Test 4: CH 14, 15, 16, 17, 18, 19, 20, 21 Flashcards by Jessica wiebe

The POMR is also knows as:

a. a source-oriented medical record
b. a SOAP/SOAPER system
c. a traditional method
d. a problem-oriented medical record
e. none

d. a problem oriented medical record

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the SOAP/SOAPER format is:

a. a way to sanitize instruments
b. a form of pt electronic record
c. a type of filing system
d. a specific charting system
e. none

d. a specific charting system

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if a pt needs to return for another exam in 6 mos, you might use a reminder system. What is the name of that system

a. reminder system
b. recall system
c. phone log
d. tickler system
e. out guide

d. tickler system

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the most common method of filing in today’s medical clinic is

a. alphabetically
b. numerically
c. by insurance
d. by subject
e. color coding

a. alphabetically

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If a medical document is filed in multiple places, you might use

a. index
b. out guide
c. cross reference
e. cross-filed card

c. cross reference

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the best method to used for making corrections in a paper medical record is

a. use a white out product
b. scribble over the error witha magic marker
c. put X’s through the error
d. draw a single line through the error, make the correction, wirth CORR or CORRECTION above the area corrected, and add your initials and date

d. draw a single line through the error, make the correction, wirth CORR or CORRECTION above the area corrected, and add your initials and date

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identifiable patient info that should appear on the outside of the chart would include

a. patient’s address
b. pt’s SSN
c. pt’s DOB
d. pt’s phone number
e. all of the above

e. all of the above

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closed files are usually kept

a. 3-6 yrs beyond the statute of limitations
b. 2-5 yrs
c. indefinitely
d. 10 yrs

a. 3-6 yrs beyond the statute of limitations

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the 3 types of cabinets used in medical clinics are

a. vertical, lateral and movable
b. metal, hanging and color coded
c. horizontal, lateral and movable
d. open, locked and movable

a. vertical, lateral and movable

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captions are used

a. to separate file folders
b. to identify major section of the file folder
c. in vertical and lateral systems
d. a and c

b. to identify major sections of the file folder

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the salutation of a letter is the

a. signature
b. greeting
c. return address
d. closing remark
e. the recipient’s name, titel and address

b. greeting

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when addressing an envelope the proper way to list the state is

a. to write out completely
b. to abbreviate it using at least 4 letters
c. to capitalize it using the official 2 letter abbreviation
d. to used any of the above, so long as it is in uppercase letters and written clearly

c. to capitalize it using the official 2 letter abbreviation

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which of the following would be incoming mail to a provider’s office

a. email
b. insurance form
c. medical journals
d. letters from pt
e. all

e. all of the above

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the MA may, with the provider’s permission, sign certain letters such as:

a. the ordering of supplies or subscriptions
b. notification of collection procedures and reminder of payments
c. dismissal letters
d. a and b

d. a and b

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when addressing an envelope

a. the address should be machine-printed with a uniform left margin
b. all punctuation should be eliminated
c. use dark ink on a light background using uppercase letters
d. all of the above

d. all

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the types of envelopes most often used are

a. number 7
b. 6 3/4
c. 10
d. a and b

d. a and b

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periodical is the nee classification for:

a. second class mail
b. third class mail
c. priority mail
d. parcel post mail

a. second class mail

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before presenting any correspondence to the provider for signature, the document should be
a. date stamped
b, checked for accuracy
c. folded and put in an envelope
d. typed on plain white paper

b. checked for accuracy

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the most secure service the USPS offers is

a. priority mail
b. express mail
c. registered mail
d. certified mail

c. registered mail

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association for healthcare documentation integrity (AHDI) credentials

a. MTs
b. CMTs
c. CMTs and RMTs
d. CMAs and RMAs

c. CMTs and RMTs

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a digital dictation system allows you to measure to

a. the 30th or 90th of a minute
b. 60 sec
c. the 10th or 100th of a min
d. 30-40 seconds

c. the 10th or 100th of a min

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the medical report must be

a. dated correctly
b. signed or initialed by the dictator
c. legible
d. all

d. all

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the specific time period in which a document is expected to be completed from the time it is received by the transcriptionist until it is returned to the provider and made part of the permanent medical record is called

a. filing time
b. turnaround time
c. completion time
d. return time

b. turnaround time

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radiology, pathology, and laboratory reports are usually termed as__ to indicate the need fr immediate turnaround

a. ASAP
b. current
c. old
d. STAT

d. Stat

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the portion of the medical fees that the pt needs to pay at the time of service is called a. co-payment b. fee for service c. out-of-pocket expense d. premium

a. co-pay

the largest medical insurance program in US is a. blue cross/blue shield b. medicaid c. medicare d. TRICARE

C. medicare

the cost that pts must pay each month is called the a. out-of-pocket expense b. co-pay c. premium d. relative value scale

c. premium

which of the following describes HIPAA a. it is about confidentiality, pt privacy and security of personal health info b. it protects health insurance coverage for workers and their families when they change or loose their jobs c. it includes national standards for electronic health care transactions d. it establishes rules for national identifiers for providers, health plans and employers e. a and c only

e. a and c only

non covered services are also known as a. non allowed services b. exclusions c. out-of-pocket services d. expensive services

b. exclusion

a statement summarizing how the insurance carrier determined reimbursement for service received by the pt is called a. explanation of benefits (EOB) b. remittance advice (RA) c. day sheet d. personal financial statement

a. EOB

``` the medical insurance that covers medical care for certain qualifying low-income individuals is a. medicare b. CHAMPUS C. TRICARE d. medicaid ```

d. medicaid

To ensure that there is a successful flow of adequate income in the clinic or office the medical assistant should a. bill the insurance carrier or pt as needed b. complete forms properly c. keep track of aging accounts d. all

d. all of the above

improper billing practices are considered a. fraud b. nonproductive c. abuse d. risky

c. abuse

which of the following is a problem with work related health insurance coverage a. part-time employees are usually not eligible b. medical benefits may not transfer equally c. insurance companies often refuse to provide coverage for some procedures, including experimental d. all

d. all of the above

the person covered under the terms of an insurance policy is called the a. primary b. secondary c. beneficiary d. elector

c. beneficiary

when more than one policy covers the individual the ___ determines which of the policies will pay first a. deductible b. exclusion c. coinsurance d. coordination of benefits

d. coordination of benefits

where does one find the address to which insurance claims are to be sent a. the phone book b. on the back of the insurance card c. in the insurance provider manual d. none

b. on the back of the insurance card

blue cross and blue shield are examples of a. managed care organizations b. health maintenance organizations c. preferred provider org d. traditional insurance org

d. traditional insurance organizations

what is the name of the coding system that includes codes for services provided to medicare or medicaid pts a. HCFA b. CPT c. ICD-9 d. HCPCS e. WHO

d. HCPCS

a diagnosis code of 6750.51 has been entered on the claim form. what system is used to assign that code a. CPT b. ICD-9-CM c. ICD-10-CM d. HCPCS e. RVS

b. ICD-9-CM

in the CPT manual, the description of the level of E&M codes includes which of the following? a. complexity of the medical decision making b. level of history taken c. new versus established pt d. all

d. all of the above

which of the following is description of volume II of the ICD-9 a. known as the tabular index, lists all diagnostic codes in numeric order b. an alphabetic listing of all known diagnosis, including symptoms and accidents and their causes c. lists procedures in tabular form d. all of the above

b. an alphabetic listing of all known diagnosis, including symptoms and accidents and their causes

deliberately billing a higher rate than what was performed to obtain greater reimbursement is called a. encoding b. down-coding c. up-coding d. exploding

c. up-coding

one way to prevent a breach of confidentiality when processing insurance claim forms is to a. ask the pt, parent or guardian to sign an auth to release med info form before the claim is completed b. ask the pt for verbal approval before sending in the claim c. have the pt write a letter requesting that the info be forwarded d. have the insurance carrier contact the pt

a. ask the pt, parent or guardian to sign and authorization to release medical info form before the claim is completed

when coding, it is imperative a. to be as precise as possible b. not to guess c. not to code what is not there d. all

d. all of the above

submitting claims electronically a. can improve cash flow b. ensures consistency c. will reduce the amt of supplies required d. all

d. all of the above

using an electronic device for direct communication between medical offices and health care plans computer is called a. subrogation b. point of service c. diagnosis-related groups d. prospective payments

b. point of service

the most common claim form for the ambulatory setting is the a. CMS-1450 b. HCFA-1000 c. CMS-1500 d. CPT-1500

c. CMS-1500

the codes showing that a pt has been seen for reasons other than sickness or injury are a. S-code b. D code c. V code d. X code

c. V codes

the insurance claims processor will confirm that a. there are no exclusions or restrictions for payment of that diagnosis b. the claim was received within seven days of the appointment c. the procedure relating to the diagnosis is medically necessary d. a and c

d. a and c

a provider's fee profile is a. based on an average of all practice's fees b. a continuous record of usual charges made for specific services c. an average of fees charged over a period of 3 mos d. the amount paid by insurance carriers

b. a continuous record of usual charges made for specific services

The pegboard system of bookkeeping is sometimes called a. write-it once system b. ledger system c. double -entry system d. duplicated page system

a. write it once system

NSF stands for a. nonsufficient funds b. not sufficient funds c. not satisfactory funding d. negligent status of funding

a. non sufficient funds

a restrictive endorsement stamp is used to a. stamp on the ledger to signify that payment has been made b. stamp the doctor's signature on insurance forms and other documents c. stamp on the statement to signify that you have sent a check d. stamp on the back of the check to signify "for deposit only"

d. stamp on the back of the check to signify "for deposit only"

when reconciling a bank statement a. the reconciling should be done every month b. the checkbook entries should be checked against the bank statement c. the reconciling should be done daily by computer d. all reconciling should be done in ink to avoid any unauthorized entries e. a and b

b. the checkbook entries should be checked against the bank statement

If a check has been deposited and is now returned because of insufficient funds, it will be necessary to: a. redeposit the check b. call the bank that returned it and verify availability of funds so the check can then be redeposited c. call the pt who wrote the check d. discard the check and credit the amount back to the pt's account

b. call the bank that returned it and verify availability of funds so the check can then be redeposited

the most common method of tracking a pt's balance is: a. the pegboard system b. computerized financial system c. the ledger card d. a and b

d. a and b

the pegboard system consists of: a. day sheets b. ledger cards c. encounter forms d. receipt forms e. all of the above

e. all of the above

In cases of divorced parents where one parent has physical custody of the child and is considered the one responsible for payment if the child is not insured with a contracted insurance carrier, the parent is called: a. the payee b. the guarantor c. the subscriber d. none

b. the guarantor

The number required by the Centers for Medicare & Medicaid Services (CMS) on claims for clinical diagnosis services is called the: a. insurance registration number b. client number c. National Provider Identifier d. contract number

c. National Provider Identifier

The advanced beneficiary notification form is used primarily for a. medicaid patients b. HMO pts c. Medicare pts d. CHAMPUS pt

c. medicare pt

a pt encounter form a. is also called a charge slip b. is also called a superbill c. is also called a pegboard form d. both a and b

d. both a and b

in most practices there is a need to have cash available on a daily basis to a. make change for a pt paying cash for services b. make funds available for all office personnel c. pay for minor and incidental expenses d. provide funds for weekly lunches for all employees

a. make change for a pt paying cash for services

when a check must be guaranteed for the amt in which it is written, a __ is issued a. cashier's check b. certified check c. voucher check d. traveler's check

a. cashier's check

restricting the used of a check should it be lost or stolen may be done through a. reconciling b. balancing c. special endorsement d. bank endorsement

c. special endorsement

the ledger is placed under the charge slip or encounter form in a pegboard system and a. verified before posting b. aligned before posting c. entered before posting d. reconciled before posting

b. aligned before posting

pt's who owe money but have moved and left no forwarding address are referred to as a. deadbeats b. skips c. non payers d. dead accounts

b. skips

statutes of limitations vary from state to state should be investigated if an unpaid account is more than a. 3 yrs old b. 5 yrs old c. 10 yrs old d. without a time limit if the account is more than a certain amount

a. 3 yrs old

lack of pmt from a pt may not be considered serious until after a. 30 days b. 60 days c. 90 days d. 120 days

b. 60 days

for an insurance claim pending more than 45 days, the medical assistant should a. call the carrier and find out if the claim was received b. rebill the insurance co c. check on the processing status of the claim with the carrier d. a and c

d. a and c

the most appropriate time to discuss fees and the pt's financial concerns is a. when services are rendered b. when scheduling an appointment c. by mail after services are rendered d. when the insurance company does not pay the fee

b. when scheduling an appointment

``` the truth-in-lending act is also known as the a. consumer protection act of 1967 b, fair debt collection practice act c. patient bankruptcy protection act d. accurate billing and collection act ```

a. consumer protection act of 1967

the charge slip is also known as the a. ledger b. encounter form c. day sheet d. CMS-1500

b. encounter form

when a pt files for BK a. there is little likelihood that the debt can be collected b. it is best to close the account and identify the loss c. file a proof-of-claim form and provide a copy of the pt's outstanding account to the BK court d. take the account to small claims court

c. file a proof-of-claim form and provide a copy of the pt's outstanding account to the BK court

In determining how aggressive to be in debt collections, you should consider a. the previous month's billing backlog b. production efficiency c. the terms of insured's policy d. the value of the dollar owed

d. the value of the dollar owed

chapter 13 BK is otherwise known as a. wage earner's BK b. farmer's BK c. fair lending BK d. allowable debt BK

a. wage earner's BK

The system that is based on the accounting principle that a. single-entry system b. double entry system c. standard of billing services bureaus d. accounts receivable accounting principles

b. double-entry system

of the following statements, which is false? a. double-entry bookkeeping is expensive b. double-entry bookkeeping is accurate c. double-entry bookkeeping is more time consuming d. double-entry bookkeeping has checks and balances in place

a. double entry bookkeeping is expensive

owner's equity is not the same as a. net worth b. proprietorship c. cbonds may be purchased to protect the practice from c. capital d. accounts payable

d. accounts payable

bonds may be purchased to protect the practice from a. embezzlement b. financial loss c. malpractice suits d. a and b e. all of the above

d. a and b

a total practice management system has the ability to a. process insurance claims electronically b. manage payroll and purchases c. generate financial records d. all

d. all of the above

computerization of medical facilities has increased because of a. emphasis being placed on the accurate documentation of medical records b. pt load c. increase in managed care plans d. a and c

d. a and c

the trial balance is created by a. collecting data from the current year and previous year and converting them into a ratio b. totaling debit balances and credit balances to confirm that total debits equal total credits c. reporting outside revenue sources and overhead expenses d. recording two sets of enteries, such as increase in assets and increase in liabilities

b. totaling debit balances and credit balances to cinfirm that total debits equal total credits

providers should purchase fidelity bonds because they a. are worth the price b. provide a sense of security c. lessen the chances of embezzlement d. will reimburse the practice for any monetary loss caused by the practice's employees

d. will reimburse the practice for any monetary loss caused by the practice's employees

a proper contract should be negotiated and signed with any computer and billing service bureau because it a. is considered a legal document b. ensures confidentiality and strict privacy of pt information c. is in compliance with HIPAA d. b and c

d. b and c

financial records should provide the following at the times a. salaries earned by providers and staff b. amount earned, owed, and collected within a given period c. where expenses were incurred in a given period d. b and c

d. b and c

a hospital cost report for medicare is part of a a. financial accounting b. managerial accounting c. cost accounting d. cost analysis

a. financial accounting

examples of variable costs include all of the following except a. clinical supplies b. equipment costs c. depreciation d. laboratory procedures

c. depreciation

the accounts receivable trial balance: a. tells you how much the practice owes to creditors b. shows any problems between the daily journal and ledger c. tracks all disbursements and compares the total with the purchases d. uses an NCR transfer strip to copy pertinent info

b. shows any problems between the daily journal and the ledger

calculating and reviewing costs provide ambulatory care settings with a. data to set fees b. monitoring of the practice's performance c. offline batch processing d. a and b

d. a and b

salary calculations, withholding taxes, and social security calculations are the responsibility of the a. practice administrator b. administrative medical assistant c. office manager d. provider

c. office manager