Midterm Exam Review Flashcards
How much free space should be left on each shelf of a filing cabinet?
Leave atleast 4 inches of working space on each shelf or in each drawer.
What is used to mark a space from which a record has been taken?
Outguide - like a bookmark
Which filing system is easiest to use?
Alphabetical - easiest and most commonly used for filing paper records
If a patient was seen in 2019, would that patient be considered active or inactive?
Inactive (active have been seen in the past 2-3 years)
Define Subscriber
Person who carries the insurance and also the person receiving the treatment
Define Carrier
The insurance company who pays the claims and collects premiums
Define Dependent
Person who receives the treatment and is the child or spouce of the subscriber
Define Group
The union or employer that has purchased or arranged insurance as a benefit
Define Provider
The dentist who provides treatment to the patient
What is the Birthday Rule
When a child is covered under both parent’s plans, the plan of the parent whos birthday falls first in the calendar year (dd/mm) is billed first.
Define Primary Carrier
Insurance company (carrier) that pays first
Define Secondary Carrier
Insurance company (carrier) that pays second
Least expensive alternative treatment
Least expensive alternative treatment is a limitation in a dental plan that allows for the least expensive treatment. Patient needs to replace a missing tooth. Treatment options are a fixed bridge for $4000 or a partial denture for $2500. Under LEAT the carrier will pay the benefits for a partial denture only. If the patient decides on the fixed bridge the patient MUST pay the difference in cost.
Define Schedule of benefits
A list of fixed specified amounts that a carrier will pay towards the cost of covered services.
Define Deductible
Amount of money each enrollee or family must pay before insurance will pay for covered services. Usually $25 to $50 per year.
Define Exclusive provider organization
Closed panel where a patient must see the dentist who is a member of the plan’s network of providers
Define Annual Maximum
12 month period of the dental contract (not always calendar year). Most patients have a maximum allowable per year
Define Usual Fee
Fee that a dentist charges a private patient for a given service. Fees are determined by the individual dentist.
Define Waiting Period
Period between employment and the date that the employee becomes eligible for benefits
Define Coordination of Benefits
Patient or dental office will receive payment from both carriers but the total received will not exceed 100% of the actual dental expense.
Define Indemnity plan
Traditional dental insurance plan.Provides benefits for dental treatment that a covered individual receives from their own dentist.
Define fixed fee schedule
An established fee for any treatment received by the patient. Under government programs the dentist must accept the payment from the carrier as payment in full and can not bill the patient the difference.
What is accounting?
process of recording, classifying, and summarizing financial transactions
What does accounts receivable manage?
the money owed to the practice
What type of accounts receivable bookkeeping system is used if n office doesn’t have a computerized system?
Pegboard System
What is a change fund?
Money available if the patient pays cash
How often should bank deposits be made?
Daily
When attempting to collect money owed by a patient, which of the following efforts is permitted?
Calling the patient between 5 & 8 PM
You CANNOT..
-Contact their employer
-threaten violence
-use false pretenses to get information
Which type of expenses continue consistently regardless of whether the dentist is in the office and professional services are being provided?
Fixed overhead
Who is the dental insurance carrier?
The party that pays the claims and collects the premiums
Under a government program, the dentist must accept the amount paid by the carrier as payment in full and not bill the patient for difference according to:
Fixed fee schedule
Which type of managed care dental plan offers patients no option other than receiving their dental treatment from a dentist who is a member of the plan?
Exclusive provider organizations
What does a patient have if they have dental coverage under more than one dental plan?
Dual coverage
Under coordination of benefits, the patient may receive payment from multiple carriers, but the total received may not be more than _____% of the actual dental expenses.
100%
Which of the following is not an example of dental insurance fraud?
Not filing the claim
Examples ARE..
-changing fees to obtain a higher payment
-accepting more payment than what was billed
-billing for services not provided
What information is collected on a patient registration form?
Information indicating the patient’s coverage under a dental insurance plan
What is generated for each patient that contains their name, current charges, previous balance and treatment completed that day?
Charge slip
What is the purpose of a walk out statement?
Reduces the number of statements that need to be sent out
A patient has an existing balance of $75. The charges for that day are $135.00. What ist he total amount due on the walk out statement?
$210
Who is the guarantor?
the person responsible for the account
If the dentist gives you a professional discount of 10% and your total fee for treatment is $210, what is the balance you owe for that treatment?
$189
The total production for a dental office in 1 day is $7000. The total amount of accounts receivable is $4600 in checks, $260 in cash, and $1600 in credit card charges. What is the total amount on the bank deposit slip?
$4860
What would the monthly payment be if using the plan outlined: Total charge is $3000, minus the down payment of $800. With the balance dvited into 4 monthly payments.
$550
When a patient has a long outstanding debt to the dental office, what is the most effective method of collection?
Collection telephone calls
The business assistant should discuss financial arranges with the patient in…
in a private area
After the ____ has completed the case presentation to the patient, the _____ may be asked to handle the discussion of the fees involved.
Dentist; business assistant
Which statement represents a detailed list of goods shipped or services rendered with an account of all costs on an itemized bill?
Invoice
What insurance term represents the dentist?
Provider
Which type of fee is determined by a percentage of pre-filed fees submitted to insurance companies?
usual fee
What rule was established to determine which carrier is the primary carrier when both parents have insurance to cover a child?
Birthday rule
Inactive files are records of patients who have not been seen in how long?
3 years
Which filing system is the easiest and most commonly used?
Alphabetic by last name
What is a ledger?
A financial statement that documents all account transactions
What statement is correct regarding computerized patient management accounts receivable record systems?
The must be protected with backupfiles stored in a safe place away from the office
Charge slips are used to do which of the following?
Transmit financial information between the treatment area an the business office
Payments on any outstanding accounts payable are known as which the following?
Disbursements
____ was adopted to enhance and protect the privacy and rights of patients.
Personal Information Protection Act (PIPA)
A patient ____ contains all of the financial information for each patient or family.
Ledger
Files for those patients who have not been seen (in the past 3 years) are called _____ files.
Inactive
When is appointment scheduling most effective?
When only one person is responsible for the scheduling
If a 15-minute time unit is used in the practice and a patient must be scheduled for a procedure that will take approx. 50 minutes to complete, the dentist should request that this patient be given a ____ unit appointment.
4 unit - 60 mins
What is the time that is reserved each day for scheduling emergency patients called?
Buffer time
What is the proper sequence of recording appointment entries?
- Make the complete entry in the appointment book or software system.
- Write the appointment card for the patient
- Double check to ensure the information is entered correctly.
When is the best time to see young children in the dental office?
In the morning
Who is a patient of record?
One who has been seen in the practice before
What is the normal time frame for scheduling recall appointments?
6 months
Which type of preventive recall system is usually most effective?
Recall by telephone
Which is not considered an expendable item?
Handpiece
expendable items are…
plastic suction tip
patient napkin
gloves
What might happen if an item is not available at the time from your regular supply company?
It goes on backorder
Which factors are determined when a product must be reordered?
-Rate of use
-shelf life
-availability of proper storage
How is an item marked for reorder?
Reorder tag
If a dental unit is not operational what is the effect on a dental practice?
-loss of income
-inconvenience to dental team
-major expense
Which category of items would dental restorative instruments fall under?
non-expendables
What are the responsiblilites of the business assistant?
scheduling patients
Which statement is incorrect about patient ledgers?
-a patient’s ledger is kept with the patient’s clinical records
TRUE is..
-the patient’s ledger contains all of the financial information for each patient or family
-The ledger should include a description of the service provided
-The ledger statement can be hard copy or electronic
What are the advantages of using the color-coded filing system?
It is easy to spot misfiled records
The cross-reference file is used with which filing system?
Numeric
Which of the following would be used to help in sorting files ffrom actice to inactive?
aging tabs
What are advantages of using an efficient appointment scheduling system?
-helps with patient satisfaction
-provides an even pace of work during the day
-decreases the time patients spend waiting in the dental office
What elements should be outlined in an appointment book?
-Office Hours
-Buffer Times
-Meetings
If a patient is seen in September for a recall exam and cleaning, what would be the recall month for a 6 month recall exam and cleaning appointment?
March
How many minutes commonly make up 1 unit of time for scheduling?
10-15 minutes
The dentist requires 1 hour 20 minutes to prepare a tooth for a single crown. The office appointment book is marked 15-minute increments. How many units of time would be needed?
6 units
Money that is owed to the practice is considered ______.
Accounts receivable
A dental office should begin collection efforts on a past due account
after 30 days
How would a business assistant follow through with the collection of fees
-letters
-phone call
-collection agency
An example of fixed overhead is
Salaries
NOT..
dental supplies
continuing education
business supplies
Which document arrives with the shipment of supplies
Packing slip
What term indicates that an account doesn’t ave enough money to cover a check
nonsufficient funds
The specified amount of money that an insured person must pay before their insurance goes into effect is the ____.
Deductible
A child or spouse of an insurance subscriber is considered an ___.
Dependent
