Question 1

A claim may be removed from the automated review cycle and submitted for a ________ review if data for any of the processing steps are missing or is unclear.

Accepted Answer

A)   Physician
B)   Adjudication
C)   Processing
D)   ManualE) A) and B)
F) None of the above

Question 2

Statutes of limitations for collecting debt:

Accepted Answer

A)   Are mandated by the federal government.
B)   May exceed 15 years.
C)   Are set state to state and may vary.
D)   Are not relevant to the office collection policy.E) A) and B)
F) None of the above

Question 3

Adult children covered under a patient's policy may continue being covered under the parent's medical insurance policy up to the age of

Accepted Answer

A)   18.
B)   21.
C)   26.
D)   30.E) B) and D)
F) None of the above

Question 4

What is the name for a list of usual procedures the office performs and the corresponding charges?

Accepted Answer

A)   encounter form
B)   collection list
C)   fee schedule
D)   routing slipE) A) and D)
F) B) and D)

Question 5

Under HIPAA, the payment portion of TPO gives providers the authority to release claim-pertinent PHI to obtain what?

Accepted Answer

A)   Third-party payment
B)   Treatment from another provider
C)   Access to a clearinghouse
D)   Payment from the patientE) A) and D)
F) None of the above

Question 6

Which of these is a billing method used to provide consistent cash flow?

Accepted Answer

A)   Cycle billing
B)   Monthly billing
C)   Guarantor billing
D)   Third-party billingE) B) and C)
F) None of the above

Question 7

A physician's NPI is part of the physician identifying information. What does NPI stand for?

Accepted Answer

A)   National Performing Index
B)   New Provider Information
C)   New Performing Identifier
D)   National Provider IdentifierE) C) and D)
F) B) and C)

Question 8

Which of these billing systems is designed to avoid once-a-month peak workloads and to stabilize the cash flow?

Accepted Answer

A)   Third-Party billing
B)   Monthly billing
C)   Guarantor billing
D)   Cycle billingE) B) and C)
F) None of the above

Question 9

Which item does not go on the patient encounter form?

Accepted Answer

A)   Patient address
B)   Date of service
C)   Insurance
D)   Previous servicesE) B) and C)
F) A) and C)

Question 10

A write-off is a financial adjustment for PAR providers of the difference between

Accepted Answer

A)   submitted charges and allowable charges.
B)   charge amount and amount paid by the patient.
C)   amount paid by the patient and amount paid by a third party.
D)   estimated charges and actual charges.E) A) and B)
F) A) and D)

Question 11

Attempted collection of a debt by telephone cannot be made after:

Accepted Answer

A)   9 p.m.
B)   8 p.m.
C)   6 p.m.
D)   5 p.m.E) All of the above
F) A) and C)

Question 12

When a person other than the patient assumes liability, or responsibility, for the charges, it is called _______________.

Accepted Answer

A)   Guarantor billing
B)   Fee adjustment
C)   Collection modification
D)   Third-party liabilityE) A) and C)
F) A) and B)

Question 13

A terminated account may result when the physician finds it impossible to

Accepted Answer

A)   diagnose the patient's condition.
B)   extract payment from a patient.
C)   contact the patient's insurance provider.
D)   estimate the cost of a patient's procedure.E) B) and C)
F) A) and B)

Question 14

When a provider receives a check with more than one patient listed on it, it is called a ______ check.

Accepted Answer

A)   Volume
B)   Bulk
C)   Draft
D)   SumE) A) and B)
F) All of the above

Question 15

Forms used by the medical practice should be updated __________ and the codes verified with the current year's diagnostic and procedural codes.

Accepted Answer

A)   Every three months
B)   Monthly
C)   Semi-Annually
D)   AnnuallyE) B) and C)
F) B) and D)

Question 16

A financial adjustment for PAR providers of the difference between submitted and allowable charges is known as a

Accepted Answer

A)   Fee adjustment.
B)   Billing correction.
C)   Write-off.
D)   Collection modification.E) C) and D)
F) None of the above

Question 17

Another name for a patient encounter form is:

Accepted Answer

A)   Charge slip
B)   Pink slip
C)   Suprabill
D)   Intake formE) B) and C)
F) A) and D)

Question 18

With electronic claims, Medicare claims are paid much faster - within __ days versus __ days.

Accepted Answer

A)   15; 45
B)   30; 45
C)   14; 29
D)   10; 25E) A) and B)
F) A) and C)

Question 19

A claim form without errors is known as what type of claim?

Accepted Answer

A)   Clearinghouse
B)   HIPAA
C)   CMS
D)   CleanE) A) and D)
F) A) and C)

Question 20

What is it called when bills are sent once a month and are timed to reach the patient no later than the last day of the month?

Accepted Answer

A)   Monthly billing cycle
B)   Guarantor billing
C)   Third-party liability billing
D)   Collection billing cycleE) C) and D)
F) All of the above

Exam 8: Billing, Reimbursement, and Collections

Forms used by the medical practice should be updated __________ and the codes verified with the current year's diagnostic and procedural codes.

Correct AnswerverifiedShow Answer

Which of these is a billing method used to provide consistent cash flow?

Correct AnswerverifiedShow Answer

Statutes of limitations for collecting debt:

Correct AnswerverifiedShow Answer

Which of these billing systems is designed to avoid once-a-month peak workloads and to stabilize the cash flow?

Correct AnswerverifiedShow Answer

A claim may be removed from the automated review cycle and submitted for a ________ review if data for any of the processing steps are missing or is unclear.

Correct AnswerverifiedShow Answer

With electronic claims, Medicare claims are paid much faster - within __ days versus __ days.

Correct AnswerverifiedShow Answer

A claim form without errors is known as what type of claim?

Correct AnswerverifiedShow Answer

When a person other than the patient assumes liability, or responsibility, for the charges, it is called _______________.

Correct AnswerverifiedShow Answer

When a provider receives a check with more than one patient listed on it, it is called a ______ check.

Correct AnswerverifiedShow Answer

A terminated account may result when the physician finds it impossible to

Correct AnswerverifiedShow Answer

A financial adjustment for PAR providers of the difference between submitted and allowable charges is known as a

Correct AnswerverifiedShow Answer

What is it called when bills are sent once a month and are timed to reach the patient no later than the last day of the month?

Correct AnswerverifiedShow Answer

A physician's NPI is part of the physician identifying information. What does NPI stand for?

Correct AnswerverifiedShow Answer

Another name for a patient encounter form is:

Correct AnswerverifiedShow Answer

Which item does not go on the patient encounter form?

Correct AnswerverifiedShow Answer

Attempted collection of a debt by telephone cannot be made after:

Correct AnswerverifiedShow Answer

Under HIPAA, the payment portion of TPO gives providers the authority to release claim-pertinent PHI to obtain what?

Correct AnswerverifiedShow Answer

A write-off is a financial adjustment for PAR providers of the difference between

Correct AnswerverifiedShow Answer

What is the name for a list of usual procedures the office performs and the corresponding charges?

Correct AnswerverifiedShow Answer

Adult children covered under a patient's policy may continue being covered under the parent's medical insurance policy up to the age of

Correct AnswerverifiedShow Answer

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With electronic claims, Medicare claims are paid much faster - within days versus days.

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