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Medical Administrative Practices > Final Study > Flashcards

Final Study Flashcards

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USMLE® Step 1 flashcards
1
Q

Managed care has simplified the patient’s responsibility for payment.

True/False

A

True

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2
Q

With managed care options, there is less emphasis on the medical assistant needing to be accurate and timely when filing insurance claims.

True/False

A

False

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3
Q

Preexisting conditions usually require a waiting period.

True/False

A

True

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4
Q

“Coordination of benefits” means that the insurance companies will take care of the paperwork.

True/False

A

False

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5
Q

Co-payment is the amount the insurance will cost the patient each month.

True/False

A

False

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6
Q

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

A

Primary Care Provider

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7
Q

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

A

Point of Services Plan (POS)

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8
Q

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

A

Resource-based relative value system

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9
Q

_________ means that prior notice and approval needs to be obtained before services will be covered.

Adjustment
Referral
Preauthorization
Benefit period

A

Preauthorization

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10
Q

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)

A

Preferred Provider Organization (PPO)

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11
Q

The ________ is the specified time during which benefits will be paid under certain types of health insurance coverage.

Benefit period
Referral
Self insurance
Adjustment

A

Benefit period

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12
Q

The amount a provider writes off the patient’s account is known as an ________.

Proof of eligibility
Preauthorization
Adjustment
Benefit period

A

Adjustment

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13
Q

________ is prescription drug coverage by Medicare.

Part B
Part C
Part D
Part A

A

Part D

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14
Q

Covers outpatient expenses including providers’ fees, lab tests, and radiologic studies.

Part A
Part B
Part C
Part D

A

Part B

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15
Q

Covers hospital admission and stays.

Part A
Part B
Part C
Part D

A

Part A

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16
Q

Advantage Insurance is Part ___.

Part A
Part B
Part C
Part D

A

Part C

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17
Q

Does not require a monthly payment.

Part A
Part B
Part C
Part D

A

Part A

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18
Q

Will start paying for services after a $147 deductible has been met.

Part A
Part B
Part C
Part D

A

Part B

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19
Q

Covers hospice care.

Part A
Part B
Part C
Part D

A

Part A

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20
Q

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
A

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

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21
Q

Ethics has to do with what is right and wrong.

True/False

A

True

22
Q

Bioethics has to do with ethical issues dealing with human life.

True/False

A

True

23
Q

When abuse is suspected, the provider and medical assistant have ethical responsibilities to report it.

True/False

A

True

24
Q

When a patient has HIV; the provider may refuse to treat the patient.

True/False

A

False

25
Q

A provider and a medical assistant can refuse to perform abortions.

True/False

A

True

26
Q

Someone who substitutes for another.

Microallocation
Surrogate
Criopreservation
Bioethics

A

Surrogate

27
Q

Biotechnology dealing with sophisticated medical research regarding the prevention of genetic disorders.

Microallocation
Macroallocation
Genetic Engineering
Criopreservation

A

Genetic Engineering

28
Q

Set of principles and guidelines usually found in professional organizations.

Bioethics
Code of Ethics
Macroallocation
Microallocation

A

Code of Ethics

29
Q

Applying biological systems to technological advances for disease diagnosis, productions of medicine, and research.

Biotechnology
Bioethics
Code of Ethics
Microallocation

A

Biotechnology

30
Q

Ethical issues dealing with life.

Code of Ethics
Biotechnology
Bioethics
Macroallocation

A

Bioethics

31
Q

Gestures and expressions have nothing to do with what a person is thinking or feeling.

True/False

A

False

32
Q

You can make sick patients “feel better” just by the way you communicate with them.

True/False

A

True

33
Q

Everyone enjoys a hug.

True/False

A

False

34
Q

Patients should not be encouraged to verbalize their feelings and concerns.

True/False

A

False

35
Q

Therapeutic communication can take place without considering the cultural and religious background of the patient.

True/False

A

False

36
Q

Personal space is the distance at which we feel comfortable with others while communicating.

True/False

A

True

37
Q

Which of the following is not part of communication:

Speech
Facial expression
Gestures
Attitude

A

Attitude

38
Q

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
A

All of the above.

39
Q

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

A

Denial

40
Q

The conscious awareness of one’s own feelings and the feelings of others is:

Congruency
Perception
Bias
Masking

A

Perception

41
Q

Anyone can take the AAMA medical assisting examination without going through a special program.

True/False

A

False

42
Q

Medical assistants are allowed to work only in the clinical area of the office.

True/False

A

False

43
Q

Medical assistants can become office managers.

True/False

A

True

44
Q

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

A

False

45
Q

Medical assistants do not have to be credentialed to work in their profession.

True/False

A

True

46
Q

Medical assistants are licensed by each state.

True/False

A

False

47
Q

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

A

True

48
Q

If you graduate from a medical assisting program and get a diploma or certificate, then you are automatically credentialed.

True/False

A

False

49
Q

Medical assistants continue their education by attending seminars, workshops, and professional meetings.

True/False

A

True

50
Q

Individuals with RMAs and CMAs (AAMA) re required to obtain continuing education units (CEUs) to recertify.

True/False

A

True

Medical Administrative Practices (1 decks)

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