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HCMA 115 FINAL REVIEW Flashcards | StudBud
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HCMA 115 FINAL REVIEW
HCMA 115 FINAL REVIEW
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1
The International Classification of Diseases was established by:
Department of Health and Human Services.
World Health Organization.
None are correct
American Medical Association.
2
Nearly all of the provider’s income is derived from the insurance payments received for services rendered
False
True
3
In the physician’s office, the accounts payable is the amount of money that all patients owe the physician.
False
True
4
Something that is legally transferable to another party is said to be __________.
intangible
unsecured
discretionary
negotiable
5
A process required by some insurance carriers in which the provider obtains permission to perform certain procedures or
True
False
6
Which of the these is the correct ICD-10-CM code for this diagnostic statement; encounter for positive pregnancy test
Z32.01
Z34.01
Z34.00
Z32.00
7
Insurance information should be collected on the first visit.
False
True
8
Which of the following scheduling systems reduces the number of calls to the office and is available to the patient 24 h
Appointment book scheduling
Paper-based scheduling
Self-scheduling
Computerized scheduling
9
Patient care approached from a holistic approach defines:
precertification
Patient-centered medical home
medical necessity
Health maintenance organizations
10
An approved list of physicians, hospitals, and other providers is a(n):
third-party administrator.
explanation of benefits.
health insurance exchange.
provider network.
11
The __________ uncovers any errors that may exist in the checkbook or, on rare occasions, the bank statement.
bookkeeping
disbursement
explanation of benefits
reconciliation
12
The semicolon indicates that modifying terms and descriptions follow.
True
False
13
Claims that are done by direct billing first go to a clearinghouse.
False
True
14
Burns are coded by:
None are correct
site and degree.
the body surface involved
site and degree and the body surface involved.
15
Placing and receiving personal calls should be avoided during business hours.
False
True
16
When documents are added to a patient’s paper record, the most recent information should be placed on top.
True
False
17
Breast Reduction CPT code is ?
19318
19328
19330
19316
18
__________ are indented under the main term and must be included in the diagnostic statement.
Main terms
Nonessential modifiers
Essential modifiers
Symptoms
19
Which of the following account aging categories requires a final demand letter before the account is turned over to a co
None are correct
60 to 90 days
30 to 60 days
90 to 120 days
20
Which of the following is
not
a disadvantage of managed care?
More paperwork may be necessary.
Reimbursement is historically less than with traditional health insurance
Providers’ choices in the treatment of patients can be limited.
Authorized services usually are covered.
21
What is the best way to decide whether patients need special assistance in disrobing?
Offer help to patients who appear ill or upset.
Wait for patients to request help.
Use special consideration with patients who have a disability.
Ask all patients if you can be of assistance.
22
Glass partitions should never be used in today’s medical offices.
True
False
23
Medical facilities should keep records on minors for how long?
Until the minor is deceased
Until the minor reaches the age of majority, plus the statute of limitati
For 10 years
Indefinitely
24
Subjective information is that which the provider observes during the physical examination of the patient.
False
True
25
Charge capture
relates to charges for missed appointments.
False
True
26
Liver function study with hepatobiliary agents, with serial images
78220
78205
78201
78223
27
Electronic data interchange is:
None are correct
sending information to one insurance carrier
transferring data back and forth between two or more entities.
sending information to one clearinghouse for processing.
28
The provider who enters into a contract with an insurance company and agrees to certain rules and regulations is called
None are correct
provider
paying
participating
29
The signs and symptoms of a disease are its __________.
prognosis
etiology
symptoms
manifestations
30
Codes with a plus sign are additional codes that must be used with which of the following?
Category III codes
Category II codes
Category I codes and category II codes
er Category I codes
31
Which type of scheduling system is often used in an urgent care setting?
Modified wave scheduling
Time patterns
Grouping procedures
Open office hours
32
Numeric filing provides extra confidentiality to medical records.
True
False
33
The billing provider’s NPI number is placed in block:
32
33a
33b
31
34
The health insurance model that offers the most flexibility for patients is known as what
Medicaid
Traditional Health Insuracne
Managed Care Organizations MCO's
Medicare
35
The insured’s name is found in block:
1
3
4
2
36
Which part of Medicare covers inpatient hospital charges?
Part D
Part A
Part B
Part C
37
A list of the fixed fees for services is a:
policy.
claim
explanation of benefits.
fee schedule.
38
A type of insurance that protects workers from loss of wages after an industrial accident that happened on the job is ca
unemployment insurance.
an individual policy
workers’ compensation.
disability insurance.
39
Medical assistants have the trust of the physician and practice that employs them. A medical assistant must:
adhere to ethical standards concerning assigning and reporting codes
All are correct
be responsible and knowledgeable to ensure that no fraud takes place
be responsible and knowledgeable to ensure that no fraud takes place
40
Which of the following is
not
an advantage of a numeric filing system?
It saves time in record retrieval and re-filing.
It allows periodic expansion without shifting folders.
It provides additional confidentiality to the chart
Filing activity is greatest when the system is initiated.
41
Determining the cause of a condition, illness, disease, injury, or congenital defect describes which of the following te
Abstract
Medically necessary
Reimbursement
Diagnosis
42
The “code first” notation can usually be ignored.
True
False
43
If your office is on the West Coast, what time is the latest time to call the East Coast?
4 PM
2 PM
1 PM
11 AM
44
Medigap polices cover which of the following?
Medicare deductible
Services not covered under Medicare
All are correct
Medicare co-insurance
45
A set dollar amount that the patient must pay for each office visit is the definition of:
adjudicate
deductible
co-insurance.
copayment
46
In some managed care plans referrals to a specialist must be approved by the:
beneficiary
policyholder.
gatekeeper.
third-party administrator.
47
Active listening involves:
focusing solely on the conversation.
All are correct
being present in the moment.
confirming what the speaker has said.
48
An incidental disclosure:
cannot reasonably be prevented.
All are correct
occurs as a result of another use or disclosure that is permitted.
is limited in nature.
49
The principal advantage of using the wave method when designing the scheduling process is that it:
enables the physician to see more patients each day.
allows flexibility to accommodate the unpredictable.
provides more breaks for staff members
gives priority to established patients.
50
Which of the following letters in the ICD-10-CM is reserved by the World Health Organization to assign new diseases with
U
Y
X
Z
51
To settle or determine judicially is the definition of:
co-insurance.
copayment.
adjudicate.
deductible
52
The advantages of using the color-coding filing system are the following:
All are correct
a misfiled record is easily spotted even from a distance.
you can use either the alphabetic or numeric color-coding system.
the use of color visually restricts the area of search for a specific rec