Question 1

NSF is the abbreviation for _________.

Accepted Answer

A)  nonsufficient funds 
B)  no such funds 
C)  non adequate funds 
D)  non satisfactory funds

Question 2

Uncollectible accounts are also called _______.

Accepted Answer

A)  bad debt 
B)  negotiable funds 
C)  unprincipled account 
D)  debase debt

Question 3

_____ has laws regulating consumer collections to ensure fair and ethical treatment of debtors.

Accepted Answer

A)  Telephone Consumer Protection Act 
B)  Fair Treatment of Debtors Act 
C)  Consumer Fairness Act 
D)  Telephone No Call Act

Question 4

________ is a report grouping unpaid claims transmitted to payers by the length of time they remain due.

Accepted Answer

A)  insurance systematic report 
B)  insurance methodical report 
C)  insurance aging report 
D)  insurance organized report

Question 5

______ is money that cannot be collected and must be written off.

Accepted Answer

A)  unaccumulated account 
B)  uncollectible account 
C)  default account 
D)  nonappearance account

Question 6

_______ ask insurance carriers to reconsider a claim determination.

Accepted Answer

A)  appeals 
B)  requests 
C)  arbitration 
D)  mediation

Question 7

A claim that is denied because of untimely submission (submitted after the contractual deadline) is ______ to appeal.

Accepted Answer

A)  subject 
B)  not subject 
C)  prolonged 
D)  automatically subject

Question 8

The practice management program is used to generate a report that lists the claims transmitted on each day and shows how long they have been in process with the payer. What is this report called?

Accepted Answer

A)  insurance aging report 
B)  patient aging report 
C)  accounts receivable report 
D)  insurance systematic report

Question 9

Regulations mandated under the Affordable Care Act (ACA) as of January 1, 2014, require a _______ to appear on both the EFT and its ERA, so the documents are easy to match up electronically.

Accepted Answer

A)  verification number 
B)  trace number 
C)  substantiation number 
D)  support number

Question 10

The term used by payers to indicate that more information is needed for claim processing is called _____.

Accepted Answer

A)  accruing 
B)  development 
C)  gathering 
D)  enhancement

Question 11

______ is the use of a procedure code that provides a higher payment.

Accepted Answer

A)  higher coding 
B)  upcoding 
C)  complex coding 
D)  advanced coding

Question 12

Which of the following is not included on a patient's statement?

Accepted Answer

A)  insurance contact information 
B)  services and dates 
C)  charges and adjustments 
D)  payments and balance due

Question 13

_____ is the document sent to patients showing how the amount of a benefit was determined.

Accepted Answer

A)  electronic advice for benefits 
B)  clarification of benefits 
C)  explanation of benefits 
D)  justification of benefits

Question 14

ERA is the abbreviation for _______.

Accepted Answer

A)  electronic remittance advice 
B)  electronic release advice 
C)  electronic reference advice 
D)  electronic recommendation advice

Question 15

______ is a type of billing which divides patients with current balances into groups to even out monthly statement printing and mailing.

Accepted Answer

A)  sequence billing 
B)  cycle billing 
C)  succession billing 
D)  series billing

Question 16

The patient aging report is used to ________.

Accepted Answer

A)  determine the age of the patient 
B)  manage the collection process 
C)  determine the compendium process 
D)  manage the insurance claims

Question 17

The collection process really begins with _____.

Accepted Answer

A)  collection phone calls 
B)  write-offs 
C)  patient statements 
D)  effective communications with patients about their responsibility to pay for services

Question 18

A claim appeal is a written request for a ______.

Accepted Answer

A)  review of the determination 
B)  cancellation of services 
C)  professional investigation 
D)  increase in repayment

Question 19

The process of gathering information to begin to adjudicate a claim is called ____.

Accepted Answer

A)  assembly 
B)  initial processing 
C)  collecting 
D)  accumulating

Question 20

The insurance aging report is used to _______.

Accepted Answer

A)  monitor deductibles paid by patients 
B)  monitor overdue claims from payers 
C)  monitor copayments paid by patients 
D)  monitor insurance premiums paid by patients

Exam 13: Claim Processing, Payments, and Collections