HIM 478 RHIA REVIEW QUESTIONS CHAPTER 8 Flashcards
When does aging start on a patient account?
A. The date the patient makes the appointment
B. The date of service
C. The date the medical bill is sent out
D. The date of the explanation of benefits
The date of service
Patient verification is completed in which stage of the revenue cycle?
A. Front end cycle
B. Mid cycle
C. Back end cycle
D. Every cycle stage
Front end cycle
The chargemaster is maintained by:
A. The health insurance company
B. The patient
C. The healthcare facility
D. The electronic clearinghouse
The healthcare facility
Patient accounts has submitted a report to the revenue cycle team detailing $100,000 of outpatient accounts that are failing NCD edits. All attempts to clear the edits have failed. There are no ABNs on file for these accounts. Based only on this information, the revenue cycle team should:
A. Bill the patients for these accounts
B. Contact the patients to obtain an ABN
C. Write off the accounts to contractual allowances
D. Write off the failed charges to bad debt and bill Medicare for the clean charges
Write off the failed charges to bad debt and bill Medicare for the clean charges
In a typical acute care setting, aging of accounts reports are monitored in which revenue cycle area?
A. Pre-claims submission
B. Claims processing
C. Accounts receivable
D. Claims reconciliation or collections
Accounts receivable
The accounts receivable collection cycle involves the time from:
A. Discharge to receipt of the money
B. Admission to billing the account
C. Admission to deposit in the bank
D. Billing of the account to deposit in the bank
Admission to deposit in the bank
The following are the most common reasons for claims denials except:
A. Billing noncovered services
B. Lack of medical necessity
C. Beneficiary not covered
D. Coverage not in effect for date of service
Coverage not in effect for date of service
Which of the following is used to reconcile accounts in the patient accounting department?
A. Explanation of benefits
B. Medicare code editor
C. Preauthorization form
D. Fee schedule
Explanation of benefits
Which of the following is the definition of revenue cycle management?
A. The regularly repeating set of events that produce revenue or income
B. The method by which patients are grouped together based on a set of characteristics
C. The systematic comparison of the products, services, and outcomes of one healthcare entity with those of a similar entity
D. The coordination of all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue
The coordination of all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue
Aging of accounts is the practice of counting the days, generally in increments, from the time a bill has been sent to the payer to the current day. What is the standard increment, in days, that most healthcare entities use for the aging of accounts?
A. 7 day increment
B. 14 day increment
C. 30 day increment
D. 90 day increment
30 day increment
When a Medicare patient has a secondary insurance plan that is listed on the remittance advice:
A. The medical biller should bill the secondary insurance
B. Medicare will send the remittance advice to the secondary insurance
C. The patient should be notified to bill the secondary insurance
D. The medical biller should contact the secondary insurance to confirm
Medicare will send the remittance advice to the secondary insurance
