Question 1

Scheduler instructions are used to prompt the scheduler to do what?

Accepted Answer

Complete the scheduling process 
correctly based on service requested.

Question 2

What activities are completed when a schedule, pre-registered patient arrives for service

Accepted Answer

Activiting the record, obtaining signatures, and finalizing financial issues

Question 3

What does scheduling allow the provider staff to do

Accepted Answer

Review the appropriateness of the service requested

Question 4

What activities are completed when a scheduled, pre-reg patient arrives for service?

Accepted Answer

Activating the record, obtaining signatures, finalize financial issues

Question 5

What are Non-emergency patients who come for service without prior notification to the provider called?

Accepted Answer

unscheduled patient

Question 6

The revenue cycle begins with scheduling a patient for service and ends with what?

Accepted Answer

The archiving of the fully resolved account

Question 7

1 registration record is being created for multiple days of service is what type of scheduling

Accepted Answer

Recurring or Series

Question 8

The time needed to prepare the patient before service is the difference between the patient’s arrival time and which of the following?

Accepted Answer

Schedule time

Question 9

What is the purpose of the initial step in the outpatient testing scheduling process

Accepted Answer

Identify the correct pt in the providers data base or add the patient to the data base

Question 10

What type of information is typically collected during the scheduling contact

Accepted Answer

Patients name dob, sex, dx, requested test, or procedure, preferred DOS , ordering physician, and physician’s telephone number.

Question 11

A patient who is admitted from the physician’s office on an urgent basis is what type of admission

Accepted Answer

Unscheduled

Question 12

Why is it important to have high quality standards for registration

Accepted Answer

Because quality failures affect the provider’s Joint Commission results on a review day

Question 13

What statement is NOT a possible consequence of selecting the wrong patient in the MPI (master patient index)?

Accepted Answer

Claim is paid in full

Question 14

In addition to the members identification #, what information is recorded in a 270 transaction

Accepted Answer

Date of birth

Question 15

What is the advantage of a preregistration program

Accepted Answer

It reduces processing times at the time of service.

Question 16

What data are required to establish a new MPI (master patient index) entry

Accepted Answer

Patient’s full legal name, dob, sex

Question 17

When screening a a beneficiary for possible MSP (Medicare secondary payer) situations,  It is necessary to ask the patient each of the MSP questions. True or False

Accepted Answer

True

Question 18

Comprehensive pre reg data includes

Accepted Answer

complete insurance and emergency contact information

Question 19

What process does a patient’s health plan use to retroactively collect pymts from liability, auto or WC plans?

Accepted Answer

Subrogation

Question 20

Patients who join MCR advantage plan will not receive a health insurance card from the payer they select.    True or False

Accepted Answer

False

Question 21

What type of plan restricts benefits for NON emergency care

Accepted Answer

PPO (non emergency)

Question 22

The portion of the adjudicated claim that is due from patient is called the

Accepted Answer

Self Pay Balance

Question 23

True or False- Medicaid Eligible patients are required to join a Medicaid HMO plan

Accepted Answer

False

Question 24

The patient is covered by there own insurance and there spouse's plan which is primary

Accepted Answer

The Patients plan

Question 25

What form is used to bill Medicare Hospital Claims

Accepted Answer

UB-04

Question 26

What are two statutory exclusions from hospice coverage

Accepted Answer

Medically Unnecessary and Custodial Care

Question 27

Medicaid patients must meet two requirements for eligibility guidelines.

Accepted Answer

Income and Expense

Question 28

Managed Care plans do not permit balance billing except for what circumstance

Accepted Answer

Deductible and Copayments

Question 29

Every patient new to healthcare must be provided a copy of what

Accepted Answer

HIPPA

Question 30

What type of plan allows subscriber to pay lower premiums costs in return for higher deductibles

Accepted Answer

Consumer Directed Health Plan

Question 31

The Fixed amount due for a specific service is called a

Accepted Answer

Copayment

Question 32

What type of plan assumes the employer has direct responsibility and risk for healthcare claims

Accepted Answer

Self Insured Claims

Question 33

What is a document called that a PCP sends to an HMO pt to authorize visit to specialist

Accepted Answer

Referral

Question 34

Failure to complete authorization requirements is a valid reason for a payor to deny a claim True or False

Accepted Answer

True

Question 35

Why do managed care plans have agreements with hospitals, physicians, and other healthcare providers to offer a range of services to plan members

Accepted Answer

To reduce healthcare costs

Question	Answer
Scheduler instructions are used to prompt the scheduler to do what?	Complete the scheduling process correctly based on service requested.
What activities are completed when a schedule, pre-registered patient arrives for service	Activiting the record, obtaining signatures, and finalizing financial issues
What does scheduling allow the provider staff to do	Review the appropriateness of the service requested
What activities are completed when a scheduled, pre-reg patient arrives for service?	Activating the record, obtaining signatures, finalize financial issues
What are Non-emergency patients who come for service without prior notification to the provider called?	unscheduled patient
The revenue cycle begins with scheduling a patient for service and ends with what?	The archiving of the fully resolved account
1 registration record is being created for multiple days of service is what type of scheduling	Recurring or Series
The time needed to prepare the patient before service is the difference between the patient’s arrival time and which of the following?	Schedule time
What is the purpose of the initial step in the outpatient testing scheduling process	Identify the correct pt in the providers data base or add the patient to the data base
What type of information is typically collected during the scheduling contact	Patients name dob, sex, dx, requested test, or procedure, preferred DOS , ordering physician, and physician’s telephone number.
A patient who is admitted from the physician’s office on an urgent basis is what type of admission	Unscheduled
Why is it important to have high quality standards for registration	Because quality failures affect the provider’s Joint Commission results on a review day
What statement is NOT a possible consequence of selecting the wrong patient in the MPI (master patient index)?	Claim is paid in full
In addition to the members identification #, what information is recorded in a 270 transaction	Date of birth
What is the advantage of a preregistration program	It reduces processing times at the time of service.
What data are required to establish a new MPI (master patient index) entry	Patient’s full legal name, dob, sex
When screening a a beneficiary for possible MSP (Medicare secondary payer) situations, It is necessary to ask the patient each of the MSP questions. True or False	True
Comprehensive pre reg data includes	complete insurance and emergency contact information
What process does a patient’s health plan use to retroactively collect pymts from liability, auto or WC plans?	Subrogation
Patients who join MCR advantage plan will not receive a health insurance card from the payer they select. True or False	False
What type of plan restricts benefits for NON emergency care	PPO (non emergency)
The portion of the adjudicated claim that is due from patient is called the	Self Pay Balance
True or False- Medicaid Eligible patients are required to join a Medicaid HMO plan	False
The patient is covered by there own insurance and there spouse's plan which is primary	The Patients plan
What form is used to bill Medicare Hospital Claims	UB-04
What are two statutory exclusions from hospice coverage	Medically Unnecessary and Custodial Care
Medicaid patients must meet two requirements for eligibility guidelines.	Income and Expense
Managed Care plans do not permit balance billing except for what circumstance	Deductible and Copayments
Every patient new to healthcare must be provided a copy of what	HIPPA
What type of plan allows subscriber to pay lower premiums costs in return for higher deductibles	Consumer Directed Health Plan
The Fixed amount due for a specific service is called a	Copayment
What type of plan assumes the employer has direct responsibility and risk for healthcare claims	Self Insured Claims
What is a document called that a PCP sends to an HMO pt to authorize visit to specialist	Referral
Failure to complete authorization requirements is a valid reason for a payor to deny a claim True or False	True
Why do managed care plans have agreements with hospitals, physicians, and other healthcare providers to offer a range of services to plan members	To reduce healthcare costs

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