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