Administrative Assisting

Question 1

What is a practice management system (PMS)?

Answer 1

Type of system that allows scheduling appointments, entering and tracking patient demographics, performing billing procedures, submitting insurance claims, processing payments, etc.

Question 2

What is an EMR

Answer 2

Digital version of a patient’s medical and health care information within a specific health care organization

Question 3

What is an EHR

Answer 3

A record of patient medical and health care information accessible to providers and other staff members with login credentials regardless of location, which contributes to more efficient patient workflow

Question 4

What is real-time adjudication (RTA)

Answer 4

tool that allows for a submission of a coded visit to the insurance company by participating providers for reimbursement decisions by third-party payers while the patient is present

Question 5

How does the specific time scheduling method work?

Answer 5

Each patient is given an individual, designated time for their appointment.

Question 6

How does wave scheduling differ from specific time scheduling?

Answer 6

Multiple patients are scheduled within the same time period (e.g., top of the hour), and they are seen based on their arrival time.

Question 7

What is a primary benefit of using wave scheduling?

Answer 7

It provides more flexibility within each hour of the schedule.

Question 8

How does the double-booking scheduling method operate?

Answer 8

Two patients are booked for the same appointment time, and medical services are provided concurrently.

Question 9

In what situations is double-booking particularly beneficial?

Answer 9

When one patient needs labs or tests done while the provider can see the other patient, allowing the provider to alternate between their care.

Question 10

How does the clustering scheduling method group patients?

Answer 10

Patients with common medical needs are scheduled together in groups (e.g., all new patients on one day).

Question 11

What defines a “new patient” appointment?

Answer 11

A patient who has not received services from the same provider or same group (and same specialty) within the past 3 years, regardless of the complaint.

Question 12

What defines an “established patient” appointment?

Answer 12

A patient who has received services from the same provider or same group (and same specialty) within the past 3 years, regardless of the reason for the current visit.

Question 13

What are some characteristics that might classify an appointment as “comprehensive”?

Answer 13

New or established patient with a specified complaint at the highest coding level, multiple complaints, injuries, or worsening chronic conditions.

Question 14

What types of services are typically included in a preventive care appointment?

Answer 14

Thorough review of body systems including preventive care and screenings (e.g., complete physical exam, annual wellness exam, chronic care management).

Question 15

What is the defining characteristic of an “urgent” appointment?

Answer 15

Medically necessary care needed within 24 hours.

Question 16

What are some examples of appointments categorized as “other entities”?

Answer 16

Non-patient related meetings such as depositions, sales representatives, staff meetings, or training.

Question 17

Which is considered a new patient?

Answer 17

A patient who has not been seen in the office for 4 years

Question 18

Name three types of information typically found in the administrative section of a patient’s medical record and three types found in the clinical section.

Answer 18

Administrative: Patient’s demographic information, Notice of Privacy Practices (NPP), insurance information.
Clinical: Health history, physical examinations, medication record.

Question 19

How should corrections be made to a paper patient medical record, and what should never be done?

Answer 19

By adding a correcting entry or addendum, or by drawing a line through the incorrect data and adding the new data, along with the date and name of the person making the correction. Data should never be permanently deleted.

Question 20

What are the key principles regarding the confidentiality and access of information contained within a patient’s medical record?

Answer 20

All information must be kept confidential and private, and accessed only by authorized individuals. Compliance with privacy regulations must always be maintained.

Question 21

What is the difference between precertification and preauthorization

Answer 21

Precertification is a request to determine if a service is covered by the patient’s policy. Preauthorization is sometimes required by the patient’s insurance company to determine medical necessity for the proposed services.

Question 22

Which methods can be used to request a referral?

Answer 22

Electronic via EHR, Phone call, Website

Question 23

What methods can be used to verify patient eligibility?

Answer 23

calling insurance or using an eligibility application in the EHR or the payer’s web-based verification service

Question 24

What does the (Current Procedural Terminology) CPT code identify?

Answer 24

Medical services
Procedures performed ​​​​​​​by the provider

Question 25

What does the Healthcare Common Procedure Coding System (HCPCS) code identify?

Answer 25

Supplies Procedures ​​​​​​​ Services not described by CPT

Question 26

What does the International Classification of Diseases, 10th revision, Clinical Modification -10-CM code identify?

Answer 26

diseases Injuries Medical conditions Patient status affecting health care​​​​​​​ Other reasons for health care encounters

Question 27

What are common insufficient documentation errors?

Answer 27

Incomplete progress notes Unauthenticated medical records (missing signatures and dates) No evidentiary radiographs to support medical necessity Insufficient documentation supporting conservative medical management was attempted Documentation that did not support certification of the plan of care for physical therapy​​​​​​​ Incorrect coding of Evaluation and Management (E/M) services to support medical necessity

Question 28

What is the goal of interoperability?

Answer 28

Exchange of information

Question 29

What is the process of reconciliation?

Answer 29

ensuring that the accounts are all balanced and accurate

Question 30

What does the revenue cycle encompass for a healthcare organization?

Answer 30

All finance-related aspects, from verifying patient eligibility to receiving appropriate reimbursement.

Question 31

At which stages of the revenue cycle is a medical assistant typically involved?

Answer 31

From verifying patient eligibility at the beginning to ensuring appropriate reimbursement at the end.

Question 32

What is the primary goal of incentive models in healthcare reimbursement?

Answer 32

To transition from fee-for-service to value-based programs by adding incentives or disincentives based on provider performance in quality, clinical measures, and patient satisfaction.

Question 33

What is an A/R aging report used for in a healthcare organization?

Answer 33

To prioritize the collection of older debts and identify potential collections from delinquent accounts.

Question 34

What is the key difference between prospective and retrospective health record audits?

Answer 34

Prospective audits are done before billing to ensure accuracy, while retrospective audits are done after billing for statistical, quality, or payer review.

Question 35

What are the main reasons for conducting health record audits?

Answer 35

To ensure documentation is complete, correct, and supports reported codes for reimbursement and quality, and to detect potential fraud or abuse.

Question 36

What are the advantages of using online banking for financial transactions in a healthcare setting?

Answer 36

It is timelier and more efficient for tasks like deposits and electronic transfers from payers.

Question 37

What is a clearinghouse and what is their purpose?

Answer 37

An intermediary that is contracted by the provider to accept and process the claims for the third-party payers and assists with reducing claim errors

Question 38

What is an example of cycle billing?

Answer 38

Billing patients in segments

Question 39

When a claim pays with an incorrect reimbursement amount, which of the following actions should be taken?

Answer 39

Submit an appeal with documentation

Question 40

What are three important steps a medical assistant should take before placing an outgoing call to a patient?

Answer 40

Open the patient’s medical record, have all necessary information available, and allow enough time while double-checking the phone number.

Question 41

How should a medical assistant begin an outgoing call to a patient?

Answer 41

The MA should identify themself and confirm if the call time is convenient for the patient.

Question 42

To whom is a medical assistant authorized to provide patient information during a phone call?

Answer 42

Only to the patient or authorized individuals who are identified on the patient’s signed privacy agreement.

Question 43

What specific information should a medical assistant include when leaving a voicemail message for a patient?

Answer 43

The name of the intended individual, date and time of the call, the MA's name and practice name (if appropriate), a return call back number, and hours for returned calls.

Question 44

What is a key consideration regarding the practice name when leaving a voicemail message?

Answer 44

Only leave the name of the practice if it does not reveal the purpose of the call, adhering to office privacy policies.

Question 45

What is the impact that data has on medical records?

Answer 45

It's a legal record essentially, treat it like it will be screened for billing, health data, along with patient's overall treatment plan

Question 46

What best describes par level when it comes to inventory checks/ordering?

Answer 46

Appropriate amount to have on hand

Question 47

What should the MA do first when a patient checks in to their appointment?

Answer 47

Verify who they are with their insurance card and ID card

Question 48

For a follow up visit, what is important to verify?

Answer 48

Still address, insurance information, nature of the visit

Question 49

When preparing a billing request, what code selection should be prepared?

Answer 49

Medical necessity

Question 50

Which of the following has an impact on determining the duration of an appointment?

Answer 50

Provider preferences

Question 51

What codes are determined by reviewing the reason for the patient's visit?

Answer 51

Diagnosis code

Question 52

What questions should be asked for screening an appointment?

Answer 52

Patient's name, telephone number, and reason for the visit

Question 53

Which forms should be used for a patient when a service might not be considered medically necessary?

Answer 53

Advance Beneficiary Notice of Non coverage (ABN)

Question 54

What report is used to show the healthcare service charge amounts that are outstanding to the organization?

Answer 54

Accounts receivable (A/R) aging reports for a health care facility include any amount of money that is anticipated to to be paid to them

Question 55

What do diagnosis codes consist of?

Answer 55

3-7 alphanumeric characters, beginning with a letter - describes the condition, cause, manifestation, location, severity, and type of injury of disease

Question 56

What should the MA do when reviewing medical documentation?

Answer 56

Check the appropriate codes are being assigned and support medical necessity - must be accurate representation of medical documentation