Thursday - Forms & Revenue Cycle

Question 1

What is the Coordination of Benefits (COB)

Answer 1

Addresses the order of insurance coverage of claims when a patient has more than one third party payer. It determines what insurance plan gets billed first.

Question 2

What is assignment of benefits (AOB)

Answer 2

Form that authorizes health insurance benefits to be sent directly to providers.

Question 3

What is the Notice of Privacy Practice (NPP)

Answer 3

Signed by patient notifying a patient of how the health organization may use personal shared information and it includes health privacy practices

Question 4

What is advance directive

Answer 4

Document that spells out what kind of treatment a patient wants in the event that he can’t speak for himself. Also known as living will

Question 5

What is account payable (A/P)

Answer 5

Accounts payable refers to the money that the healthcare facility owes others

Question 6

What is an account payable ledger

Answer 6

The ledger shows the past transactions between a company and its suppliers.

It contains amounts owed, dates, and other details relevant to the repayment of short term liabilities

Question 7

What is account receivable (A/R)

Answer 7

Money that is expected but has not yet been received. Money owed to the facility

Question 8

What is advanced beneficiary notice (ABN)

Answer 8

Form provided to a patient if a provider believes that a service may be declined because Medicare might consider it unnecessary

Question 9

what is non sufficient funds

Answer 9

NSF checks occur when a patient pays with a check without having sufficient funds in the bank to cover payment

Question 10

Which of the following parties is financially responsible for payment?

Answer 10

Guarantor

Question 11

What is utilization management?

Answer 11

Ensures that patients are getting right quality care

Question 12

What is Utilization Review

Answer 12

Reviews individual cases to ensure that medical care services are medically necessary

Question 13

What is remittance advice (RA)

Answer 13

A document sent by the insurance company to the provider explaining the allowed charge amount, the amount reimbursement for services, and the patient’s financial responsibilities.

Question 14

What is explanation of benefits (EOB)

Answer 14

A document sent by the insurance company to the patient explaining that allowed charge amount, the amount, reimbursed for services, and the patient’s financial responsibility

Question 15

What is the CMS-1500 Form

Answer 15

The standard insurance claim form used for all government and most commercial insurance companies

Question 16

What is practice management software (PMS)

Answer 16

Sometimes called medical practice management (MPM) it is used to run the day-to-day business side of the ambulatory care facility.

Interfaces with the EHR software

Question 17

Which document provides detailed information about charges, payments, and remaining amounts owed to a provider

Answer 17

Account Receivable Ledger

Question 18

What protects against embezzlement and wrongdoing

Answer 18

Bonding

Question 19

Health history form

Answer 19

Form that asks patients to list any illnesses or surgeries they have had, family history, medications taken, chronic health issues, allergies, and other physicians they consulted

Question 20

MSDS (Material Safety Data Sheet)

Answer 20

Data concerning the safe use of chemical disinfectants; “right to know” ;black and yellow notebook.

Question 21

When a patient request a copy of his medical records the CMAA should first Request the patient to sign

Answer 21

Release of medical records

Question 22

OSHA Form 301

Answer 22

Used to report an incident to OSHA

Question 23

UB-04

Answer 23

Submit claim for hospital services

Question 24

Avoids overlapping payment

Answer 24

Coordination of benefits

Question 25

Ensure accurate accounting

Answer 25

Day Sheet

Question 26

A formal request for reconsideration of a denied claim

Answer 26

A claim appeal