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CH 7 > CH 7 > Flashcards

CH 7 Flashcards

1
Q

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?

A

Enter Amount

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2
Q

What menu in Medisoft is used to access the claim Management dialog box?

A

the Activites menu

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3
Q

What happens to the List Only Claims That Match dialog box when it is restored to its original setting using the Apply button?

A

all the boxes in the dialog box will become blank and the full list of claims is again displayed

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4
Q

Claims that are not paid in full may negatively and directly affect ________.

A

the practice’s bottom line

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5
Q

How many digits are report type codes?

A

two

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6
Q

What does the Submission Count area of the Carrier 1 tab list?

A

the number of claims submitted

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7
Q

In Medisoft, what is a condition that data must meet to be selected?

A

filter

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8
Q

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?

A

Location

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9
Q

How can a claim that is active in the Claim Management dialog box be edited?

A

by clicking the Edit button or by double clicking the claim itself, both option would work

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10
Q

How many insurance carrier codes may be entered in the Primary Insurance box if claims are being sent to a clearinghouse?

A

more than one

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11
Q

Which button in the Claim Management dialog box begins the process of sending electronic claims or printing paper claims?

A

Print/Send

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12
Q

Which of the tabs in the Claim dialog box lists information about the transactions included in a claim?

A

Transaction tab

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13
Q

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?

A

click the delete button to delete the selected claim and release the transactions bound to the claim

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14
Q

What is the purpose of the EDI Notes box in the Case dialog box?

A

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

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15
Q

What is the first step in transmitting electronic claims in Medisoft?

A

selecting Revenue Management on the Activites menu

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16
Q

What chart numbers will be included if the Chart Numbers boxes are left blank in the Create Claims dialog box?

A

all the chart numbers

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17
Q

Which of the following would be considered a clean claim?

A

a claim that has the correct information for the patient and the encounter

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18
Q

What are the differences between the Carrier 1 tab and the Carrier 2 and Carrier 3 tabs?

A

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

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19
Q

By what characteristic can claims in the List Only Claims That Match NOT be sorted?

A

procedure code

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20
Q

Which of the following is a type of health insurance in which organizations control both the financing and the delivery of healthcare to
policyholders?

A

Managed Care

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21
Q

What happens when and EDI receiver is selected in the process of transmitting electronic claims?

A

a list of claims ready to be sent is displayed

22
Q

Which method is used to restore the List Only Claims That Match dialog box to its original settings once it has been reopened?

A

click the Defaults button, then click the Apply button

23
Q

What type of claims can be created using filters in Medisoft?

A

claims for specific patients
claim transactions that exceed a certain dollar amount
claims for specific insurance carriers

24
Q

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?

A

enter 7 in the Frequency Type field of the Carrier 1 tab

25
Q

Which of the following is the percentage of charges that insured pays for after the payment of the deductible amount?

A

Coinsurance

26
Q

What do the filters in the List Only Claims That Match dialog box do with the existing claims that meet the specified criteria?

A

list them

27
Q

How would you indicate that a secondary insurance carrier is responsible for a claim in the Transaction tab of the Claim dialog box?

A

check the Ins 2 Resp box

28
Q

What can be done with claims after they are created in Medisoft?

A

they can be printed and mailed and transmitted electronically

29
Q

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?

A

apply a filter to the data in Medisoft

30
Q

What is the purpose of the comments in the comments tab of the Claim dialog box?

A

for internal use only

31
Q

Which of the following insurance claims can be prepared in the practice management program?

A

CMS-1500
HIPAA Equivalent Encounter Information (837P)
HIPAA X12 837 Health Care Claim

32
Q

Which of the tabs in the Claim dialog box displays information about claims being submitted to a patient’s primary insurance carrier?

A

Carrier 1 tab

33
Q

What button is clicked to send claims files?

A

Send

34
Q

What is the EDI Report area within the Diagnosis tab of the Case dialog box used to indicate to a payer?

A

how an attachment will be transmitted and when an attachment will accompany the claim

35
Q

What must be placed in between insurance carrier codes in the Primary Insurance field of the Create Claims dialog box?

A

commas

36
Q

What button is clicked to create the claims once all necessary information has been entered in the Create Claims dialog box?

A

Create

37
Q

What entity assigns the Attachment Control Number on a transmission?

A

practice

38
Q

Which buttons simplify the task of moving from one entry to another in Claim Management?

A

navigator buttons

39
Q

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?

A

clicking the Apply button

40
Q

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?

A

Report Transmission Code

41
Q

Which button in the Claim Management dialog box is used to restore data when necessary?

A

Restore Data button

42
Q

If a claim is rejected by an insurance carrier it should be _____ before resubmission.

A

reviewed

43
Q

Which of these actions may be performed in the Claim Management dialog box?

A

the status of existing claims can be changed
claims can be printed or submitted electronically
existing claims can be reviewed and edited

44
Q

What Claim Status is applied to claims after they are transmitted?

A

Sent

45
Q

How many data elements are represented by the CMS-1500?

A

150

46
Q

What type of errors does the preview report feature check for?

A

ANSI errors

47
Q

Which of the following claims is made active when the Next Claim button is clicked in the Claim Management dialog box?

A

the next claim in the list

48
Q

What information is displayed in the Batch field in the Carrier 1 tab?

A

the batach number

49
Q

Which button in the Claim Management dialog box reprints a claim that has already been printed?

A

Reprint Claim

50
Q

How is the dollar amount entered in the Enter Amount box of the Create Claims dialog box filters data?

A

it acts as the minimum total amount required for a case before a claim can be entered

51
Q

Which of the tabs in the Claim dialog box display information about claims being submitted to a patient’s secondary and tertiary insurance
carriers?

A

Carrier 2 and Carrier 3 tabs

CH 7 (1 decks)

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