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RMAI Chapters 16-20 2024 Flashcards | StudBud
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RMAI Chapters 16-20 2024
RMAI Chapters 16-20 2024
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1
What scheduling system can be helpful if patient calls and needs to be seen that day but no appointments are available?
double-booking
wave
modified-wave
advanced
2
Any payment the medical office makes for goods or services is called?
accounts receivable
a disbursement
a counter check
a limited check
3
A detailed travel plan that lists dates and times of flights and events, locations, and telephone numbers is?
program
locum tenens
itinerary
agenda
4
What subsection of the surgery section includes procedures on the spleen and bone marrow?
Digestive System
Hemic/Lymphatic Systems
Endocrine System
Cardiovascular System
5
The fixed dollar amount a subscriber must pay or "meet" each year before the insurer begins to cover expenses is the?
deductible
premium
coinsurance
capitation
6
What patients would a medical provider most likely render treatment as a professional courtesy?
children
any patient who cannot pay
elderly patients
other healthcare professionals
7
Which part of the accounting process consists of the systematic recording of business transactions?
vouching
journalizing
reconciliation
bookkeeping
8
Counseling codes are used?
the patient is referred to a third party for counseling
for risk factor reduction and behavior change intervention
only by a practitioner assistant or nurse practitioner
the patient specifically requests a counseling referral
9
What is not one of the six main sections in the CPT manual?
Physical Therapy
Pathology and Laboratory
Anesthesiology
Surgery
10
To find ICD-10 code for anesthesia for surgery to correct benign prostatic hypertrophy (BPH), you look in what series.
V01–V83
630–679
800–999
N00–N99
11
What insurance covers a patient who has been hospitalized for up to 90 days for each benefit period?
CHAMPVA
Medicare Part B
Medicaid
Medicare Part A
12
In ICD-10, in what chapter would a code for an injury diagnosis be found?
Chapter 18
Chapter 20
Chapter 19
Chapter 17
13
What is the step in preparing the appointment book?
schedule new patient appointments
schedule new patient appointments
schedule routine appointments
establish the matrix of the appointment book
14
What is used only in the hospital inpatient setting?
ICD-9-CM Volume I
ICD-10-PCS
CPT codes
ICD-10-CM
15
How should data in medical billing programs be entered?
use prefixes such as Mr., Mrs., or Ms.
use "see above" for repeated data
include invalid data only if necessary
enter information using capital letters
16
The use of ICD codes is mandated by ?
CDC
HIPAA
NIH
HMOs
17
To find information regarding prefixes and suffixes used in the CPT coding manual, you would look in?
Evaluation and Management section of the manual
general index for the manual
office procedures manual
Introduction to the manual
18
What chapter of the ICD-10 is used to code for pregnancy, childbirth, and the puerperium?
Chapter 5
Chapter 19
Chapter 15
Chapter 10
19
What is what the patient owes after the insurance company has paid?
premium
patient liability
exclusion
comorbidity
20
In a typical medical practice, insurance claims are filed?
a few business days after the date of service
9 months after the service is rendered
the day before the date of service
the day before the filing limit is reached
21
Appointment reminders include appointment cards, reminder mailings, reminder calls, and ?
superbills
repeat visits
recall notices
special appointments
22
What is an example of a Category II code is a code used for?
weight reduction counseling
annual physical examinations
fracture management
pain management
23
What statement is true about electronic banking?
The computer used for banking must be locked up at the end of the day
The computer computes the new balance each time you record a check.
You must still reconcile the bank statement on paper.
Cash flow in the office becomes slower and more difficult.
24
A medical provider or practice manager may periodically review what reports to ensure the accuracy of the books.
statement of income and expense
cash flow statement
quarterly return
trial balance
25
What is the main reason a diabetic patient who takes insulin must eat meals and snacks at regular times?
keep the blood sugar from dropping too low
lower the blood pressure
increase the heart rate
keep the blood pressure from dropping too low
26
What convention is used in ICD-10 to set off nonessential or supplementary terms that do not affect the code?
( )
{ }
[ ]
: :
27
The ICD-10 code for routine obstetric care will be found in which of the following series of codes?
O00–O9A
P00–P96
H00–H59
Z00–Z99
28
The process of classifying and reviewing past-due accounts from the first date of billing?
superbill
invoice
statement
age analysis
29
A condition that is of sudden onset or that suddenly becomes much worse is considered a?
subchronic condition
intermittent condition
chronic condition
acute condition
30
For a service to be considered a consultation, the service must meet the 3Rs. What are the correct 3Rs?
request, review, report
release, request, record
release, record, report
request, record, report
31
What is a guideline for making a call requesting payment from a patient?
Pose as a government official to convince the patient to pay.
Tell other people in the office about it and ask for suggestions.
Call the patient after 8 a.m. or before 9 p.m.
Refuse to talk to anyone except patient, not even the patient's attorney.
32
How much will a medical practice receive if the provider charges $100 for services, patient pays with a credit card?
95–99
86–89
90–94
$100
33
What are usually components of a practice's accounting system?
a 401(k) plan
daily log and disbursements journal
employment contracts
W-4 forms from all employees
34
The CPT is updated and new codes are provided for use beginning?
annually on July 1
on the first day of each month
annually on January 1
semiannually on January 1 and July 1
35
What symbol appears next to codes that are new since the last CPT revision?
lightning bolt
lightning bolt
circle with diagonal line
red dot
36
How often are the ICD codes updated?
yearly
every two years
weekly
monthly
37
What is the term for the 10-digit number that identifies the provider’s medical specialty?
provider code
taxonomy code
capitation
national identifier
38
When you are obtaining patient information for an appointment, you should include the?
purpose of the visit
patient's occupation
patient's diagnosis
patient's marital status
39
An advantage of a computerized scheduling system is that it
cancels any chance that two patients can be scheduled at the same time
does not need color-coding to clarify the appointment schedule
eliminates a wait for patients when coming to the office
can identify patients who routinely are late forget appointments or cancel
40
The difference between the charge billed to the insurance carrier and the allowed charge payment is based on?
credit
adjustment
debit
payment
41
To complete the description for a CPT code that has an indented description, you should?
refer to the previous year's CPT manual for guidance
refer to the next CPT code for further information
try to think of another way to describe the procedure being coded
refer to the description for previous CPT code to complete the description
42
A written-contract account is ?
one that is open to charges made occasionally
an account with only one charge
the total of the outstanding balance on the patient ledger cards
one the practitioner and patient sign an agreement for payment installments
43
The appointment scheduling system that groups similar appointments together during the day or week is?
cluster scheduling
double-booking
combination scheduling
time-specified scheduling
44
A person who is on vacation goes to a medical provider with symptoms of food poisoning what type of account is set up?
collection account
open-book account
single-entry account
account payable
45
A condition that is long-standing is considered a?
chronic condition
erratic condition
acute condition
intermittent condition
46
What is included in Medicare benefits for respite care?
Medicare has no respite care benefits.
The patient must be terminally ill with 2 years or less to live.
Medicare provides a respite for the terminally ill patient.
The terminally ill patient is moved to a care facility for the respite.
47
How many codes are required for giving a patient an injection of a vaccine?
2
depends on the type of vaccine
3
1
48
What is correct regarding electronic claim submissions?
Clearinghouses will modify data as necessary to ensure a standard format.
Claims are prepared for transmission after all required data been entered.
Claims cannot be transmitted directly by electronic data interchange (EDI
Claims cannot be entered into the health plan's computer system
49
What guidelines are applicable when filing a Medicaid claim and interacting with Medicaid patients?
Submit claims without proving Medicaid membership.
Send claims to the national claims center.
Treat the patient as if he or she has private insurance.
Allow a 2-year time limit on all claim submissions.
50
The payment system used by Medicare is based on?
the price of medical equipment used
resources
fee-for-service agreements
prevailing rates in the region
51
For coding purposes, what is not a complexity level for medical decision-making?
moderate-complexity MDM
general-purpose MDM
straightforward MDM
low-complexity MDM
52
A plus sign (+) is used to indicate?
add-on codes
stand-alone codes
primary codes
V codes
53
An account that is open to charges made occasionally as needed is called ?
written-contract account
account payable
open-book account
collection account
54
The most frequently used CPT codes are the?
evaluation and management codes
surgery codes
radiology codes
anesthesiology codes
55
Which of the following is
not
part of the process for verifying workers' compensation coverage?
obtaining the employer's verification that the accident was work-related
getting the name of the verifier at the patient's company
getting the name and policy number of patient's health insurance policy
asking the verifier at patient's company for original date of the injury
56
Medical offices usually have to help minimize the risk of fraud by discovering, correcting coding and billing problems.
billing software program
compliance plan
external auditor
financial management plan
57
A type of endorsement used by attorneys when they accept a check for a client who has no personal claim on transaction?
qualified endorsement
blank endorsement
restrictive endorsement
mechanical endorsement
58
What convention is used in ICD-10 to indicate that an entry is not classified as part of the preceding code?
Code Also
Excludes
NEC
Includes
59
Payment by credit card for a medical practice _
decreases the cash flow in the office
provides prompt payment from the credit card company
increases the time spent on paperwork
increases the complexity of preparing statements
60
A new patient calls the provider’s medical office and asks how long the appointment will take what is the best response?
"20 to 30 minutes"
"30 minutes or more"
"15 to 20 minutes"
"60 minutes or more"
61
What Medicare plan covers prescription medications?
Part D
Part A
Part B
Part C
62
A practice that needs flexibility to allow appointments that take more or less time than expected could use__scheduling?
advance
non advance
wave
open-hours
63
Inaccuracy in linking diagnostic codes and procedural codes will result in all except?
denied claims
internal coding audits
reduced payments
prison sentences
64
Which of the following is not part of Medicare's resource-based relative value scale?
a nationally uniform conversion factor
a geographic adjustment factor
adjustments according to the cost-of-living index
Medigap, to reduce the gap in coverage
65
Under a contracted or fixed prepayment called ___, providers are paid a fixed amount of money to provide needed care.
managed care
copayment
capitation
dual coverage
66
What is included in Medicare benefits for respite care?
The patient must be terminally ill with 2 years or less to live.
Medicare provides a respite for the terminally ill patient.
The terminally ill patient is moved to a care facility for the respite
Medicare has no respite care benefits.
67
The Tabular List is mainly organized by?
the patient's condition
the codes found in the Alphabetic Index
the body system involved
the patient's symptoms
68
Where in the CPT manual will information about the proper use of modifiers be found?
Introduction
Appendix B
Appendix C
Appendix A
69
One advantage of submitting claims electronically is?
electronic submissions are cost-efficient
electronic claims cannot be rejected
patients can submit their own claims easily
the practice can receive larger payments
70
In ICD-10, what chapter includes diagnosis codes for congenital malformations, deformations, chromosomal abnormalities?
17
18
20
21
