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Administrative Office Procedure

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