Final Study Flashcards
Managed care has simplified the patient’s responsibility for payment.
True/False
True
With managed care options, there is less emphasis on the medical assistant needing to be accurate and timely when filing insurance claims.
True/False
False
Preexisting conditions usually require a waiting period.
True/False
True
“Coordination of benefits” means that the insurance companies will take care of the paperwork.
True/False
False
Co-payment is the amount the insurance will cost the patient each month.
True/False
False
The _______ is a doctor chosen by the patient who is the first doctor the patient sees and is responsible for making referrals for further treatment by a specialist or for hospitalization.
Preauthorization
Primary Care Provider
Preferred Provider Organization
Referral
Primary Care Provider
A ________ allows the enrollee to have the freedom to obtain medical care from an HMO provider or to self-refer to a non-HMO provider at a greater cost
Preauthorization
Proof of Eligibility
Point of Services Plan (POS)
PPO
Point of Services Plan (POS)
The _________ was developed using values for each medical and surgical procedure based on work, practice, and malpractice costs and factoring in the regional differences.
Resource-based relative value system
Self insurance
Adjustment
Preauthorization
Resource-based relative value system
_________ means that prior notice and approval needs to be obtained before services will be covered.
Adjustment
Referral
Preauthorization
Benefit period
Preauthorization
A ________ is an organization of providers who network together to offer discounts to purchasers for health care insurance.
Resource-based relative value system
Usual customary and reasonable
Primary care provider
Preferred Provider Organization (PPO)
Preferred Provider Organization (PPO)
The ________ is the specified time during which benefits will be paid under certain types of health insurance coverage.
Benefit period
Referral
Self insurance
Adjustment
Benefit period
The amount a provider writes off the patient’s account is known as an ________.
Proof of eligibility
Preauthorization
Adjustment
Benefit period
Adjustment
________ is prescription drug coverage by Medicare.
Part B
Part C
Part D
Part A
Part D
Covers outpatient expenses including providers’ fees, lab tests, and radiologic studies.
Part A
Part B
Part C
Part D
Part B
Covers hospital admission and stays.
Part A
Part B
Part C
Part D
Part A
Advantage Insurance is Part ___.
Part A
Part B
Part C
Part D
Part C
Does not require a monthly payment.
Part A
Part B
Part C
Part D
Part A
Will start paying for services after a $147 deductible has been met.
Part A
Part B
Part C
Part D
Part B
Covers hospice care.
Part A
Part B
Part C
Part D
Part A
Match the words to the descriptions below.
Adjustment Capitation COB EOB Medigap policy
- Plan to determine salary of the provider
- Individual plan covering the patient’s medicare deductible and co-pay
- Provision of an insurance contract that limits benefits to 100% of the cost
- Increase or decrease to patient accounts
- Insurance report that is sent with claim payment
Adjustment * Increase or decrease to patient accounts
Capitation * Plan to determine salary of the provider
COB * Provision of an insurance contract that limits benefits to 100% of the cost
EOB * Insurance report that is sent with claim payment
Medigap policy * Individual plan covering the patient’s medicare deductible and co-pay
Ethics has to do with what is right and wrong.
True/False
True
Bioethics has to do with ethical issues dealing with human life.
True/False
True
When abuse is suspected, the provider and medical assistant have ethical responsibilities to report it.
True/False
True
When a patient has HIV; the provider may refuse to treat the patient.
True/False
False
A provider and a medical assistant can refuse to perform abortions.
True/False
True
Someone who substitutes for another.
Microallocation
Surrogate
Criopreservation
Bioethics
Surrogate
Biotechnology dealing with sophisticated medical research regarding the prevention of genetic disorders.
Microallocation
Macroallocation
Genetic Engineering
Criopreservation
Genetic Engineering
Set of principles and guidelines usually found in professional organizations.
Bioethics
Code of Ethics
Macroallocation
Microallocation
Code of Ethics
Applying biological systems to technological advances for disease diagnosis, productions of medicine, and research.
Biotechnology
Bioethics
Code of Ethics
Microallocation
Biotechnology
Ethical issues dealing with life.
Code of Ethics
Biotechnology
Bioethics
Macroallocation
Bioethics
Gestures and expressions have nothing to do with what a person is thinking or feeling.
True/False
False
You can make sick patients “feel better” just by the way you communicate with them.
True/False
True
Everyone enjoys a hug.
True/False
False
Patients should not be encouraged to verbalize their feelings and concerns.
True/False
False
Therapeutic communication can take place without considering the cultural and religious background of the patient.
True/False
False
Personal space is the distance at which we feel comfortable with others while communicating.
True/False
True
Which of the following is not part of communication:
Speech
Facial expression
Gestures
Attitude
Attitude
The goal of therapeutic communication at the point of care is:
- To collect a blood specimen
- To determine the reason for the visit
- To explain the treatment for the patient
- All of the above
All of the above.
Your patient refuses to accept a diagnosis, claiming the doctor “must be mistaken.” Assuming the doctor is correct, which self-defense mechanism is the patient using?
Repression
Denial
Projection
Compensation
Denial
The conscious awareness of one’s own feelings and the feelings of others is:
Congruency
Perception
Bias
Masking
Perception
Anyone can take the AAMA medical assisting examination without going through a special program.
True/False
False
Medical assistants are allowed to work only in the clinical area of the office.
True/False
False
Medical assistants can become office managers.
True/False
True
Choosing to attend an accredited medical assisting program is not as important as getting trained as quickly as possible so you can find employment.
True/False
False
Medical assistants do not have to be credentialed to work in their profession.
True/False
True
Medical assistants are licensed by each state.
True/False
False
Anyone can call himself or herself a medical assistant, but professional medical assistants have graduated from an accredited program and obtained a credential to prove their competency.
True/False
True
If you graduate from a medical assisting program and get a diploma or certificate, then you are automatically credentialed.
True/False
False
Medical assistants continue their education by attending seminars, workshops, and professional meetings.
True/False
True
Individuals with RMAs and CMAs (AAMA) re required to obtain continuing education units (CEUs) to recertify.
True/False
True
