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NCCT Practice Exam

Medical Billing and Coding

TermDefinition
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
Created by: KyNewsom