CH 7 Flashcards
You have been asked to create claims for all the cases that have charged totaling at least $500.
What filter would you use from the Create Claims dialog box to accomplish this task?
Enter Amount
What menu in Medisoft is used to access the claim Management dialog box?
the Activites menu
What happens to the List Only Claims That Match dialog box when it is restored to its original setting using the Apply button?
all the boxes in the dialog box will become blank and the full list of claims is again displayed
Claims that are not paid in full may negatively and directly affect ________.
the practice’s bottom line
How many digits are report type codes?
two
What does the Submission Count area of the Carrier 1 tab list?
the number of claims submitted
In Medisoft, what is a condition that data must meet to be selected?
filter
You have been asked to create claims for all the procedures that were performed at a specific hospital. What filter you would use from the
Create Claims dialog box to accomplish this task?
Location
How can a claim that is active in the Claim Management dialog box be edited?
by clicking the Edit button or by double clicking the claim itself, both option would work
How many insurance carrier codes may be entered in the Primary Insurance box if claims are being sent to a clearinghouse?
more than one
Which button in the Claim Management dialog box begins the process of sending electronic claims or printing paper claims?
Print/Send
Which of the tabs in the Claim dialog box lists information about the transactions included in a claim?
Transaction tab
You have made a mistake entering claim information in the Claim Management dialog box and you want to redo your work from scratch.
Which action would you take?
click the delete button to delete the selected claim and release the transactions bound to the claim
What is the purpose of the EDI Notes box in the Case dialog box?
it is used for entering extra information for procedures and diagnoses that might be required by the patient’s insurance carriers
to process the electronic claim
What is the first step in transmitting electronic claims in Medisoft?
selecting Revenue Management on the Activites menu
What chart numbers will be included if the Chart Numbers boxes are left blank in the Create Claims dialog box?
all the chart numbers
Which of the following would be considered a clean claim?
a claim that has the correct information for the patient and the encounter
What are the differences between the Carrier 1 tab and the Carrier 2 and Carrier 3 tabs?
the Carrier 2 and Carrier 3 tabs do not have a Frequency Type box, and the Carrier 1 tab has a Pending radio button in the Claim Status box
By what characteristic can claims in the List Only Claims That Match NOT be sorted?
procedure code
Which of the following is a type of health insurance in which organizations control both the financing and the delivery of healthcare to
policyholders?
Managed Care
What happens when and EDI receiver is selected in the process of transmitting electronic claims?
a list of claims ready to be sent is displayed
Which method is used to restore the List Only Claims That Match dialog box to its original settings once it has been reopened?
click the Defaults button, then click the Apply button
What type of claims can be created using filters in Medisoft?
claims for specific patients
claim transactions that exceed a certain dollar amount
claims for specific insurance carriers
You are filing an insurance claim electronically through Medisoft and need to indicate that the claim you are sending is a replacement of a
previously sent claim. How you would indicate this in Medisoft?
enter 7 in the Frequency Type field of the Carrier 1 tab
Which of the following is the percentage of charges that insured pays for after the payment of the deductible amount?
Coinsurance
What do the filters in the List Only Claims That Match dialog box do with the existing claims that meet the specified criteria?
list them
How would you indicate that a secondary insurance carrier is responsible for a claim in the Transaction tab of the Claim dialog box?
check the Ins 2 Resp box
What can be done with claims after they are created in Medisoft?
they can be printed and mailed and transmitted electronically
You are working at a practice and have been asked to create claims for services performed between the fifteenth of the month and the end
of the month. What feature of Medisoft may be used to accomplish this task?
apply a filter to the data in Medisoft
What is the purpose of the comments in the comments tab of the Claim dialog box?
for internal use only
Which of the following insurance claims can be prepared in the practice management program?
CMS-1500
HIPAA Equivalent Encounter Information (837P)
HIPAA X12 837 Health Care Claim
Which of the tabs in the Claim dialog box displays information about claims being submitted to a patient’s primary insurance carrier?
Carrier 1 tab
What button is clicked to send claims files?
Send
What is the EDI Report area within the Diagnosis tab of the Case dialog box used to indicate to a payer?
how an attachment will be transmitted and when an attachment will accompany the claim
What must be placed in between insurance carrier codes in the Primary Insurance field of the Create Claims dialog box?
commas
What button is clicked to create the claims once all necessary information has been entered in the Create Claims dialog box?
Create
What entity assigns the Attachment Control Number on a transmission?
practice
Which buttons simplify the task of moving from one entry to another in Claim Management?
navigator buttons
How are the selected filters applied to the claims data once the desired boxes have been filled in on the List Only Claims That Match dialog box?
clicking the Apply button
Which of the following is a field located in the EDI section of the Diagnosis tab that is used to indicate that a report is being transmitted
via the mail?
Report Transmission Code
Which button in the Claim Management dialog box is used to restore data when necessary?
Restore Data button
If a claim is rejected by an insurance carrier it should be _____ before resubmission.
reviewed
Which of these actions may be performed in the Claim Management dialog box?
the status of existing claims can be changed
claims can be printed or submitted electronically
existing claims can be reviewed and edited
What Claim Status is applied to claims after they are transmitted?
Sent
How many data elements are represented by the CMS-1500?
150
What type of errors does the preview report feature check for?
ANSI errors
Which of the following claims is made active when the Next Claim button is clicked in the Claim Management dialog box?
the next claim in the list
What information is displayed in the Batch field in the Carrier 1 tab?
the batach number
Which button in the Claim Management dialog box reprints a claim that has already been printed?
Reprint Claim
How is the dollar amount entered in the Enter Amount box of the Create Claims dialog box filters data?
it acts as the minimum total amount required for a case before a claim can be entered
Which of the tabs in the Claim dialog box display information about claims being submitted to a patient’s secondary and tertiary insurance
carriers?
Carrier 2 and Carrier 3 tabs
