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TEST YOUR KNOW
Administrative Office Procedure
| Question | Answer |
|---|---|
| Which of the following is the commercial medical insurance intended to cover Medicare deductible, coinsurance and other non-covered items. | MEDIGAP |
| What is the birthday rule? | A method used to determine primary insurance carriers on dual enrolled minors |
| A person covered under the primary insured's policy is known as a ? | (220) DEPENDENT |
| Define PREAUTHORIZATION? | (220) Obtaining approval for a service through the individuals insurance company by establising that it is a medical necessity. |
| What is PREDETERMINATION mean? | Process of ascertaining the amount the insurance carrier will pay for a specific service. |
| What does PRECERTIFICATION mean? | Process of determining whether a service is covered under the insured person's plan |
| What is a PREEXISTING CONDITION? | A diagnosed and treated health condition that the patient had before obtaining insurance. |
| The dollar amount the insured person pays for the insurance coverage is known as the | DEDUCTIBLE |
| The authorization given to an insurance company to send insurance payments directly to the provider is known as the | ASSIGNMENT OF BENEFITS |
| Who does MEDICARE PART A provide coverage for? | (224) HOSPITALIZATION |
| A hospital payment system that categorizes patients by diagnosis and treatment is referred to as? ICD-CPT-UCR-HCPCS-DRG | (227) Diagnosis-Related Groups are establised by a comparison of patients with medically related diagnoses or treatmetns |
| The pages of the medical record contained within the patients file are the property of the _______? | PHYSICIAN |
| The method of filing used when documentation is placed in order based on the date of occurence is? | Chronological Order |
| When using the SOAP method of charting, which of the following belongs to the O section?a)CC:headache b) order of an ECG c) BP:127/82 D) Request for follow-up appointment | BP: 127/82 O = OBJECTIVE |
| What is the GOLDEN RULE of documentation: | If it is not documented, it was not done |
| To correct an error in a patients chart, the MA should do what? | Date and sign the corrections |
| The "P" in the SOAP method of the charting stands for what? | Plan for tests and treatments |
| The medical assistant should attempt to answer all incoming telephone calls by how many rings? | BY THE THIRD RING |
| The primary purpose of screening telephone calls is to? | Manage the physicians time by referring only necessary calls |
| Yahoo is an example of a/an ______? | SERACH ENGINE |
| Which item describes the action of arranging information in an electronic file to make the document easier to read? EDITING - FORMATTING - SAVING - PRINTING | FORMATTING |
| Which manaual identifies procedural codes for submitting insurance claims? | CPT |
| The PEGBOARD system of accounting generates the what type of documents: | RECEIPT |
| Insurance that provides protection for wage earners and pays for medical care resulting from occupational accident is called what? | Workers Compensation |
| The daily summary of what remains unpaid on the patient accounts is called? | Accounts Receivable |
| The system used for classifying diseases to facilitate collection of health and information is | ICD-9-CM = INTERNATIONAL CLASSIFICATION OF DISEASE |
| Following the indexing rules for filing, which of the following names comes first? McWilliams - McCally-Mahill-MacHall | MacHall |
| To insure mail delivery the next day, you would send correspondence via what type of mail? | Express Mail |
| Which of the following does DEBIT mean? a) Total b)Subtract c)Charge d)subtotal e)balance | CHARGE - You are POSTING a CHARGE to an account |
| The potion held back from payroll checks for the purpose of paying goverment taxes is known as? | WITHHOLDINGS |
| Which of the following is a 3rd party health plan that is funded by the federal goverment? a)Blue cross and blue shield b)humana c) aetna d) TRICARE e) cigna | TRICARE (aka: CHAMPUS) |
| If a policy holder of a 80/20 plan had foot surgery for a total of $3,600.00. How much of this bill is the subscriber responsible for? | 3600 + 20% = $720.00 |
| An authorization to the insurance company to make payments directly to the physician is called ______? | Assignment of benefits |
| If a child is covered by both parents insurance and the total medical charges come to $365.00 and 280.00 is covered by the primary insurance, how are the rest of the charges handled. | A claim is submitted to the secondary insurance for the difference |
| If a Par-provider's charge for a service is $65.00 and the allowed charge is $50.00. How much does the patient pay? | $65-$50.00= $15.00 |
| Which of the following are the 3 parts of a contract? a)Confidentiality, acceptance,liability b) consent,examination,payment c)offer,acceptance,consideration d)Participation,acceptance,consideration | C) OFFER - ACCEPTANCE - CONSIDERATION |
| Select the best way of ending a telephone conversation? a)bye-bye b)talk to you later c)so long d)until next time e)good bye | Good Bye |
| You are alone working in a busy front office. You are speaking on the telephone when the 2nd incoming line starts to ring. What would be your next step? | Ask the 2nd caller the nature of the call, his/her name and if they can be placed on hold. |
| What does ARBITRATION refer to? | An alternative way of resolving malpractice disputes out of court |
| The Health Insurance Portability and Accountability Act HIPPA) became federal law in what year? | 1996 (pg 43) |
| What does HIPPA outline? | What is considered confidential information |
| Define NEW PATIENT | One who has never recieved professional care by the physician |
| What is an ESTABLISHED PATIENT? | One who has been seen within 3 years |
| What is TRUE WAVE APPOINTMENTS SCHEDULING? | A flexible schedule system where patients are seen on the hour |
| What is Clustered Appointment Scheduling | Scheduling system in which a block of time is set aside for patient with similar conditions. |
| What is STREAM APPOINTMENT SCHEDULING | This gives patients a specific appointment time |
| The acronym CHEDDAR is what? | Documentation format of a patients encounter |
| What does CHEDDAR stand for | C= Chief Complaint , H = History, E= Exam, D = Detailed Problem, D= Drugs and Dosages, A = Assessment, R = Retrun visit info or referral |
| A business letter in which all lines start flush with the left margin is called what? | BLOCK STYLE |
| A letter with an "Open Puntuation", is one that ____? | NO PUNCTUATION IS USED |
Created by:
kimber954
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