Exam 1 Quizzes

Question 1

On which form would you most likely find the following statement? The microscopic exam reveals cysts. Some apocrine metaplasia is noted.

Answer 1

Pathology Report

Question 2

On what form would you most likely find the following statement? Chief complaint - right breast tumor

Answer 2

History

Question 3

On what form would you most likely find the following statement? Birthdate - 12/10/69 Insurance - Medicaid

Answer 3

Face Sheet

Question 4

On what form would you most likely find the following statement? Type of Anesthesia - General

Answer 4

Operative Report

Question 5

On what form would you most likely find the following statement documented by a physician? Admitting Diagnosis - Condyloma

Answer 5

Face Sheet

Question 6

On what form would you most likely find the following statement? The patient tolerated this procedure well and was taken to the Recovery Room in stable condition

Answer 6

Operative Report

Question 7

Which of the following forms would most likely contain the following statement? Patient has been a diabetic since childhood

Answer 7

History

Question 8

On what form would you most likely find the following statement? She is a smoker. Her father is a borderline diabetic and her mother had carcinoma of the stomach

Answer 8

History

Question 9

On which form would you most likely find the following statement? Temp is 98.7 pulse 72 respirations 20 BP 122/56

Answer 9

Physical Examination

Question 10

On which form would you most likely find the following statement? Patient is allergic to iodine

Answer 10

History

Question 11

The encounter form is a source of ? Information for the medical insurance specialist

Answer 11

billing

Question 12

T or F? Accepting assignmenet of benefits means that the physician bills the payer on behalf of the patient and receives payment directly.

Answer 12

Correct answer is True

Question 13

Which government group has the authority to enforce the HIPAA Privacy Rule?

Answer 13

OCR

Question 14

T or F? A provider may not treat a patient unless the patient has first signed an Acknowledgement of Receipt of Notice of Privacy Practices

Answer 14

Correct answer is False

Question 15

T or F? Fraud is never intentional

Answer 15

Correct answer is False

Question 16

T or F? The policyholder and the patient are always the same individual

Answer 16

Correct answer is False

Question 17

A patient’s group insurnace number written on the patient informaiton or update form must match

Answer 17

the number on the patient’s insurance card

Question 18

The authorization to release information must specify

Answer 18

the entity to whom the informaiton is to be released

Question 19

If a husband has an insurance policy but is also eligible for benefits as a dependent under his wife’s insurance policy; the wife’s policy is considered to be his

Answer 19

secondary

Question 20

T or F? Patients have the right to access; copy; inspect; and request amendments of their medical and billing record

Answer 20

Correct answer is True

Question 21

The two types of posting methods are

Answer 21

manual and computer

Question 22

T or F? HCPCS Level II coes should be referenced when billing Medicare or Medicaid claims

Answer 22

Correct answer is True

Question 23

T or F? Debits are used for entering charges and is sometimes called the charge column

Answer 23

Correct answer is True

Question 24

T or F? Posting is a transfer of information from one record to another

Answer 24

Correct answer is True

Question 25

The column on the ledger card that is used for entering charges is the

Answer 25

debit column

Question 26

T or F? UCR stands for usual; charge; reasonable

Answer 26

Correct answer is False

Question 27

T or F? Entering charges on a patient ledger obviates the necessity of entering them on the day sheet

Answer 27

Correct answer is False

Question 28

A history of the patients’ charges and payments that may be sent as a monthly statement

Answer 28

ledger

Question 29

an amount that increases the accounts receivable

Answer 29

debit

Question 30

the remainder left after posting all transactions to the patients’ ledger

Answer 30

balance

Question 31

T or F? Resource-based fee structures are based on the procedure’s difficulty; the practice expense it involves; and the risk it entails

Answer 31

Correct answer is True

Question 32

T or F? The Medicare Fee Schedule’s conversion factor is set for a 1 year period

Answer 32

Correct answer is True

Question 33

The OIG Work Plan describes

Answer 33

planned projects for investigating possible fraud in various billing areas

Question 34

T or F? Under Medicare rules; no modifiers can be used with code combination listed in the CCI

Answer 34

Correct answer is False

Question 35

T or F? If a provider’s usual fee is higher than a payer’s allowed charge; the higher of the two fees is paid

Answer 35

Correct answer is False

Question 36

If a participating provider’s usual fee is $400 and the allowed amount is $350; what amount is written off?

Answer 36

$50

Question 37

The usual fees for excluded services are

Answer 37

collected at the time of service

Question 38

In calculation of RBRVS fees; the three relative value units are multipleied by

Answer 38

their respective geographic practice cost indeces

Question 39

T or F? The Medicare Fee Schedule is based on the UCR method of setting charges

Answer 39

Correct answer is False

Question 40

Medicare typically pays for what percentage of the allowed charge

Answer 40

80%

Question 41

How many diagnosis code pointers can be assigned to a procedure code on a CMS-1500 claim form?

Answer 41

four

Question 42

Which of the following is not a commonly used transmission method for HIPAA claims

Answer 42

Fax

Question 43

The NPI is used to report the ? On a claim

Answer 43

provider identifier

Question 44

T or F? Many items of information are common to CMS-1500 and HIPAA 837 claims

Answer 44

Correct answer is True

Question 45

T or F? Neither diagnosis codes nor procedure codes are required data elements

Answer 45

Correct answer is False

Question 46

The content of claims and the taxonomy codes are set by

Answer 46

NUCC

Question 47

T or F? The billing provider and the rendering provider are always the same person in an organization

Answer 47

Correct answer is False

Question 48

T or F? When a claim is created the medical insurance specialist enters information about the charge and payments for a patient’s visit

Answer 48

Correct answer is True

Question 49

T or F? If the services reported on a claim invlove a preauthorization the preauthorization number should be reported

Answer 49

Correct answer is True

Question 50

Which of the following may be the same as the patient?

Answer 50

Subscriber