What is an authorization? (3.5)

Asking for payment for a procedure

The OIG Work Plan describes

Planned projects for investigation

Patient's PHI may be released without authorization to? (2.4)

employers in workers' compensation cases

The authorization to release information must specify? (2.4)

the entity to whom the info is to be released

Which step is not a collection preregistration basic? (3.2)

Asking for driver license number

A compliance plan contains? (2.10)

consistent written policies and procedures

Patients always have the right to? (2.4)

withdraw their authorization to release information

What is a referral (3.5)

Form to request service from another doctor

Scenarios to determine which would likely warrant a breach notification? (2.6)

database of a large insurance company is accessed by hacker

The major government-sponsored health programs are? (1.7)

TRICARE, CHAMPVA, Medicare, and Medicaid

Health information that does not identify an individual is referred to as? (2.4)

DE-identified health information

What makes a new patient new? (3.1)

Not seeing a provider in an in 3 years

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MBC 1800 Mid-Term

55 termsStudBud Administration8 plays

MBC 1800 Mid-Term

Flashcards55 cardsFPractice quizPHost liveL

Questions 55

Answers

1
What is an authorization? (3.5)
Performing a procedure
Asking for payment for a procedure
A non-covered service
Insurance Policy
2
In an HMO a gatekeeper coordinates the patient's care and providers referrals? (1.4)
PCP
PPO
EPO
NPP
3
What is code linkage (6.1)
HCPCS code to CPT code
ICD-10 code to CPT code
ICD-10 Code to another ICD-10 code
Cpt Code to CMS-1500 form
4
Medical standards of behavior requiring truthfulness, honesty, and integrity? (1.9)
ethics
certifcation
skills
attributes
5
There are 5 types of information for new patients which one is not one to college (3.2)
ABN signature
Insurance
Medical History
Salary
6
The OIG Work Plan describes
The FBI investigations
Doctor Raises
Planned projects for investigation
OCR rights
7
Health plans pay for services? (1.2)
coded
covered
out-of-network
indemnity
8
What happens if a prior authorization is not done correctly? (3.5)
The service is performed
The service is denied
The service is discounted
The service is changed
9
CAC
Computer Assisted Coding
Computer Assisted Calculation
Computer Association Coding
Computer assignments coding
10
The first step in medical billing cycle? (1.8)
check in patients
preregister patients
follow up payments
review coding compliance
11
Patient's PHI may be released without authorization to? (2.4)
social workers
employers in workers' compensation cases
local newspaper
family and friends
12
The authorization to release information must specify? (2.4)
the name of the treating physician
the entity to whom the info is to be released
the number of pages to be release
the social security number of the patient
13
A group number on a written form must match the group number listed on the ?? (3.2)
Bill Pay
Credit Card
Drive License Card
Insurance I.D
14
Authorization allowing benefits to be paid directly to a provider
Assignment of Benefits
Assignment of Bills
Acknowledge of Benefits
Assignment of Payment
15
Insurance policy contains the summarizes of payment for medically necessary? (1.2)
third-party payer
covered services
schedule of benefits
provider
16
What is a fixed rate? (6.10)
Fixed prepayment
Copay
Fee for Schedule
Schedule Benefits
17
RVU
Reasonable Value Stock
Relative Value Scale
Reasonable Value Scale
Relative Value Stock
18
What is EDI?
electronic data internet
emergency data interchange
electronic data interchange
exchange data interchange
19
Which government group has the authority to enforce the HIPAA Privacy Rule? (2.4)
OIG
CIA
MEDICAID
OCR
20
What is AP?
accounts payable
accounts promised
accounts payer
accounts payments
21
Which step is not a collection preregistration basic? (3.2)
Asking for driver license number
Asking for Insurance I.D.
Scheduling Appointments
Gathering information
22
recognition of a superior level of skill by an official organization?
ethics
professionalism
certification
etiquette
23
There are 8 types of charges to be collected, which one is not a step (3.8)
Deductibles
Zero Balance
Copayments
Coinsurance
24
Confidential authentication information?
password
de-identified health information
encryption
breach notification
25
A compliance plan contains? (2.10)
consistent written policies and procedures
medical office staff names
the practice's main health plans
a list of all practice's patients
26
What is CE?
clear-housing entity
covered entity
cost entity
customer entity
27
What is CDHPs?
containment-driven health plans
consumer-driven health plans
claims-driven health plans
clear-housing driven health plans
28
Patients always have the right to? (2.4)
withdraw their authorization to release information
alter the information in their medical records
restrict the release of all DE-identified
block release of information about their communicable
29
what is EHR?
electronic health retention
electronic hub records
electronic health records
emerge health records
30
Why is code linkage important? (6.1)
Code linkage is base pay
Code linkage links time
Code linkage are chains
Code linkage is an edit
31
GPCI
Geographic Problem Cost Index
Geographic Program Cost Index
Geographic Patient Cost Index
Geographic Practice Cost Index
32
What is one of the 5 steps to collect for new patients? (3.2)
Medical History
Urinalysis
Piece of mail
Monthly expenses
33
Physician who transfers care of a patient to another physician
Referring Party
Recommending Physician
Referring Physician
Recording physician
34
A self-insured health plan may use its owns? (1.7)
physician-employees
funds
primary care physicians
gatekeepers
35
RTCA
Real Time Adjustments
Real Thing Adjudication
Right Time Adjustments
Real Time Adjudication
36
What is a referral (3.5)
When you schedule an appointment with your doctor
Form to request service from another doctor
A physical form for school
A form to make an appointment
37
EP
Everyday Patient
Estimated practice
Established Patient
Established Program
38
A notice of privacy practices is given to? (2.4)
the health plans with which a practice contracts
a practice's business associates
all physicians who refer patients to the practice
a practice's patients
39
Scenarios to determine which would likely warrant a breach notification? (2.6)
database of a large insurance company is accessed by hacker
DE-identified health info is accessed by an outside provider
a company's workforce members use information in good faith
released to the government statistical purposes info
40
person or organization that performs a function or activity for a covered entity.
business associate (BAs)
clear-housing
covered entity
authorization
41
The major government-sponsored health programs are? (1.7)
Medicare and TRICARE
TRICARE, CHAMPVA, Medicare, and Medicaid
medicare and medicaid
HEDIS, medicare, and CHAMPVA
42
The most popular type of insurance? (1.5)
PCP
POS
HMO
PPO
43
Which is also known as health insurance? (1.2)
medical insurance
policyholder
preventive medical services
benefits
44
Coinsurance is calculated based on? (1.3)
a capitation rate
a fixed charge for each visit
the number of policyholders in a plan
a percentage of a charge
45
What is E/M?
encounter method
emergency and management
electronic management
evaluation and management
46
Which one is not one of the three types of edits? (6.2)
Column 1 and 2 pair codes
Column 3 and 4 pair codes
Modifier Indicators
Mutually Exclusive edits
47
Health information that does not identify an individual is referred to as? (2.4)
statutory data
authorized health release
DE-identified health information
protected health information
48
Which of the following laws is designed to uncover fraud and abuse? (2.2)
fraud and abuse act
ARRA
HIPAA
HITECH Act
49
record of a patient's financial transactions
patient ledger
encounter form
compliance
adjudication
50
What makes a new patient new? (3.1)
Not seeing the provider in 6 months
Not seeing the provider in 2 years
Not seeing a provider in an in 3 years
Not seeing the provider in 5 years
51
Internal audit of claims conducted before transmission
audit
external audit
Prospective audit
internal audit
52
Utilization of certified EHR technology to improve quality, efficiency, and patient safety.
clear-housing
HIPPA privacy rule
meaningful use
Business associate (BAs)
53
COB
Calling of basics
Coordination of bills
Coordination of benefits
Calculation of benefits
54
Providing Free services to other physicians and their families
Professional Counseling
Courtesy call
Job reference aid
Professional Courtesy
55
the main purpose of the HIPAA security rule is to? (2.5)
protect research data
control the confidentiality and integrity of access to PHI
regulate electronic transactions
protect medical facilities from criminal acts

MBC 1800 Mid-Term Flashcards | StudBud

MBC 1800 Mid-Term

55 termsStudBud Administration8 plays

MBC 1800 Mid-Term

Flashcards55 cardsFPractice quizPHost liveL

Questions 55

Answers

1
What is an authorization? (3.5)
Performing a procedure
Asking for payment for a procedure
A non-covered service
Insurance Policy
2
In an HMO a gatekeeper coordinates the patient's care and providers referrals? (1.4)
PCP
PPO
EPO
NPP
3
What is code linkage (6.1)
HCPCS code to CPT code
ICD-10 code to CPT code
ICD-10 Code to another ICD-10 code
Cpt Code to CMS-1500 form
4
Medical standards of behavior requiring truthfulness, honesty, and integrity? (1.9)
ethics
certifcation
skills
attributes
5
There are 5 types of information for new patients which one is not one to college (3.2)
ABN signature
Insurance
Medical History
Salary
6
The OIG Work Plan describes
The FBI investigations
Doctor Raises
Planned projects for investigation
OCR rights
7
Health plans pay for services? (1.2)
coded
covered
out-of-network
indemnity
8
What happens if a prior authorization is not done correctly? (3.5)
The service is performed
The service is denied
The service is discounted
The service is changed
9
CAC
Computer Assisted Coding
Computer Assisted Calculation
Computer Association Coding
Computer assignments coding
10
The first step in medical billing cycle? (1.8)
check in patients
preregister patients
follow up payments
review coding compliance
11
Patient's PHI may be released without authorization to? (2.4)
social workers
employers in workers' compensation cases
local newspaper
family and friends
12
The authorization to release information must specify? (2.4)
the name of the treating physician
the entity to whom the info is to be released
the number of pages to be release
the social security number of the patient
13
A group number on a written form must match the group number listed on the ?? (3.2)
Bill Pay
Credit Card
Drive License Card
Insurance I.D
14
Authorization allowing benefits to be paid directly to a provider
Assignment of Benefits
Assignment of Bills
Acknowledge of Benefits
Assignment of Payment
15
Insurance policy contains the summarizes of payment for medically necessary? (1.2)
third-party payer
covered services
schedule of benefits
provider
16
What is a fixed rate? (6.10)
Fixed prepayment
Copay
Fee for Schedule
Schedule Benefits
17
RVU
Reasonable Value Stock
Relative Value Scale
Reasonable Value Scale
Relative Value Stock
18
What is EDI?
electronic data internet
emergency data interchange
electronic data interchange
exchange data interchange
19
Which government group has the authority to enforce the HIPAA Privacy Rule? (2.4)
OIG
CIA
MEDICAID
OCR
20
What is AP?
accounts payable
accounts promised
accounts payer
accounts payments
21
Which step is not a collection preregistration basic? (3.2)
Asking for driver license number
Asking for Insurance I.D.
Scheduling Appointments
Gathering information
22
recognition of a superior level of skill by an official organization?
ethics
professionalism
certification
etiquette
23
There are 8 types of charges to be collected, which one is not a step (3.8)
Deductibles
Zero Balance
Copayments
Coinsurance
24
Confidential authentication information?
password
de-identified health information
encryption
breach notification
25
A compliance plan contains? (2.10)
consistent written policies and procedures
medical office staff names
the practice's main health plans
a list of all practice's patients
26
What is CE?
clear-housing entity
covered entity
cost entity
customer entity
27
What is CDHPs?
containment-driven health plans
consumer-driven health plans
claims-driven health plans
clear-housing driven health plans
28
Patients always have the right to? (2.4)
withdraw their authorization to release information
alter the information in their medical records
restrict the release of all DE-identified
block release of information about their communicable
29
what is EHR?
electronic health retention
electronic hub records
electronic health records
emerge health records
30
Why is code linkage important? (6.1)
Code linkage is base pay
Code linkage links time
Code linkage are chains
Code linkage is an edit
31
GPCI
Geographic Problem Cost Index
Geographic Program Cost Index
Geographic Patient Cost Index
Geographic Practice Cost Index
32
What is one of the 5 steps to collect for new patients? (3.2)
Medical History
Urinalysis
Piece of mail
Monthly expenses
33
Physician who transfers care of a patient to another physician
Referring Party
Recommending Physician
Referring Physician
Recording physician
34
A self-insured health plan may use its owns? (1.7)
physician-employees
funds
primary care physicians
gatekeepers
35
RTCA
Real Time Adjustments
Real Thing Adjudication
Right Time Adjustments
Real Time Adjudication
36
What is a referral (3.5)
When you schedule an appointment with your doctor
Form to request service from another doctor
A physical form for school
A form to make an appointment
37
EP
Everyday Patient
Estimated practice
Established Patient
Established Program
38
A notice of privacy practices is given to? (2.4)
the health plans with which a practice contracts
a practice's business associates
all physicians who refer patients to the practice
a practice's patients
39
Scenarios to determine which would likely warrant a breach notification? (2.6)
database of a large insurance company is accessed by hacker
DE-identified health info is accessed by an outside provider
a company's workforce members use information in good faith
released to the government statistical purposes info
40
person or organization that performs a function or activity for a covered entity.
business associate (BAs)
clear-housing
covered entity
authorization
41
The major government-sponsored health programs are? (1.7)
Medicare and TRICARE
TRICARE, CHAMPVA, Medicare, and Medicaid
medicare and medicaid
HEDIS, medicare, and CHAMPVA
42
The most popular type of insurance? (1.5)
PCP
POS
HMO
PPO
43
Which is also known as health insurance? (1.2)
medical insurance
policyholder
preventive medical services
benefits
44
Coinsurance is calculated based on? (1.3)
a capitation rate
a fixed charge for each visit
the number of policyholders in a plan
a percentage of a charge
45
What is E/M?
encounter method
emergency and management
electronic management
evaluation and management
46
Which one is not one of the three types of edits? (6.2)
Column 1 and 2 pair codes
Column 3 and 4 pair codes
Modifier Indicators
Mutually Exclusive edits
47
Health information that does not identify an individual is referred to as? (2.4)
statutory data
authorized health release
DE-identified health information
protected health information
48
Which of the following laws is designed to uncover fraud and abuse? (2.2)
fraud and abuse act
ARRA
HIPAA
HITECH Act
49
record of a patient's financial transactions
patient ledger
encounter form
compliance
adjudication
50
What makes a new patient new? (3.1)
Not seeing the provider in 6 months
Not seeing the provider in 2 years
Not seeing a provider in an in 3 years
Not seeing the provider in 5 years
51
Internal audit of claims conducted before transmission
audit
external audit
Prospective audit
internal audit
52
Utilization of certified EHR technology to improve quality, efficiency, and patient safety.
clear-housing
HIPPA privacy rule
meaningful use
Business associate (BAs)
53
COB
Calling of basics
Coordination of bills
Coordination of benefits
Calculation of benefits
54
Providing Free services to other physicians and their families
Professional Counseling
Courtesy call
Job reference aid
Professional Courtesy
55
the main purpose of the HIPAA security rule is to? (2.5)
protect research data
control the confidentiality and integrity of access to PHI
regulate electronic transactions
protect medical facilities from criminal acts