Electronically processing claim forms to insurance carriers:

reduces the amount of preparation time for the claims processor

Patients should be given a receipt:

when they make payment in any form

Information required to file a third-party claim on the CMS-1500 form includes all but:

the co-pay receipt given to patient at time of visit

Computerized accounting systems:

automatically update records as information is entered into the system

Which of the following statements is not true when using HCPCS Level II codes?

The search for the correct HCPCS code begins in the Tabular List.

You should not accept a check that is:

written for more than the amt due so the patient can have some cash

As soon as cash money is received in the office, it should be:

placed out of sight in a secure location

When a third-party payer identifies an error on the claim form, the claim is:

rejected with a request to resubmit the form with corrections

When processing a credit balance, if a refund is due to a patient, you must:

verify that you have the patient’s current address

A provider may not charge a patient for:

an amount reimbursed after accepting assignment

What is the first step in completing a claim form?

Check for a photocopy of the patient’s insurance card.

HCPCS Level I codes are known as:

Current Procedural Terminology.

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MA 210 FINAL REVIEW

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Answers

1
Electronically processing claim forms to insurance carriers:
reduces the amount of preparation time for the claims processor
lengthens the turnaround time
is more expensive than traditional manual claims processing
is discouraged because of the danger of violating HIPAA
2
When composing collection letters, avoid words that tend to antagonize, such as:
missed
forgotten
overlooked
ignored
3
Physicians who treat patients under workers’ compensation plans are usually required to register with the state WC
every 5 years
only once, unless they move or change the name of the medical practice
on an annual basis
anytime they need to file a claim
4
A check must include some form of which phrase to be negotiable?
security features included
pay to the order of
for deposit only
In God We Trust
5
Patients should be given a receipt:
when they make payment in any form
only when they pay in cash
when they charge the bill to a credit card
when they pay by check
6
Under the birthday rule, if the parents’ divorce and retain their plans, the parent with _____ is primary.
the parent with the plan that provides the best coverage
the plan in effect the longest
custody
the greater income
7
The ____ is a method of reimbursement in which the Medicare payment for patient services is made
diagnosis-related group
prospective payment system
geographic practice cost index
conversion factor
8
Where in the CPT manual would you find information about modifiers?
Tabular list
Alphabetic index
Appendix C
Appendix A
9
Information required to file a third-party claim on the CMS-1500 form includes all but:
the insured’s name, full address, and telephone number
the relationship to the insured
access to a photocopy of the patient’s insurance card
the co-pay receipt given to patient at time of visit
10
Which of the following are types of information contained in the patient’s billing record (account or ledger)?
payments
charges
all of the above
balance due
11
?is a method of reimbursement in which the Medicare payment for patient services based on a predetermined, fixed amount:
diagnosis-related group
geographic practice cost index
conversion factor
prospective payment system
12
Collection agencies may charge ____for their services.
a full percentage
$50
$35
50%
13
Which of the following is not a fee usually charged by a clearinghouse?
customer service fee
flat monthly fee
per-claim transaction fee
start-up fee
14
When a patient arrives at the medical office, you should copy (or scan) _____ of the insurance card(s).
neither side
only the back
only the front
both sides
15
The total amount of cash and checks, including credit and debit card payments, should be manually recorded on a?
debit sheet
credit sheet
none of the above
cash control sheet
16
Computerized accounting systems:
are more expensive for the practice than manual systems in the long run
typically offer only two types of reporting options
automatically update records as information is entered into the system
offer more room for errors
17
Which of the following statements is not true when using HCPCS Level II codes?
The search for the correct HCPCS code begins in the Tabular List.
The search for the correct HCPCS code begins in the Index.
Both CPT and HCPCS Level II codes can be reported on the same claim.
18
Assigning a dx code that does not match patient documentation for the purpose or increasing reimbursement through DRG is
downcoding.
bundling.
unbundling.
upcoding.
19
You should not accept a check that is:
uncorrected and includes the seven components that make a check valid
a third-party check from an authorized insurance company
marked “paid in full” and pays the account in full
written for more than the amt due so the patient can have some cash
20
When depositing checks by mail, they should be endorsed by _____ endorsement only.
personal
blank
stamped
restrictive
21
Once a patient is ready to leave the hospital __is used to ensure that the patient is being discharged appropriately.
discharge planning
diagnostic planning
capitation
utilization review
22
The standard claim form designed by the Cent for Medicare and Medicaid Services to submit services for 3rd ins payment
the coordination of benefits
the fee disclosure
the Affordable Care Act
the CMS-1500
23
When using practice management software, the procedures indicated on a patient’s encounter form should be coded:
no more than once a month
at the end of each day
at the end of each week
as soon as possible
24
As soon as cash money is received in the office, it should be:
deposited in a checking account
deposited in a savings account
placed out of sight in a secure location
stored in an envelope on the reception desk
25
Which HCPCS Level II codes are temporary codes for procedures, services, and supplies?
M codes
J codes
L codes
G codes
26
When a patient arrives at the medical office, you should copy (or scan) _____ of the insurance card(s).
neither side
both sides
only the front
only the back
27
When a third-party payer identifies an error on the claim form, the claim is:
held indefinitely until the medical office calls to inquire about its stat
paid, with a penalty fee subtracted for the error
rejected with a request to resubmit the form with corrections
rejected and barred from resubmission
28
Money due to the practice is known as:
year-to-date reports
accounts payable
account aging
accounts receivable
29
Part ___ of Medicare is for payment of medical expenses such as office visits and X-ray and laboratory services.
B
C
D
A
30
Refers to the discovery of the maximum amount of money that a carrier will pay for primary surgery, consultation service
pretreatment
preauthorization
predetermination
precertification
31
When coding, the primary reason for the office visit is listed first, and other reasons are listed in what order?
Numerical order
Order of importance
Chronological order
Alphabetical order
32
: Under the birthday rule, if the parents’ divorce and retain their plans, the parent with _____ is primary.
custody
the greater income
the plan in effect the longest
the parent with the plan that provides the best coverage
33
The CPT manual uses symbols to indicate specific information about code numbers. For example, the + symbol stands for:
add-on code.
modifier -51 exempt.
new code.
revised text.
34
Which of the following are considered third-party (insurance) plans?
Medicare
All of the above
Group health plans
Court-ordered health coverage
35
An adjustment code would be used for which of the following?
payment made with a credit card
co-pay due at the time of service
payment made with a money order
canceled account balance
36
When processing a credit balance, if a refund is due to a patient, you must:
deduct a small processing fee (usually no more than 5 percent)
apply the funds as a credit toward future services
verify that you have the patient’s current address
send the check to the patient’s insurance company
37
A provider may not charge a patient for:
a service not covered by the patient’s insurance
the part of the deductible that has not been met
any coinsurance that is due
an amount reimbursed after accepting assignment
38
When an entry is made on the day sheet, it is called:
journalizing
crediting
balancing
ordering
39
Medicare pays ____ of the approved medical bill amount once the deductible is satisfied.
80
20
70
60
40
A(n) _____ form lists the procedures performed in a medical office and their respective codes.
coding
credit
confidentiality
encounter
41
A professional courtesy discount is an example of a(n):
balance
adjustment
deposit
overpayment
42
What is the first step in completing a claim form?
Correctly complete boxes 1–3 on the form.
Check for a photocopy of the patient’s insurance card.
Write the provider’s federal tax ID number in the appropriate space.
Check to see if the patient’s signature is on file for release of info
43
Who publishes Current Procedural Terminology (CPT)?
World Health Organization
Department of Health and Human Services
American Public Health Association
American Medical Association
44
The term refers to the discovery of the max amt of money that a carrier will pay for primary surgery, consult services
pretreatment
precertification
predetermination
preauthorization
45
When writing a check, the date:
must be numerical
can be written or numerical
must be preprinted on the check
must be written
46
Part ___ of Medicare is for payment of medical expenses such as office visits and X-ray and laboratory services.
B
C
D
A
47
If a mistake is made in writing a check, it is necessary to write “_____” across the check and stub and write a new one.
VOID
DO NOT USE
ERROR
ERROR
48
Services performed in the office are generally marked on a patient’s encounter form by the:
administrative medical assistant.
patient.
provider.
clinical medical assistant
49
A(n) _____ check is a check paid directly from a checking account via the Internet.
cashier’s
limited
certified
electronic
50
Discounts must generally be authorized by the:
provider
patient
administrative medical assistant
clinical medical assistant
51
HCPCS Level I codes are known as:
Current Procedural Terminology.
ICD-10-CM.
all of the above
National codes.
52
A provider may not charge a patient for:
the part of the deductible that has not been met
an amount reimbursed after accepting assignment
a service not covered by the patient’s insurance
any coinsurance that is due
53
ICD codes are descriptive of the:
form of treatment used.
presenting disease or condition.
presenting symptoms.
medications used in treatment.
54
If a stop payment is placed on a check, the bank will:
require the payee to pay a fee to cash the check
refuse to honor the check
contact the payer for permission before transferring cash to the payee
freeze the account of the payee
55
Because a primary care physician (PCP) in an HMO makes referrals and approves additional care if needed, he or she is
care manager
patient advocate
gatekeeper
specialist
56
An outsourced billing service does not _____ statements.
create
print
mail
sort
57
Who publishes Current Procedural Terminology (CPT)?
American Medical Association
Department of Health and Human Services
American Public Health Association
World Health Organization
58
The ICD-9-CM remained in use in the United States until September 30th of what year?
2017
2018
2016
2015
59
The _____ is the amount in numbers that the check is written for.
drawee
negotiable amount
written amount
numeric amount
60
A health care model of groups of doctors who give coordinated high-quality care to Medicare patients is known as:
the Accountable Care Organization
the Patient-Centered Medical Home
the Affordable Care Act
the Health Maintenance Organization
61
Blue Cross was originally set up to pay for:
preventive health care
hospital expenses
physicians’ services
prescription medications
62
The CMS-1500 form is accepted by:
Neither
Medicaid
Medicare
both Medicare and Medicaid
63
If you make collection calls before or after the legal hours in your state, you can be liable for:
stalking
filing a false claim
assult
harrassment
64
Which of the following would not be a required step in utilizing medical necessity guidelines?
Review of the family history section of the progress note
Review of the narrative diagnostic finding(s) indicated
Review the order from provider
65
If a patient’s check is returned to the office by the bank and is marked “NSF,” it means:
The check cleared and the funds were deposited into the office’s account.
There is not enough money in the patient’s account to cover the check.
The numerical amount on the check does not match the written amount.
The patient forgot to sign the check.
66
When using a manual method, all charges and payments made to an individual patient’s account are posted on a(n):
patient ledger card
charge slip
superbill
encounter form
67
Which of the following would be considered a step or steps to verify insurance coverage and eligibility?
Determine if the insurance is managed care.
All of the above are necessary steps.
Complete required fields, verifying you have the correct patient info, eli
Access the website for the patient’s insurance carrier (or use the EHR app
68
When using the pegboard system, the day sheet does not:
identify the procedures performed on a patient during previous office visit
act as a complete financial record of charges made and payments received
hold all of the daily entries
act as a list of patients seen
69
An overdraft is when:
earned interest is waived.
do not use a personal check.
a check is more than the amount in the bank account.
you open a savings account.
70
When posting a payment to a patient’s account, you must enter all but which of the following into the system?
previous balance
payment amount
date of the payment
form of payment
71
A bank statement obtained through an ATM usually contains the last _____ transactions made on an account.
20
10
5
15
72
A check will be instantly returned by the bank if:
it was written more than 30 days ago
the written amount is the same as the numeric amount
the signature is missing
a mistake is corrected with a single line and is initialed
73
If the pt balance is $450 and the patient agrees to pay $45 a month on the 12th of each month, how long will it take?
12 months
45 days
450 days
10 months
74
Deposits should be always be delivered to the bank:
at different times and days of the week
on the same day at the same time every week
on the same day every week
at the same time of day
75
When following up on a delinquent claim, if the carrier tells you that it is still in process, you should:
resubmit the claim by mail
resubmit the claim by fax
send the patient a statement
request an anticipated date of payment
76
Most financial accounting is based on the _____ method of bookkeeping.
credit balance
debt balance
single-entry
double-entry
77
A(n) _____ form lists the procedures performed in a medical office and their respective codes.
coding
confidentiality
credit
encounter
78
It is recommended that a practice which uses monthly billing set aside ____ for processing and mailing statements.
a few hours a month
4–5 days a month
1–2 days a month
an hour a day

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