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NCCT Practice Exam
Medical Billing and Coding
| Term | Definition |
|---|---|
| Crime | An act that violates criminal law is called |
| Narcotic | What license must a physician have to dispense, prescribe, or administer controlled substances? |
| Non compos mentis | A Latin term signifying that a person is not of sound mind is |
| Breach of duty | Violation or omission of a legal or moral duty is called |
| Unethical | It is ________to deny treatment to an HIV infected patient. |
| Felony | A major crime for which greater punishment is imposed other than a misdemeanor is a |
| Incompetence | Lack of physical or mental fitness is known as |
| Coordination of Benefits | To prevent the insured from receiving a duplicate payment for losses under more than one insurance policy is called |
| Non-verbal communication | Body language, body posture, space and distance are all examples of |
| Outpatient | A patient receiving ambulatory care at a hospital or other health facility without being admitted as a bed patient is called an |
| Negligence | Failure to do something that a reasonable person would do under ordinary circumstances that ends up causing harm to another person or a person's property is |
| at the left hand margin | A business letter written in full block style will have all lines |
| Fax machine | What office instrument is designed to receive and send printed documents via the telephone? |
| Catastrophic | Health insurance that provides protection against the high cost of treating severe or lengthy illnesses or disabilities is called |
| Bioethics | The branch of study of moral issues, questions, and problems, arising in the practice of medicine and in biomedical research is called |
| Partial Disability | An injury that prevents a worker from performing one or more of the regular functions of his job would be known as a |
| Abandonment | The withdrawal of a physician from the care of a patient without reasonable notice of such discharge from a case by the patient is |
| Ethics | what are right and wrong |
| Res judicata | Latin for "things decided" that is, a matter already decided by judicial authority is called |
| Medicare | A health program for people age 65 and older under Social Security is called |
| False Imprisonment | Holding or detaining a person against his or her will is called |
| Health Maintenance Organization (HMO) | An organization that offers health insurance at a fixed monthly premium with little or no deductible and works through a primary care provider is called a |
| First | Business or handwritten mail that weighs less than 11 ounces is known as _______ class mail. |
| Deductible | An amount the insured must pay before a policy begins is called a |
| Claim | A request for payment under an insurance contractor bond is called a |
| Health Insurance Portability and Accountability Act (HIPAA) | is a federal regulation that requires health care professionals to protect the privacy and confidentially of patients health information. |
| Emancipated minor | A person who is no longer under the care, custody, or supervision of a parent is called an |
| Coding | The process of changing words into numbers so that computers can be used in processing insurance claims is called |
| Tri-Care | A civilian health and medical program of the uniform services is called |
| American Medical Association (AMA) Code of Ethics | The statement "A physician shall respect the law" is a part of the |
| Database Management System | A system whereby large quantities of data can be accessed, searched, sorted, and arranged very rapidly by computer is called a |
| Assault | An unlawful threat or attempt to do bodily injury to another is |
| Accident | An unexpected event which may cause injury is called |
| Breach of Contact | Failure to achieve an agreed upon result, even when the highest degree of skill has been used, is called |
| W-4 | The number of Employees Withholding Exemption Certificate is |
| Hardware | A computer monitor, hard drive, and printer are known as |
| Subscriber/policyholder | One who belongs to a group insurance plan is called |
| Delete | The computer key DEL command means |
| Time Limit | A notice of insurance claim or proof of loss must be filed within a designated ____________ or it can be denied. |
| Assignment of Benefits | An agreement by which a patient assigns to another party the right to receive payment from a third party for the service the patient has received is called |
| Worker's Compensation | A form of insurance paid by the employer providing cash benefits to workers injured or disabled in the course of employment is called |
| Usual, Customary and Reasonable | Insurance plans that pay a physician's full charge if it does not exceed his normal charge or does not exceed the amount normally charged for the service is called |
| Speak loudly | When caring for patients with physical disabilities, which of these is not an appropriate consideration for most? |
| Invasion of privacy | A violation of a person's right not to have his or her name, photograph, or private affairs exposed of made public without giving consent is |
| Colon | When caring for patients with physical disabilities, which of these is not an appropriate consideration for most? |
| Res gestae | Latin for "things done;deeds", the facts and circumstances attendant to the act of question would be called |
| October 1 - September 1 | The Tri-Care fiscal year is from |
| Reasonable Care | The health worker is protected by law if it can be determined that he or she acted reasonable as compared with fellow workers. This is called |
| Law | A rule of conduct made by a government body is |
| Medical etiquette | Conduct, courtesy, and manners that are customarily used in a medical office by medical professionals are known as |
| Breach of Confidentiality | Which of these generally results from an act of carelessness, without an intent to harm? |
| Medical Grievance Committee | An impartial panel established to listen to and investigate patient's complaints about medical care or excessive fees is called a |
| Third | An incoming call should be answered by the _______ ring. |
| Provider | A person or institution that gives medical care is a |
| Res Ipsa Loquitur | The presumption or inference of negligence when an accident is otherwise unable to be explained in terms of ordinary and known experience is called |
| Thirds faced-up | A letter should be folded in ___________ using a #10 envelope. |
| Hospital benefits | Payment for hospital charges incurred by an insured person because of injury or illness is called |
| Fourth | Parcel post or ___________ class mail is used for bound printed matter, film, and sound recordings. |
| Extended Care Facility | A skilled nursing facility for patients receiving specialized care after discharge from a hospital is called |
| Forgery | A fraudulent signature is called |
| Gunshot wound | A physician must have the patient's permission in writing to reveal any confidential information except for which of the following? |
| Deposition | Testimony of a witness under oath and written down before trail for possible use when the case comes to trail is |
| Insurance agent | An agent of an insurance company who solicits or initiates contracts for insurance coverage and services, and is the policyholder for the insurer is called |
| Suspension | To interrupt or discontinue a suit temporary with the intention or resumption at a later date, or ask for a continuance is called a |
| Indemnities | Benefits that are made in the form of cash payments are known as |
| Take all complaints seriously | When handling a patient complaint which one of the following would be most appropriate? |
| Adjuster | A person who represents either party of an insurance claim is the |
| Caller's driver license number | Which one of the following items is not needed when taking a routine phone message? |
| Premium | Payment made periodically to keep an insurance policy in force is called a |
| Fee-of-Service | A method of charging whereby a physician presents a bill for each service rendered is called |
| Negligence | The most common type of medical tort liability is |
| Subpoena | A writ that commands a witness to appear at a trail or other proceeding and to give testimony is a |
| Contributory negligence | A patient's failure to act prudently and reasonably, or doing that which a reasonable person would not do under similar circumstances is called |
| Ask the caller if you may put the caller on hold | Before placing a telephone caller on hold it is appropriate to |
| Grammar | is the study of words and their relationship to other words in a sentence. |
| Comprehensive | In insurance, greater coverage of diseases or an accident, and greater indemnity payment in comparison with a limited clause is called |
| Dread disease rider | A rider added to a policy to provide additional benefits for certain conditions is called |
| Move the cursor, right, left, up and down | The computer's directional arrow keys |
| Peer review | Medical research is often published in medical journals that are evaluated by members of the medical community through a process known as |
| Software | The term for the technology that tells a computer what to do is known as the |
| How easy the system is to the user | Referring to computers, the term "user friendly" refers to |
| Privileged Communication | Information given by a patient to medical personnel which cannot be disclosed without consent of the person who gave it is |
| Defamation | Injuring the name and reputation of another person by making false statements to a third person is |
| Third | A newsletter that weighs less than one pound would be considered __________ class mail. |
| Ethics | Right or wrong conduct is known as |
| Empathy | The ability to see things from another person's point of view is |
| Respondeat superior (let the master answer) | Responsibility of an employer for the acts of an employee is |
| Civil law | A statue that enforces private right and liabilities, as differentiated from criminal law is called a |
| Backup | Making a duplicate file to protect computer information from being lost is called making a |
| Judgement | The final decision of a court in an action or suit is |
| Benefits | A sum of money provided in an insurance policy, payable for covered services is called |
| Explanation of benefits | A recap sheet that accompanies a Medicare or Medicaid check, showing breakdown and explanation of payment on a claim is called |
| Consent | Permission granted by a person voluntarily and his right mind is |
| Co-payment | A type of insurance whereby the insured pays a specific amount per unit of service and the insurer pays the rest of the cost is called |
| Grace period | An interval after a payment is due to the insurance company in which the policy holder may make payments, and still the policy remains in effect is called |
| Plaintiff | One who institutes a lawsuit is |
| Will | A legal statement of how an individual's property is to be distributed after death is |
| Participating Physician | A doctor who agrees to accept an insurance companies pre-established fee as the maximum amount to be collected is called |
| Show respect to their culture | When working with patients from a culture different than your own, one should |
| Defendant | A person being sued is called the |
| Fraud | An intentional perversion of truth for the purpose of inducing another in reliance upon it to part with some valuable thing belonging to him or to surrender a legal right is called |
| Assumption of risk | Consent to treatment based on full understanding of all possible risks of unpreventable results of that treatment is called |
| Coinsurance | When a patient has health insurance; the percentage of covered services that is the responsibility of the patient to pay is known as |
| Expert testimony | A statement given concerning some scientific, technical, or professional matter by an expert, such as a physician is called |
| Admission | Under the Peer Review Improvement Act of 1982, Peer Review Organizations are responsible for the review for appropriateness and necessity of putting a patient into the hospital by a process known as ___________ review. |
| Battery | A deliberate physical attack upon a person is called |
| Proximate cause | That which in natural and continuous sequence, unbroken by any new independent cause, produces an event and without which the injury would not have occurred is called |
| Breach | The breaking of a law, promise, or duty is called |
| Smile | Prior to answering an incoming call the medical assistant should |
| Preexisting Condition | A previous injury, disease or physical condition that existed before the health insurance policy was issued is called |
| Health Insurance Portability and Accountability Act (HIPAA) | In the health care field the acronym HIPAA stands for |
| Statue of Limitations | The time established for filing law suits is |
| Tort | A wrong committed against another person or the person's property is a |
| Contract | An agreement between two or more parties for the doing or not doing of some definite thing is |
| Invasion of privacy | Unauthorized disclosure of information regarding any patient to a third party may result in |
| Major Medical | Insurance that is meant to offset medical expenses resulting from a catastrophic illness is called |
| Medigap | Policies that supplement Medicare. Can not have if patient has Medicare Part C |
| Government Employees | Who is covered under federal Blue Cross Blue Sheild? |
| Auto-mobile insurance | What is no-fault? |
| Contract between individual and insurance company individual pays premium and insurance agrees to compensate for loss | What is an automobile insurance policy? |
| Unions usually pay most of premium of insurance | Who is covered under group health insurance? |
| Group and individual | Two types of commercial insurance |
| Medicare, Medicaid, and Tricare | What are three government health plans? |
| Active Military and their dependents | Who is covered under Tricare? |
| Medicare | Which insurance covers individuals 65 & older, Disabled, End Stage Renal Disease (ESRD), and Lou Gehrig's (ALS)? |
| Medicaid | Which insurance covers low income, disabled patients, and their dependents? |
| Blue Cross Blue Shield | Which insurance covers hospitalization? |
| Advanced Beneficiary Notice | form patient signs that will require them to pay for services not covered by Medicare |
| Part A-Hospital Part B-Outpatient Physicians Part C-Medicare Advantage Plans Part D-Prescriptions | What are the four parts of Medicare? |
| Medicare Advantage Plan | Combination of Part A &B under commercial insurance that follows Medicare guidelines |
| Medicare Benefit Period | Begins 1st day of hospitalization |
| Hospice | care provided to terminally ill patients |
| Defensive Enrollment Eligibility Reporting System (DEERS) | Database of military for military personnel and their dependents for healthcare. |
| CHAMPVA | coverage for veterans and their dependents who have been disabled in the line of duty |
| Dual Eligible (Medi/Medi) | Medicare as primary and Medicaid as secondary insurance |
| Medicaid | is jointly funded by federal and state government but each state administers its own Medicaid program |
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