Question 1

Under a coordination of benefits provision, when should any additional coverage be reported to the primary payer?

Accepted Answer

A)  reported only if you are a participating provider with both insurance companies 
B)  reported only if you are a participating provider with the secondary insurance 
C)  it is not required to be reported at all 
D)  reported only if the patient has signed an assignment of benefits statement 
A)  reported only if you are a participating provider with both insurance companies 
B)  reported only if you are a participating provider with the secondary insurance 
C)  it is not required to be reported at all 
D)  reported only if the patient has signed an assignment of benefits statement

Question 2

Eligibility for government-sponsored plans where income is the criterion may change as quickly as

Accepted Answer

A)  monthly. 
B)  weekly. 
C)  yearly. 
D)  daily. 
A)  monthly. 
B)  weekly. 
C)  yearly. 
D)  daily.

Question 3

What does COB stand for in medical insurance terms?

Accepted Answer

A)  coordination of businesses 
B)  collection of benefits 
C)  collection of businesses 
D)  coordination of benefits 
A)  coordination of businesses 
B)  collection of benefits 
C)  collection of businesses 
D)  coordination of benefits

Question 4

What should be verified when someone requests PHI for TPO purposes?

Accepted Answer

A)  the person's authority to access PHI and signed acknowledgment of receipt of notice of privacy practices 
B)  signed acknowledgment of receipt of notice of privacy practices 
C)  the identity of the person and signed acknowledgment of receipt of notice of privacy practices 
D)  the identity of the person and person's authority to access PHI 
A)  the person's authority to access PHI and signed acknowledgment of receipt of notice of privacy practices 
B)  signed acknowledgment of receipt of notice of privacy practices 
C)  the identity of the person and signed acknowledgment of receipt of notice of privacy practices 
D)  the identity of the person and person's authority to access PHI

Question 5

What Medicare form is used to show charges to patients for potentially non-covered services?

Accepted Answer

A)  Acknowledgment of Receipt of Notice of Privacy Practices 
B)  HIPAA X 12 270/271 
C)  Advance Beneficiary Notice 
D)  Assignment of Benefits 
A)  Acknowledgment of Receipt of Notice of Privacy Practices 
B)  HIPAA X 12 270/271 
C)  Advance Beneficiary Notice 
D)  Assignment of Benefits

Question 6

What type of questions should physicians be asked regarding billing and coding issues?

Accepted Answer

A)  none of these are correct 
B)  essential 
C)  basic 
D)  basic and essential 
A)  none of these are correct 
B)  essential 
C)  basic 
D)  basic and essential

Question 7

If a provider has agreed to accept assignment, he/she will

Accepted Answer

A)  write off the deductible. 
B)  bill the patient for any amount not paid by the payer. 
C)  write off the copay/coinsurance. 
D)  accept the payer's allowed charge as payment in full. 
A)  write off the deductible. 
B)  bill the patient for any amount not paid by the payer. 
C)  write off the copay/coinsurance. 
D)  accept the payer's allowed charge as payment in full.

Question 8

What provision explains how insurance policies will pay if more than one policy applies?

Accepted Answer

A)  birthday rule 
B)  gender rule 
C)  coordination of benefits 
D)  custody rule 
A)  birthday rule 
B)  gender rule 
C)  coordination of benefits 
D)  custody rule

Question 9

After one health plan has paid on a claim, which insurance makes the next payment, if applicable?

Accepted Answer

A)  disability insurance 
B)  secondary insurance 
C)  primary insurance 
D)  tertiary insurance 
A)  disability insurance 
B)  secondary insurance 
C)  primary insurance 
D)  tertiary insurance

Question 10

If a patient has coverage under two insurance plans, one under which the patient is the policyholder and one under which the patient is a dependent, the primary plan is

Accepted Answer

A)  the plan in effect for the patient the longest. 
B)  the patient's plan. 
C)  the spouse's plan. 
D)  either plan, depending on coverage. 
A)  the plan in effect for the patient the longest. 
B)  the patient's plan. 
C)  the spouse's plan. 
D)  either plan, depending on coverage.

Question 11

Which of the following is another common term for encounter forms?

Accepted Answer

A)  superbills 
B)  charge slips 
C)  routing slips 
D)  all of these are correct 
A)  superbills 
B)  charge slips 
C)  routing slips 
D)  all of these are correct

Question 12

If a retired patient with Medicare also has coverage under a working spouse's plan, the primary plan is

Accepted Answer

A)  Medicare. 
B)  the plan in effect for the longest. 
C)  the spouse's plan. 
D)  the plan with the lowest premium. 
A)  Medicare. 
B)  the plan in effect for the longest. 
C)  the spouse's plan. 
D)  the plan with the lowest premium.

Question 13

Pick the type of use of PHI that a practice would employ to train their staff to improve the quality of their health care.

Accepted Answer

A)  payment 
B)  patient information form 
C)  health care operations 
D)  treatment 
A)  payment 
B)  patient information form 
C)  health care operations 
D)  treatment

Question 14

Identify the information that is not typically included on an encounter form.

Accepted Answer

A)  the patient's prior balance, if any 
B)  check boxes to indicate the timing and need for a follow-up appointment to be scheduled for the patient during checkout 
C)  a checklist of managed care plans under contract and their utilization guidelines 
D)  the patient's plan benefits 
A)  the patient's prior balance, if any 
B)  check boxes to indicate the timing and need for a follow-up appointment to be scheduled for the patient during checkout 
C)  a checklist of managed care plans under contract and their utilization guidelines 
D)  the patient's plan benefits

Question 15

An RTA generates

Accepted Answer

A)  the actual amount the patient will owe. 
B)  an estimate on the amount the patient will owe. 
C)  RTA does not generate these services. 
D)  an estimate on the amount the payer will send. 
A)  the actual amount the patient will owe. 
B)  an estimate on the amount the patient will owe. 
C)  RTA does not generate these services. 
D)  an estimate on the amount the payer will send.

Question 16

When a provider asks a health plan for approval of a service, the response is known as the

Accepted Answer

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

Question 17

What do payers issue when they approve a service?

Accepted Answer

A)  prior authorization number 
B)  self-referral 
C)  trace number 
D)  referral waiver 
A)  prior authorization number 
B)  self-referral 
C)  trace number 
D)  referral waiver

Question 18

The first health plan to pay when more than one plan is in effect is called the

Accepted Answer

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

Question 19

Pick the type of use of PHI that a practice would employ to discuss a patient's case with another provider.

Accepted Answer

A)  health care operations 
B)  patient information form 
C)  payment 
D)  treatment 
A)  health care operations 
B)  patient information form 
C)  payment 
D)  treatment

Question 20

Identify the best time during which to begin collecting patient information.

Accepted Answer

A)  preregistration process 
B)  verification process 
C)  billing process 
D)  coordination of benefits process 
A)  preregistration process 
B)  verification process 
C)  billing process 
D)  coordination of benefits process

Under a coordination of benefits provision, when should any additional coverage be reported to the primary payer?

Eligibility for government-sponsored plans where income is the criterion may change as quickly as

What does COB stand for in medical insurance terms?

What should be verified when someone requests PHI for TPO purposes?

What Medicare form is used to show charges to patients for potentially non-covered services?

What type of questions should physicians be asked regarding billing and coding issues?

If a provider has agreed to accept assignment, he/she will

What provision explains how insurance policies will pay if more than one policy applies?

After one health plan has paid on a claim, which insurance makes the next payment, if applicable?

If a patient has coverage under two insurance plans, one under which the patient is the policyholder and one under which the patient is a dependent, the primary plan is

Which of the following is another common term for encounter forms?

If a retired patient with Medicare also has coverage under a working spouse's plan, the primary plan is

Pick the type of use of PHI that a practice would employ to train their staff to improve the quality of their health care.

Identify the information that is not typically included on an encounter form.

An RTA generates

When a provider asks a health plan for approval of a service, the response is known as the

What do payers issue when they approve a service?

The first health plan to pay when more than one plan is in effect is called the

Pick the type of use of PHI that a practice would employ to discuss a patient's case with another provider.

Identify the best time during which to begin collecting patient information.

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

Under a coordination of benefits provision, when should any additional coverage be reported to the primary payer?

Eligibility for government-sponsored plans where income is the criterion may change as quickly as

What does COB stand for in medical insurance terms?

What should be verified when someone requests PHI for TPO purposes?

What Medicare form is used to show charges to patients for potentially non-covered services?

What type of questions should physicians be asked regarding billing and coding issues?

If a provider has agreed to accept assignment, he/she will

What provision explains how insurance policies will pay if more than one policy applies?

After one health plan has paid on a claim, which insurance makes the next payment, if applicable?

If a patient has coverage under two insurance plans, one under which the patient is the policyholder and one under which the patient is a dependent, the primary plan is

Which of the following is another common term for encounter forms?

If a retired patient with Medicare also has coverage under a working spouse's plan, the primary plan is

Pick the type of use of PHI that a practice would employ to train their staff to improve the quality of their health care.

Identify the information that is not typically included on an encounter form.

An RTA generates

When a provider asks a health plan for approval of a service, the response is known as the

What do payers issue when they approve a service?

The first health plan to pay when more than one plan is in effect is called the

Pick the type of use of PHI that a practice would employ to discuss a patient's case with another provider.

Identify the best time during which to begin collecting patient information.

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