NHA administrative assisiting

Question 1

type of scheduling that allows 3 people to be booked at the same time and be attended in order of arrival
- 1 patient being late does not interrupt providers schedule

Answer 1

wave scheduling

Question 2

type of scheduling where 2 patients are schedules at the same time to see the same provider

Answer 2

double-booking

Question 3

this notice describes how a patients medical info may be used or disclosed+ how to access

Answer 3

notice of privacy practices

Question 4

this system allows patients to cancel, confirm, or reschedule an appointment

Answer 4

automated call routing

Question 5

SOAP method to document on progress sheet

Answer 5

S- subjective (chief complaint-what patient says)
O-objective(clinical indication-vital signs)
A- assessment/ medical diagnosis
P-plan for treatment

Question 6

electronic medical record system function that allows providers to digitally order lab and radiology testign, treatments, referrals, and prescriptions

Answer 6

computerized physician order entry (CPOE)

Question 7

what are some parts of a patients demographic info

Answer 7

• full name
• dob
• address
• insurance
• marital status
• job
• social security

Question 8

provided to the patient by the insurance company as a statement detailing what services were paid, denied, or reduced in payment

Answer 8

explanation of benefits (EOB)

Question 9

explanation of benefits sent to the provider from the insurance company

Answer 9

remittance advice (RA)

Question 10

a form a Medicare patient will sign when they think Medicare might not pay for a specific service or item

Answer 10

advance beneficiary notice (ABN)

Question 11

allows specific reporting of diseases and newly recognized conditions, symptoms, injuries, etc
- 3 to 7 letters used

Answer 11

ICD- 10- CM
-International Classification of Diseases

Question 12

system comprised of medical classifications for procedural codes used in inpatient settings (w/in hospitals) that record various treatments and testing

Answer 12

ICD-10-PCS
- procedure coding system (PCS)
INPATIENT

Question 13

used to document procedures and technical services based on services by providers in outpatient settings
- OUTPATIENT

Answer 13

CPT codes
- current procedural terminology

Question 14

group of codes and descriptions represent procedures, supplies, products, and services not listed in CPT code

Answer 14

HCPCS
- healthcare common procedure coding system

Question 15

used to request payment from health insurance payers, like Medicare, after a patient has been treated
- claim is sent to the insurance company for reimbursement of services

Answer 15

CMS 1500

Question 16

referrals should only be submitted after the approval of ____ and authorization of the _________- has been obtained

Answer 16

the provider
insurance company

Question 17

provider obtains permission to perform certain services or refers patient to specialist

Answer 17

preauthorization

Question 18

A decision by your health insurer or plan that a procedure when you are hospitalized is medically necessary.

Answer 18

precertification

Question 19

amount owed to the provider for services rendered

Answer 19

accounts receiveable

Question 20

if a check is returned to the medical office for nonsufficient funds, what is done

Answer 20

medical office has the right to charge additional fees to the patients account

Question 21

includes EMR and other info to be used between facilities

Answer 21

EHR

Question 22

method of filing where a new report is laid on top of an older report

Answer 22

shingling

Question 23

process of moving active files to an inactive status

Answer 23

purging

Question 24

describes the unlawful act of billing services at a higher rate than contracted to receive a larger reimbursement from a third-party payer

Answer 24

upcoding

Question 25

provides info regarding chemicals used in a medical facility

Answer 25

SDS- safety data sheets

Question 26

when MA receives instruction from doctor to refer a patient to a derm, what action do you take first

Answer 26

complete a patient referral form

Question 27

when a duplicate payment is given for services, what happens

Answer 27

credit balance is added to patients account

Question 28

the difference between what your physician billed your insurance company and what the insurance company has paid. _____________ are not billed to the patient; instead, they are written off by the health care provider

Answer 28

insurance disallowance

Question 29

a complete listing of fees used by Medicare to pay doctors or other providers/suppliers

Answer 29

fee schedule

Question 30

collab of physicians and health care staff whose goal is to reestablish the cost and quality of health care - patients are not directly involved in this process

Answer 30

ACO accountable care org

Question 31

provide patients with in-home services by health professionals to minimize effects of disabilities or diseases and to restore patients overall health

Answer 31

home health agency

Question 32

maximum reimbursement a third party will provide for a particular procedure or service

Answer 32

allowable amount

Question 33

policy where insurance and policyholder share the cost of covered services in a specific ratio, like 80:20

Answer 33

coinsurance

Question 34

list of charges for procedures and services performed at the providers office

Answer 34

fee schedule