Medical Office Management - C

Question 1

A bed patient in a hospital is called a(n) _______.

Answer 1

inpatient

Question 2

A person who represents either party of an insurance claim is the _______.

Answer 2

adjuster

Question 3

A request for payment under an insurance contractor bond is called a(n) _______.

Answer 3

claim

Question 4

Payment made periodically to keep an insurance policy in force is called _______.

Answer 4

premium

Question 5

A person or institution that gives medical care is a(n) _______.

Answer 5

provider

Question 6

Which of the following insurance plans provides a fixed payment per month to the physician, regardless of the services rendered?

Answer 6

capitation

Question 7

An amount the insured must pay before policy benefits begin is called _________.

Answer 7

deductible

Question 8

An organization the offers health insurance at a fixed monthly premium with little or no deductible and works through a primary care provider is called a(n) ______.

Answer 8

health maintenance organization

Question 9

Health insurance that provides protection against the high cost of treating severe or lengthy illnesses or disabilities is called _______.

Answer 9

catastrophic

Question 10

A patient receiving ambulatory care at a hospital or other health facility without being admitted as a bed patient is called a(n) _____.

Answer 10

outpatient

Question 11

An injury that prevents a worker from performing one or more of the regular functions of his job would be known as a _______.

Answer 11

partial disability

Question 12

A previous injury, disease or physical condition that existed before the health insurance policy was issued is called ________.

Answer 12

preexisting condition

Question 13

One who belongs to a group insurance plan is called ______.

Answer 13

subscriber

Question 14

A sum of money provided in an insurance policy, payable for covered services is called _______.

Answer 14

benefits

Question 15

To prevent the insured from receiving a duplicate for losses under more than one insurance policy is called ________.

Answer 15

coordination of benefits

Question 16

When a patient has health insurance, the percentage of covered services that is the responsibility of the patient to pay is known as _______.

Answer 16

coinsurance

Question 17

Insurance that is meant to offset medical expenses resulting from a catastrophic illness is called ________.

Answer 17

major medical

Question 18

An unexpected event which may cause injury is called _______.

Answer 18

accident

Question 19

A doctor who agrees to accept an insurance companies pre-established fee as the maximum amount to be collected is called ________.

Answer 19

participating physician

Question 20

Insurance plans that pay a physician’s full charge if it does not exceed the amount normally charged for the service is called _________.

Answer 20

usual, customary and reasonable

Question 21

A notice of insurance claim or proof of loss must be filed within a designated _______ or it can be denied.

Answer 21

time limit

Question 22

A health program for people age 65 and older under social security is called _______.

Answer 22

medicare

Question 23

A civilian health and medical program of the uniform services is called _______.

Answer 23

Tri-Care

Question 24

A form of insurance paid by the employer providing cash benefits to workers injured or disabled in the course of employment is called ________.

Answer 24

workers’ compensation

Question 25

A recap sheet that accompanies a Medicare or Medicaid check, showing breakdown and explanation of payment on a claim is called ________.

Answer 25

explanation of benefits

Question 26

A type of insurance whereby the insured pay a specific amount per unit of service and the insurer pays the rest of the cost is called ________.

Answer 26

co-payment

Question 27

In insurance, greater coverage of diseases or an accident, and greater indemnity payment in comparison with a limited clause is called _______.

Answer 27

comprehensive

Question 28

A rider added to a policy to provide additional benefits for certain conditions is called ______.

Answer 28

dread disease rider

Question 29

An interval after a payment is due to the insurance company in which the policy holder may make payments, and still policy remains in effect is called ______.

Answer 29

grace period

Question 30

An agreement by which a patient assigns to another party the right to receive payment from a third party for the service the patient has received is called _______.

Answer 30

assignment of benefits

Question 31

A skilled nursing facility for patients receiving specialized care after discharge from a hospital is called _____.

Answer 31

extended care facility

Question 32

Payment for hospital charges incurred by an insured person because of injury or illness is called _______.

Answer 32

hospital benefits

Question 33

An agent of an insurance company who solicits or initiates contracts for insurance coverage and services, and is the policyholder for the insurer is called _______.

Answer 33

insurance agent

Question 34

A method of charging whereby a physician presents a bill for each service rendered is called _______.

Answer 34

fee-for-service

Question 35

The Tri-Care fiscal year is from

Answer 35

October 1 to September 30

Question 36

The number on the Employees Withholding Exemption Certificate is _______.

Answer 36

W-4

Question 37

FICA provides benefits for ________.

Answer 37

social security

Question 38

As part of the office bookkeeping procedures, the physician’s bank statement should be reconciled with the _____.

Answer 38

checkbook

Question 39

A record of debits, credits, and balances is referred to as a patient’s ________.

Answer 39

ledger

Question 40

A signature on the reverse side of a check is called _______.

Answer 40

endorsement

Question 41

A form to itemize deposits made to savings or checking accounts is called _______.

Answer 41

deposit slip

Question 42

To correct a handwritten error in a patient’s chart, it is only acceptable to _______.

Answer 42

draw a line through the error, insert the correct information, date and initial it.

Question 43

Low income patients can be covered by what type of insurance?

Answer 43

Medicaid

Question 44

The reference procedural code book that uses a numbering system developed by the AMA is called a(n) _______.

Answer 44

current procedural terminology

Question 45

________ is a method used for determining whether a particular service or procedure is covered under a patient’s policy.

Answer 45

precertification

Question 46

The International Classification of Disease, 9th Revision, Clinical modification (ICD-9-CM) is used to code _____.

Answer 46

diagnosis

Question 47

In insurance coding using an “E” code designates ________.

Answer 47

classification of environmental events, such as poisoning

Question 48

E/M codes are located in the ________ manual.

Answer 48

CPT

Question 49

Which codes can modifiers be added to, to indicate that a procedure or service has been altered in some way?

Answer 49

CPT

Question 50

The _______ form is used by non-institutional providers and suppliers to bill Medicare, Part B covered services.

Answer 50

CMS-1500