Question 1

What does the administrative/billing medical assistant send in to the secondary payer with the claim form?

Accepted Answer

A)  COB 
B)  file 837P 
C)  EOB 
D)  RA 
A)  COB 
B)  file 837P 
C)  EOB 
D)  RA D

Question 2

What term does the HIPAA claim use for the insurance policyholder or guarantor?

Accepted Answer

A)  provider 
B)  subscriber 
C)  patient 
D)  qualifier 
A)  provider 
B)  subscriber 
C)  patient 
D)  qualifier B

Question 3

The organization or person that should receive payment is the _____________.

Accepted Answer

A)  billing provider 
B)  pay-to provider 
C)  physician 
D)  patient 
A)  billing provider 
B)  pay-to provider 
C)  physician 
D)  patient B

Question 4

All of the financial aspects of office visits, such as charges and payments, are

Accepted Answer

A)  transactions 
B)  claim forms 
C)  provider numbers 
D)  none of these 
A)  transactions 
B)  claim forms 
C)  provider numbers 
D)  none of these

Question 5

What code is used to indicate whether a claim is an original, replacement, or voided code?

Accepted Answer

A)  claim frequency code 
B)  claim submission reason code 
C)  claim filing indictor code 
D)  both claim frequency code and claim submission reason code 
A)  claim frequency code 
B)  claim submission reason code 
C)  claim filing indictor code 
D)  both claim frequency code and claim submission reason code

Question 6

What must a medical assistant do when preparing claims with PMPs?

Accepted Answer

A)  extract the data elements 
B)  verify coverage 
C)  record diagnoses, procedures, and charges 
D)  transmit claims beneficiaries 
A)  extract the data elements 
B)  verify coverage 
C)  record diagnoses, procedures, and charges 
D)  transmit claims beneficiaries

Question 7

What administrative code is used to identify the type of health plan?

Accepted Answer

A)  claim frequency code 
B)  claim submission reason code 
C)  claim filing indictor code 
D)  both the claim frequency code and the claim submission reason code 
A)  claim frequency code 
B)  claim submission reason code 
C)  claim filing indictor code 
D)  both the claim frequency code and the claim submission reason code

Question 8

With a few exceptions, the electronic claim is the same as __________.

Accepted Answer

A)  clearinghouse form 
B)  paper form 
C)  HCFA-1500 
D)  HCPCS form 
A)  clearinghouse form 
B)  paper form 
C)  HCFA-1500 
D)  HCPCS form

Question 9

If a paper RA is received, what should be sent to the secondary health plan?

Accepted Answer

A)  CMS-1500 
B)  RA 
C)  medical records 
D)  both the CMS-1500 and the RA 
A)  CMS-1500 
B)  RA 
C)  medical records 
D)  both the CMS-1500 and the RA

Question 10

What does HIT stand for?

Accepted Answer

A)  healthy initiatives team 
B)  health integration technology 
C)  health interface technology 
D)  health information technology 
A)  healthy initiatives team 
B)  health integration technology 
C)  health interface technology 
D)  health information technology

Question 11

What do some payers offer as an Internet-based service into which employees key the standard data elements?

Accepted Answer

A)  EDI 
B)  EDE 
C)  DDE 
D)  clearinghouse 
A)  EDI 
B)  EDE 
C)  DDE 
D)  clearinghouse

Question 12

What is the same as a COB transaction?

Accepted Answer

A)  adjustment 
B)  EOB 
C)  HIPAA 837 
D)  RTCA 
A)  adjustment 
B)  EOB 
C)  HIPAA 837 
D)  RTCA

Question 13

What is not a major database in PMPs?

Accepted Answer

A)  provider 
B)  guarantor 
C)  diagnosis codes 
D)  next of kin 
A)  provider 
B)  guarantor 
C)  diagnosis codes 
D)  next of kin

Question 14

On the CMS-1500 claim, if the patient and the insured are not the same person, which of these is required?

Accepted Answer

A)  insured's name 
B)  patient's relationship to the insured 
C)  insured's address 
D)  all of these 
A)  insured's name 
B)  patient's relationship to the insured 
C)  insured's address 
D)  all of these

Question 15

A claim accepted by a health plan for adjudication is called _____.

Accepted Answer

A)  clean claim 
B)  e-form 
C)  837P claim 
D)  HIPAA claim 
A)  clean claim 
B)  e-form 
C)  837P claim 
D)  HIPAA claim

Question 16

When in the billing process is an EOB sent to a patient?

Accepted Answer

A)  after their visit at check out 
B)  after the claim gets paid or denied 
C)  before it is sent to the clearinghouse 
D)  it doesn't get sent to patient, it is sent to provider 
A)  after their visit at check out 
B)  after the claim gets paid or denied 
C)  before it is sent to the clearinghouse 
D)  it doesn't get sent to patient, it is sent to provider

Question 17

Laboratory services rendered by an independent provider are performed by a(n)

Accepted Answer

A)  subscriber 
B)  provider 
C)  outside laboratory 
D)  None of these 
A)  subscriber 
B)  provider 
C)  outside laboratory 
D)  None of these

Question 18

What is the most common method to handle health care claim transmission?

Accepted Answer

A)  hire clearinghouses 
B)  file 837P 
C)  use a remittance advice 
D)  use bulk mail 
A)  hire clearinghouses 
B)  file 837P 
C)  use a remittance advice 
D)  use bulk mail

Question 19

When sending a claim to a tertiary payer, what needs to be attached?

Accepted Answer

A)  nothing needs to be sent, it is electronic 
B)  HIPAA claim 
C)  secondary RA 
D)  CMS-1500 
A)  nothing needs to be sent, it is electronic 
B)  HIPAA claim 
C)  secondary RA 
D)  CMS-1500

Question 20

What are the financial aspects of an office visit, such as a copayment, called?

Accepted Answer

A)  elements 
B)  exchanges 
C)  transactions 
D)  adjustments 
A)  elements 
B)  exchanges 
C)  transactions 
D)  adjustments

What does the administrative/billing medical assistant send in to the secondary payer with the claim form?

What term does the HIPAA claim use for the insurance policyholder or guarantor?

The organization or person that should receive payment is the _____________.

All of the financial aspects of office visits, such as charges and payments, are

What code is used to indicate whether a claim is an original, replacement, or voided code?

What must a medical assistant do when preparing claims with PMPs?

What administrative code is used to identify the type of health plan?

With a few exceptions, the electronic claim is the same as __________.

If a paper RA is received, what should be sent to the secondary health plan?

What does HIT stand for?

What do some payers offer as an Internet-based service into which employees key the standard data elements?

What is the same as a COB transaction?

What is not a major database in PMPs?

On the CMS-1500 claim, if the patient and the insured are not the same person, which of these is required?

A claim accepted by a health plan for adjudication is called _____.

When in the billing process is an EOB sent to a patient?

Laboratory services rendered by an independent provider are performed by a(n)

What is the most common method to handle health care claim transmission?

When sending a claim to a tertiary payer, what needs to be attached?

What are the financial aspects of an office visit, such as a copayment, called?

From Patient to Payment Understanding Medical Insurance

Electronic Health Records, HIPAA, and Hitech: Sharing and Protectin

Patient Encounters and Billing Information

Diagnostic Coding

Procedural Coding

Payment Methods and Checkout Procedures

Private Payersblue Cross and Blue Shield

Medicare

Medicaid

Tricare and Champva

Workers Compensation and Automobiledisability Insurance

Claim Processing, Payments, and Collections

Hospital Insurance

Filters

Exam 7: Health Care Claim Preparation and Transmission

What does the administrative/billing medical assistant send in to the secondary payer with the claim form?

What term does the HIPAA claim use for the insurance policyholder or guarantor?

The organization or person that should receive payment is the _____________.

All of the financial aspects of office visits, such as charges and payments, are

What code is used to indicate whether a claim is an original, replacement, or voided code?

What must a medical assistant do when preparing claims with PMPs?

What administrative code is used to identify the type of health plan?

With a few exceptions, the electronic claim is the same as __________.

If a paper RA is received, what should be sent to the secondary health plan?

What does HIT stand for?

What do some payers offer as an Internet-based service into which employees key the standard data elements?

What is the same as a COB transaction?

What is not a major database in PMPs?

On the CMS-1500 claim, if the patient and the insured are not the same person, which of these is required?

A claim accepted by a health plan for adjudication is called _____.

When in the billing process is an EOB sent to a patient?

Laboratory services rendered by an independent provider are performed by a(n)

What is the most common method to handle health care claim transmission?

When sending a claim to a tertiary payer, what needs to be attached?

What are the financial aspects of an office visit, such as a copayment, called?

From Patient to Payment Understanding Medical Insurance

Electronic Health Records, HIPAA, and Hitech: Sharing and Protectin

Patient Encounters and Billing Information

Diagnostic Coding

Procedural Coding

Payment Methods and Checkout Procedures

Private Payersblue Cross and Blue Shield

Medicare

Medicaid

Tricare and Champva

Workers Compensation and Automobiledisability Insurance

Claim Processing, Payments, and Collections

Hospital Insurance

Filters