rule 
C)  custody rule 
D)  parent rule 
A)  birthday rule 
B)  gender rule 
C)  custody rule 
D)  parent rule

Question 19

If the practice accepts credit and debit cards it must

Accepted Answer

A)  pay a fee to a credit card company. 
B)  accept a discount from the patient on their bill. 
C)  agree to accept the allowed amount as payment in full from the insurance company. 
D)  wait until the claim has been processed to charge the credit card. 
A)  pay a fee to a credit card company. 
B)  accept a discount from the patient on their bill. 
C)  agree to accept the allowed amount as payment in full from the insurance company. 
D)  wait until the claim has been processed to charge the credit card.

Question 20

What type of charges do practices routinely collect at the time of service?

Accepted Answer

A)  copays, noncovered, and self-pay patients 
B)  copayments or coinsurance and noncovered only 
C)  charges for self-pay patients only 
D)  noncovered or overlimit fees and self-pay patients only 
A)  copays, noncovered, and self-pay patients 
B)  copayments or coinsurance and noncovered only 
C)  charges for self-pay patients only 
D)  noncovered or overlimit fees and self-pay patients only

What must patients who are members of CDHPs do before their health plan makes a payment?

Which of these documents will the patient not complete?

A patient presents for an appointment and you must locate the information about their health plan. Determine where this information should be located.

What type of information is included in a patient's social history?

Which of the following is gathered via the patient information form?

You are working at a practice and have been asked to document some payer communications. Determine where the communications should be recorded.

Who should the front desk at a medical office ask about whether any of their pertinent personal or insurance information has changed?

NonPAR stands for

What information must be documented in the patient's financial record when communicating with payers?

Which of the following is used to send necessary data to payers for a claim?

When the practice can get answers quickly from insurance plans, it will benefit from

Describe what should be done when incorrect or conflicting data are discovered on encounter forms.

Sometimes the use of a third payer is necessary after two health plans have made payments on a claim. This type of insurance is known as

Which of the following entities would be given a referral number by the patient?

What can be used to verify insurance company information?

In what order are benefits typically determined when the parents do not have joint custody arrangements?

For unassigned claims, the payment for services rendered is expected

Under what rule is a child's primary coverage under the father's plan when both parents have coverage?

If the practice accepts credit and debit cards it must

What type of charges do practices routinely collect at the time of service?

Introduction to the Medical Billing Cycle

Electronic Health Records, Hipaa, and Hitech: Sharing and Protecting Patients Health Information

Diagnostic Coding: Introduction to ICD-10-CM

Procedural Coding: CPT and HCPCS

Visit Charges and Compliant Billing

Health Care Claim Preparation and Transmission

Private Payers/BlueCross BlueShield

Medicare

Medicaid

Tricare and Champva

Workers Compensation and Disabilityautomotive Insurance

Payments Ras, Appeals, and Secondary Claims

Patient Billing and Collections

Hospital Billing and Reimbursement

CPT and HCPCS

Filters

Exam 3: Patient Encounters and Billing Information

What must patients who are members of CDHPs do before their health plan makes a payment?

Which of these documents will the patient not complete?

A patient presents for an appointment and you must locate the information about their health plan. Determine where this information should be located.

What type of information is included in a patient's social history?

Which of the following is gathered via the patient information form?

You are working at a practice and have been asked to document some payer communications. Determine where the communications should be recorded.

Who should the front desk at a medical office ask about whether any of their pertinent personal or insurance information has changed?

NonPAR stands for

What information must be documented in the patient's financial record when communicating with payers?

Which of the following is used to send necessary data to payers for a claim?

When the practice can get answers quickly from insurance plans, it will benefit from

Describe what should be done when incorrect or conflicting data are discovered on encounter forms.

Sometimes the use of a third payer is necessary after two health plans have made payments on a claim. This type of insurance is known as

Which of the following entities would be given a referral number by the patient?

What can be used to verify insurance company information?

In what order are benefits typically determined when the parents do not have joint custody arrangements?

For unassigned claims, the payment for services rendered is expected

Under what rule is a child's primary coverage under the father's plan when both parents have coverage?

If the practice accepts credit and debit cards it must

What type of charges do practices routinely collect at the time of service?

Introduction to the Medical Billing Cycle

Electronic Health Records, Hipaa, and Hitech: Sharing and Protecting Patients Health Information

Diagnostic Coding: Introduction to ICD-10-CM

Procedural Coding: CPT and HCPCS

Visit Charges and Compliant Billing

Health Care Claim Preparation and Transmission

Private Payers/BlueCross BlueShield

Medicare

Medicaid

Tricare and Champva

Workers Compensation and Disabilityautomotive Insurance

Payments Ras, Appeals, and Secondary Claims

Patient Billing and Collections

Hospital Billing and Reimbursement

CPT and HCPCS

Filters