Frage 1
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If a child covered by both a primary and secondary insurance is charged $350.00 for a procedure. The primary insurance pays $275.00. How is the remaining balance paid?
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The patient’s parents are responsible for the remaining balance.
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The medical assistant submits a claim with the secondary insurance for $275.00.
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The medical assistant submits a claim with the secondary insurance for $75.00.
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The medical assistant submits a claim with the secondary insurance for $350.00.
Frage 2
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True or false? Math skills are not important for the medical assistant because everything is done on the computer.
Frage 3
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A payment system in which payments to providers are fixed and based on the number of enrollees over a period of time regardless of the type or numbers of services provided is called:
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capitation
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medigap
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limiting fee
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POS
Frage 4
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True or false? Each insurance carrier will have its own negotiated fee schedule.
Frage 5
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True or false? A medical office might have a separate fee schedule for patient’s paying out-of-pocket.
Frage 6
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True or false? Unless prohibited by law, a medical office may have more than one fee schedule established by different insurance carriers.
Frage 7
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True or false? During the patient interview, the medical assistant should document the patient’s statements into the progress note.
Frage 8
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True or false? A professional appearance including clean scrubs, groomed hair, and appropriate makeup will contribute to the professionalism of the medical office and gain the patient’s trust.
Frage 9
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In order to ensure that Casey is comfortable, the medical assistant should __________
Frage 10
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True or false? A day sheet tracks all of the patient transactions for one specific day in a medical office.
Frage 11
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True or false? Only payments made at the medical office are recorded on the day sheet.
Frage 12
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A medical assistant should record which of the following transactions on the day sheet?
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An insurance payment received in the daily mail, a patient payment dropped off at the medical office, and a bankruptcy adjustment.
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A bankruptcy adjustment.
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A patient payment dropped off at the medical office.
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An insurance payment received in the mail.
Frage 13
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The total on the __________ should match the total on the bank deposit slip.
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day sheet
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superbill
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claim
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patient ledger
Frage 14
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In alphabetic filing, a patient’s first name is the __________ filing unit.
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FOURTH
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SECOND
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FIRST
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THIRD
Frage 15
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True or false? Correspondence with a patient does not need to be included in the patient’s medical record.
Frage 16
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True or false? Workers’ compensation has its own fee schedule and a provider cannot bill a patient for the difference between their billed amount and workers’ compensation allowed amount.
Frage 17
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What services does workers’ compensation pay for?
Frage 18
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True or false? Services performed one month ago cannot be submitted for reimbursement.
Frage 19
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When a patient gives permission for the insurance carrier to pay the provider directly, this is called:
Frage 20
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True or false? The Explanation of Benefits (EOB) is not a bill, but a summary of the services submitted and insurance payments to the doctor’s office.
Frage 21
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__________ plans reimburse physicians according to the procedures performed.
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CAPITATION
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CAPITA
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DEDUCTIBLE
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FEE FOR SERVICE
Frage 22
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The cost-sharing measure in which the insured pays a percentage of the insurance carrier’s allowed amount is called:
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CODEDUCTIBLE
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COPAYMENT
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COINSURANCE
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COPREMIUM
Frage 23
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When a patient is covered under more than one policy, __________ is used to ensure the claim is not paid to more than 100%.
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AN ADJUSTMENT
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CROSS-REFERENCE
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BENEFIT OVERLAP
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COORDINATION OF BENEFITS
Frage 24
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True or false? Refunds owed to the patient can be provided as a standing credit balance or the medical assistant can issued a refund check to the patient.
Frage 25
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True or false? All office equipment should be documented on the office inventory and checked for regular maintenance and repair so they are in proper working order for patient use.
Frage 26
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True or false? It is important to know a patient’s insurance carrier before looking up the cost of a procedure in the fee schedule.
Frage 27
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Posting information to the day sheet would be considered a __________ activity, whereas using the information from the day sheets and other forms to create a document that summarizes the medical office’s finances would be this type of activity: __________
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accounting, bookkeeping
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insurance, financial
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financial, insurance
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bookkeeping, accounting
Frage 28
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Billing statements should be sent to patients:
Frage 29
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A financial statement that records the charges, receipts and services rendered on a given day is a:
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balance sheet
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day sheet
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petty cash fund
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checkbook
Frage 30
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Patient statements are generated:
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quarterly
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monthly
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every two months
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weekly
Frage 31
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The abbreviation DOS stands for:
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date of stamp
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date of symptom
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date of signature
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date of service
Frage 32
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Which of the following are CPT codes for the administration of the influenza vaccine?
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G0008
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90658, 90471, and G0008
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90658
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90471
Frage 33
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The procedural code for Diagnostic Mammogram of both breasts is __________
Frage 34
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True or false? The progress note is a summary of the procedures and diagnosis of the visit office.
Frage 35
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True or false? OTC stands for over-the-counter.
Frage 36
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required for all patients.
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a request for a specialist opinion.
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a transfer of specific care of the patient.
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provided for certain procedures or hospital admissions
Frage 37
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Mr. Caudill is feeling depressed about his new diagnosis. The medical assistant knows of another patient who was recently diagnosed with the same disorder and gives Mr. Caudill the patient’s phone number. Which of the following statements regarding the medical assistant’s actions are true:
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The medical assistant violated Title One of HIPAA and could face disciplinary action.
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The medical assistant did nothing wrong.
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The medical assistant helped the patient network with others.
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The medical assistant violated Title Two of HIPAA and could face disciplinary action.
Frage 38
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What does the acronym SOAPE represent?
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Shivering, outward, aching, pain, eventual
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Sickness, observation, aching, pain, elevation
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Subjective data, objective data, assessment, plan, and evaluation
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Stomach, ovary, ankle, pancreas, ear
Frage 39
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After a claim is processed, payment and the remittance advice (RA) are sent to the:
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guarantor
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patient
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health plan
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provider
Frage 40
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True or false? The total amount of cash and checks needs to be documented at the bottom of the deposit slip.
Frage 41
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Which of the following statements regarding EFT is false?
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EFT allows payment to be automatically deposited into the provider account
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EFT still has a corresponding remittance advice (RA).
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EFT still requires the endorsement of a check
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EFT still requires the endorsement of a check, allows payment to be automatically deposited, and still has a corresponding remittance advice (RA)
Frage 42
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True or false? Checks are documented individually on a deposit slip.
Frage 43
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All checks prepared for a deposit must be:
Frage 44
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True or false? The medical assistant only needs to be aware of deposits and checks when reconciling a bank statement.
Frage 45
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True or false? The medical assistant only needs to document checks received from insurance carriers on the bank deposit slip.
Frage 46
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True or false? It is appropriate to charge a fee for NSF checks.
Frage 47
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f a patient mails a check payment without having sufficient funds, the medical office could:
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deduct the amount from the medical office’s checking account balance.
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add the amount due back to the patient ledger.
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document a description of the transaction in the patient ledger.
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deduct the amount from the medical office’s checking account balance, add the amount due back to the patient ledger, or document a description%2
Frage 48
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True or false? Postdated checks are not accepted as payment in the medical office.
Frage 49
Frage 50
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What types of payment are most commonly used in the medical office?
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cash
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cash, personal check, or credit card
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cash or personal check
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cash, personal check, or third party check only
Frage 51
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True or false? Cash and checks are listed separately on the deposit slip.
Frage 52
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Bank deposit slips should be prepared:
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by the physician only
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weekly
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monthly
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daily
Frage 53
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True or false? A patient’s outstanding balances are accounts payable.
Frage 54
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True or false? The medical office may not impose a returned check fee for NSF checks because it is against insurance agreements.
Frage 55
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True or false? It is acceptable to insist on cash only payments from patients with previous NSF checks.
Frage 56
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True or false? Third party checks have a greater risk of being NSF.
Frage 57
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If the patient writes “payment in full” and the account is not fully paid, the medical assistant should scratch the documentation from the check.
Frage 58
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What precautions should be taken when accepting a check?
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Do not accept third party checks.
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Scan the check for accuracy.
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Scan for accuracy, don't accept checks made out for more money than owed, and don't accept third party checks.
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Do not accept checks made out for more money than owed.
Frage 59
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Which detail should be documented on a check?
Frage 60
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True or false? The biller should not contact the patient about past due balances at their employment unless the work phone contact has been approved by the patient.
Frage 61
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True or false? The Federal Trade Commission (FTC) enforces the Fair Debt Collection Practices Act (FDCPA). This act encourages debt collectors to use abusive, unfair, or deceptive practices to collect past due monies.
Frage 62
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True or false? It is good practice to document the date and time you attempt to call patients about collections on accounts.
Frage 63
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True or false? The Internet is a good resource when trying to collect money owed from a patient who has moved without leaving a forwarding address.
Frage 64
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True or false? A blank prescription is documented as an in-office order in the Order Entry section of the patient record.
Frage 65
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True or false? The medical assistant must document the date and time of a phone message in order to determine the average turnaround time to complete messages.
Frage 66
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According to Amma Patel’s Phone Encounter, Ms. Patel called Walden-Martin: __________
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two days ago.
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yesterday.
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this morning.
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this afternoon.
Frage 67
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True or false? It is not important to document the time Ms. Patel plans to pick up her prescription.
Frage 68
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Which of the following orders can be generated by clicking the Add button beneath the Out-of-Office table?
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Medication prescription
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Requisition
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Blank prescription
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All of the above
Frage 69
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You can access a specific patient encounter by selecting __________
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Patient Demographics.
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the Clinical Care module.
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the Record dropdown menu.
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an encounter listed in the Patient Dashboard.
Frage 70
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The ICD-10 CM code for obesity is __________
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E65.9.
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E66.9.
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E66.0.
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E60.0.
Frage 71
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True or False? The certified medical assistant is permitted to prepare a non-medical prescription, such as an order for a fitness center, for provider approval using a documented order in the patient record.
Frage 72
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True or false? It is not necessary for the order to be documented in the patient record before the medical assistant can generate an order.
Frage 73
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In order to document the University Laboratory results for Ms. Yan, the medical assistant should: __________
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click on the Superbill.
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document the results within the Phone Encounter only. No other documentation is necessary.
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select “Diagnostic/Lab Results” from the Clinical Care info panel.
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use the Order Entry record section in Clinical Care.
Frage 74
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True or false? Z86.73 is part of the ICD-9 CM coding system.
Frage 75
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ICD-10 CM code Z79.01 is used to identify which patient condition?
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Transient Ischemic Attack (TIA)
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Long Term Use of Anticoagulants
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Traumatic Brain Injury (TBI)
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CVA
Frage 76
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True or false? The date field within the Diagnostic/Lab Results tab is the date the medical office receives the results.
Frage 77
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True or false? The Problem List allows the user to enter both the ICD 9 CM code and ICD 10 code as part of the record.
Frage 78
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The ICD-10 CM code for Personal History of CVA is Z86.73. This code is also used for which condition?
Frage 79
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The ECG has a cost of $89.00. Where will the user obtain the charge for service to document on the Insurance Tracer?
Frage 80
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Which data elements are part of the Insurance Claim Tracer?
Frage 81
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True or false? The policy ID of the patient account is not part of the Insurance Claim Tracer.
Frage 82
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The Insurance Claim Tracer was generated: __________
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because the original claim was denied.
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as an alternative method of claim submission.
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as a follow up to a claim yet to be paid.
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as a method of adding additional services for reimbursement.
Frage 83
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True or false? The date of service and date of claim are always different.
Frage 84
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True or false? The Insurance Claim Tracer is generated from the Correspondence function of SimChart for the Medical Office.
Frage 85
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The Insurance Claim Tracer is available in __________
.
Frage 86
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The status of the Ella Rainwater’s claim for this encounter is: __________
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denied.
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resubmitted.
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submitted.
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in progress.
Frage 87
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The Alzheimer’s Disease handout is found under what category of the Patient Education record?
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Health Promotion
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Procedures
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Diagnosis
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Tests
Frage 88
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True or false? Prior Authorization is located in the Form Repository.
Frage 89
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Which field of the Prior Authorization form signifies the patient’s eligibility of managed care services?
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Effective date
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Authorization number
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Procedure code
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Expiration date
Frage 90
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True or false? Prior authorization forms have both an effective and expiration date.
Frage 91
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Which of the following is listed on the Prior Authorization form?