Deck 4: Working With Cases

Question 1

What term is used to describe a grouping of transactions that share a common element?

A) file
B) case
C) chart
D) record

Answer 1

case

Question 2

How many cases is a patient allowed to have per office visit in Medisoft?

A) 1
B) 2
C) 3
D) None of these are correct; there is no set limit.

Answer 2

None of these are correct; there is no set limit.

Question 3

Transactions are usually grouped into cases based on the ______________ for which a patient seeks treatment.

A) prescription refill request
B) medical condition
C) referral request
D) All of these are correct.

Answer 3

medical condition

Question 4

Identify likely reasons to set up a new case for a patient.

A) The patient changes insurance carriers.
B) The patient has developed a new medical condition.
C) The patient has two closely related health issues.
D) The patient changes insurance carriers or the patient has developed a new medical condition.

Question 5

You are working at a medical practice and need to record information for a patient's second visit to the practice related to his condition of diabetes. How would this information be recorded in Medisoft?

A) record the information under their existing case for diabetes
B) create a new case for this treatment of this condition
C) create a new patient record for this encounter at the office
D) None of these are correct.

Question 6

You are working at a medical practice and need to record information for a patient's second visit to the practice. Her first visit was to treat a broken wrist and this one is to treat her asthma condition. How would this information be recorded in Medisoft?

A) record the information under her existing case for asthma
B) create a new case for the treatment of this condition
C) create a new patient record for this encounter at the office
D) None of these are correct.

Question 7

You are working at a medical practice and need to record information for a patient's first visit to the practice. His visit is to treat a hand injury and he also needs treatment for a throat infection. How would this information be recorded in Medisoft?

A) group this information into an existing case for the patient
B) create one case for the encounter that addresses both conditions
C) create two cases, one for each condition
D) None of these are correct.

Question 8

Which of these conditions would likely require more than one case?

A) A patient has two unrelated conditions.
B) A patient has two related conditions but changed insurance plans in between office visits.
C) A patient sees the practice two separate times for the same condition.
D) A patient has two unrelated conditions or a patient has two related conditions but changed insurance plans in between office visits.

Question 9

On what form must offices transmit transactions to a patient's insurance carrier to receive payment?

A) as an insurance claim
B) as a group of Medisoft cases
C) as a single Medisoft case
D) All of these are correct.

Question 10

What is made every single time a physician treats a patient?

A) a case
B) a record
C) an insurance claim
D) All of these are correct.

Question 11

Explain the reason why a new case must be created when a patient is injured at work.

A) so that the claims are billed to the workers' compensation plan, not to the patient's personal policy
B) so that the claims are billed to the patient's personal policy, not to the workers' compensation plan
C) so that the patient can be billed for the claim
D) None of these are correct.

Question 12

What type of data is primarily stored in the Patient/Guarantor dialog box?

A) demographic information
B) medical condition information
C) referring provider information
D) physician notes

Question 13

What patient information is stored in the Case dialog box?

A) the patient's diagnosis
B) the patient's procedures
C) the patient's insurance plan
D) All of these are correct.

Question 14

Which of the Case command buttons is used to add, delete, or change information in an existing case?

A) Edit Case button
B) Delete button
C) Copy Case button
D) New Case button

Question 15

How many tabs are there in the Case dialog box?

A) three
B) eight
C) nine
D) eleven

Question 16

The information required to complete the eleven tabs in the Case dialog box comes from documentation found where?

A) a file
B) patient's medical record or chart
C) physician notes
D) insurance claim

Question 17

Identify the quickest method of creating a new case for an existing patient.

A) Copy Case button
B) Move Case button
C) Add Case button
D) New Case button

Question 18

Using the Edit Case button, users may _______________ information in an existing case.

A) add
B) change
C) delete
D) All of these are correct.

Question 19

What button removes a case from the system if the case has no open transactions?

A) Edit Case
B) Copy Case
C) Delete Case
D) Erase Case

Question 20

What contains the physician's notes about a patient's condition and diagnosis?

A) the record of procedures
B) the record of documentation
C) the progress notes
D) the record of diagnoses and procedures

Question 21

What type of information is contained on the patient information form?

A) information about the patient's insurance coverage
B) the patient's name and address
C) information about the patient's allergies
D) All of these are correct.

Question 22

Identify the contents of an encounter form.

A) list of patient's conditions and treatments
B) list of services performed and the charges for them
C) information about a patient's personal information and health history
D) All of these are correct.

Question 23

Where is information about a patient's medical conditions and treatments stored in Medisoft?

A) the Case dialog box
B) the Patient/Guarantor dialog box
C) the Patient List dialog box
D) All of these are correct.

Question 24

Which of the following items in the Case dialog box can not be changed?

A) Guarantor
B) Description
C) Case number
D) All of these are correct.

Question 25

You have just used the Copy Case button to copy all of a patient's information into a new case. Summarize the action you should take next.

A) check the old case to make sure that none of the information has changed
B) check each tab to make sure the copied information is accurate for the new case
C) immediately submit the copied information for billing
D) None of these are correct.

Question 26

Using Copy Case, what fields almost always require editing?

A) patient's address
B) the case description
C) the referring provider
D) the case description and the referring provider

Question 27

What button in the Case folder displays an option to verify eligibility for the patient and case?

A) Eligibility button
B) Verification button
C) Face Sheet button
D) Set Default button

Question 28

Explain how you could print a sheet of information about the patient and case from the Case dialog box.

A) by clicking the Save button
B) by clicking the Print button
C) by clicking the Set Default button
D) by clicking the Face Sheet button

Question 29

Where are cases deleted in Medisoft?

A) in the Case dialog box
B) in the Patient/Guarantor dialog box
C) in the Patient List dialog box
D) All of these are correct.

Question 30

What type of information is located in the Account tab?

A) referral source
B) patient's assigned provider
C) authorized number of visits
D) All of these are correct.

Question 31

What tab contains basic information about a patient and his or her employment?

A) Personal tab
B) Account tab
C) Condition tab
D) Demographic tab

Question 32

What does the Description box of the Personal tab contain?

A) information about a patient's employment status
B) information about a patient's complaint
C) information about a patient's personal information
D) information about a patient's marital status

Question 33

What is a physician who recommends that a patient see a specific other physician called?

A) referring provider
B) transfer provider
C) gateway provider
D) specialist

Question 34

In what tab of the Case folder is the patient's case number located?

A) Account tab
B) Personal tab
C) Miscellaneous tab
D) Policy 1 tab

Question 35

In what tab of the Case folder is a patient's referring provider listed?

A) Personal tab
B) Miscellaneous tab
C) Policy 1 tab
D) Account tab

Question 36

If a patient's treatment is only authorized through a certain date, in what tab of the Case folder is this date entered?

A) Miscellaneous tab
B) Policy 1 tab
C) Account tab
D) Personal tab

Question 37

Which of the following could be a referring provider?

A) a physician who recommends that a patient see a specific other physician
B) a physician who receives a patient from a specific different physician
C) a physician who asks a specific different physician about a patient

Question 38

For what type of cases is the Attorney box in the Account tab used?

A) criminal cases
B) accident cases
C) referral cases
D) supervising cases

Question 39

You have been asked to mark a case as closed. Demonstrate a way that you could indicate this in Medisoft.

A) enter the phrase "Case Closed" in the description box on the Personal tab.
B) click the Close button on the Case dialog box.
C) place a check mark in the Case Closed box on the Personal tab.
D) All of these are correct.

Question 40

Explain what is indicated by closing a case.

A) that no more data will be entered into the case
B) that a new case needs to be opened
C) that the patient is no longer using the practice
D) that the patient has been referred to another physician

Question 41

Identify a situation that would generally require a check mark to be placed in the Case Closed box of the Personal tab.

A) The patient has changed insurance carriers.
B) The patient is no longer a patient at the practice.
C) The patient has recovered completely from a condition.
D) All of these are correct.

Question 42

Where should a patient's reason for seeing a physician be entered in Medisoft?

A) the Other Arrangements box of the Account tab
B) the Status box of the Personal tab
C) the Description box of the Personal tab
D) the Description box of the Account tab

Question 43

You are completing the Personal tab for a patient but do not know what her status is as a student. How should you fill out the Student Status box?

A) indicate that the patient is a full-time student
B) indicate that the patient is a part-time student
C) indicate that the patient is a nonstudent
D) None of these are correct.

Question 44

To what does the Status box in the Personal tab refer?

A) the patient's employment status
B) the patient's marital status
C) the patient's student status
D) the patient's case status

Question 45

To what does the Facility box in the Account tab refer?

A) the place where the practice is located
B) the place where a patient is receiving treatment
C) the place where a patient's test results are processed
D) the place where a patient is referred for treatment

Question 46

What type of information do practices sometimes enter in the Case Billing Code box in the Account tab to classify and sort patients?

A) billing cycle
B) insurance carrier
C) diagnosis
D) All of these are correct.

Question 47

The ____________ carrier to whom claims are submitted is the primary insurance carrier.

A) first
B) second
C) third
D) last

Question 48

Who may be the TRICARE sponsor?

A) an insurance carrier
B) a primary care physician
C) an active-duty armed services member
D) a veteran

Question 49

What part of the Case dialog box is used to record information about a patient's primary insurance carrier and coverage?

A) Policy 1 tab
B) Policy 2 tab
C) Policy 3 tab
D) All of these are correct.

Question 50

What is listed in the Insurance 1 box under the Policy 1 tab?

A) the code number of the primary insurance carrier
B) the name of the primary insurance carrier
C) the address of the primary insurance carrier
D) the code number and name of the insurance carrier

Question 51

In what kind of plan are payments made to the physician from a managed care company for patients who select the physician as their primary care provider, regardless of whether the patients visit the physician or not?

A) premium plan
B) capitated plan
C) coinsurance plan
D) fee-for-service plan

Question 52

Who is served by the TRICARE program?

A) survivors of deceased military members
B) spouses and children of active-duty service members
C) military retirees and their families
D) All of these are correct.

Question 53

What type of status may be chosen in the Sponsor Status box of the Medicare and Tricare tab?

A) Civilian
B) Active
C) National Guard
D) All of these are correct.

Question 54

You need to indicate in Medisoft that a patient is an Active member of the armed forces. Where would you make this distinction?

A) the Branch of Service box of the Medicaid and Tricare tab
B) the Sponsor Status box
C) the Policy 2 tab
D) the Policy 3 tab

Question 55

Compare and contrast the features of the Policy 3 tab to those of the Policy 1 and Policy 2 tabs.

A) The Policy 3 tab does not contain the Crossover Claim box.
B) The Policy 3 tab does not contain the Capitated Plan box.
C) The Policy 3 tab does not contain the Crossover Claim box or the Capitated Plan box.
D) There are no differences; all three tabs have the same features.

Question 56

What type of program is EPSDT?

A) a Medicaid program
B) a Medicare program
C) a TRICARE program
D) a CHAMPUS program

Question 57

Name the only tab of the Case dialog box to have the Crossover Claim box.

A) Policy 1 tab
B) Policy 2 tab
C) Policy 3 tab
D) Medicare and Tricare tab

Question 58

Choose the correct meaning of a check mark in the Accept Assignment box in the Policy 1 tab.

A) The provider accepts payment directly from the referring provider.
B) The provider accepts payment directly from the patient.
C) The provider accepts payment directly from the insurance carrier.
D) The provider accepts payment directly from the supervising provider.

Question 59

Explain the purpose of setting up delayed secondary billing.

A) To ensure that a claim is not created for the secondary carrier until a response has been received from the primary carrier
B) To ensure that a claim is not created for the tertiary carrier until a response has been received from the secondary carrier
C) To ensure that a claim is not created for the primary carrier until a response has been received from the secondary carrier
D) To ensure that claims are not sent to the secondary carrier before the primary carrier

Question 60

What is the Non-Availability Indicator box used to specify?

A) whether a patient is available for treatment
B) whether a provider is available to provide treatment
C) whether an insurance carrier is available to provide coverage
D) whether a nonavailability (NA) statement is required

Question 61

What Service Authorization Exception Code is used to indicate Special Handling?

A) 2
B) 4
C) 5
D) 7

Question 62

What type of claims may require a Service Authorization Exception Code?

A) Medicaid claims
B) Medicare claims
C) TRICARE claims
D) CHAMPUS claims

Question 63

In what tab of the Case folder should information related to an automobile accident be entered?

A) Miscellaneous
B) Personal
C) Policy 1
D) Condition

Question 64

What is the maximum number of diagnosis codes that can be entered in one Medisoft case under the default settings?

A) two
B) six
C) eight
D) twelve

Question 65

What information does the Diagnosis tab not contain?

A) a patient's diagnosis
B) information about allergies
C) electronic media claim (EDI) notes
D) All of these are correct.

Question 66

Who uses the information in the Condition tab to process claims?

A) primary physicians
B) insurance carriers
C) referring providers
D) All of these are correct.

Question 67

What type of information is stored in the Condition tab?

A) data about a patient's illness
B) data about a patient's disability
C) data about a patient's accident
D) All of these are correct.

Question 68

What tab in the Case dialog box would you use to record information about a patient's hospitalization?

A) Condition tab
B) Miscellaneous tab
C) Diagnosis tab
D) Comment tab

Question 69

What box on the Comment tab is used to record information about necessary special handling of a patient's electronic claims?

A) Allergies and Notes box
B) EDI Notes box
C) EDI Report box
D) Attachment Control Number box

Question 70

What type of patient conditions may be indicated by the Illness Indicator box?

A) an illness
B) an injury
C) a last menstrual period
D) All of these are correct.

Question 71

The Estimated Date of Birth box in the Condition tab records

A) an estimate of the date a woman became pregnant.
B) the closest guess to the birth date of a patient who does not have a birth date of record.
C) the date a pregnant woman's baby is due.
D) None of these are correct.

Question 72

You are working at a practice and have entered a patient's status in the Worker's Compensation-Return to Work Indicator as Limited, in accordance with physician instructions. What other information do you need to enter as a direct result?

A) the percent of disability
B) the last day the patient worked
C) the dates of a patient's hospitalization
D) the dates of a patient's disability

Question 73

Where are notes about special conditions related to the patient's health recorded?

A) Allergies and Notes box
B) EDI Notes box
C) EDI Report box
D) Attachment Control Number box

Question 74

In what tab of the Case folder can a patient's referral date be entered?

A) Miscellaneous
B) Condition
C) EDI
D) Comment

Question 75

What tab is used to enter case notes?

A) Miscellaneous tab
B) Condition tab
C) EDI tab
D) Comment tab

Question 76

If a patient requires lab tests performed by an outside lab, where can this information be recorded?

A) the Miscellaneous tab
B) the Condition tab
C) the Personal tab
D) the Policy 1 tab

Question 77

What tab is used to enter information for electronic claims specific to the case?

A) Miscellaneous tab
B) Condition tab
C) EDI tab
D) Comment tab

Question 78

In what tab are vision claims and home health claims entered in the Case folder?

A) the Miscellaneous tab
B) the Condition tab
C) the EDI tab
D) the Comment tab

Question 79

You have been asked to include some notes on patient statements to be printed. Where would you input such notes in the Case dialog box?

A) the Miscellaneous tab
B) the Condition tab
C) the EDI tab
D) the Comment tab

Question 80

To whom does the Date Last Seen box in the Miscellaneous tab refer?

A) the primary provider at the practice
B) the outside primary care provider
C) the referring provider
D) None of these are correct.