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| Question | Answer |
|---|---|
| Putting oneself in another person's situation describes the quality of | empathy |
| Making a point in a straightforward manner shows the quality of | assertiveness |
| To use time and other resources to avoid waste and complete work in a timely manner | efficiency |
| Healthful habits, good grooming. and appropriate dress on the fob exhibits the quality of | professional image |
| Appearing on time for an appointment shows the quality of | punctuality |
| Greeting patients in the medical office is an example of which type of work | records management |
| The most common place of employment for an administrative medical assistant is | a physician practice |
| The quality that is involved in performing tasks with complete correctness is | accuracy |
| Three personal, attributes needed by an administrative medical assistant are | genuine liking of people, cheerfulness, and empathy |
| The profession of medical assisting has | ethical standards |
| The following is a not legal requirement for physicians | obtain recovery for all patients |
| The following is a legal responsibility of physicians | perform to the best of their ability |
| A physician who wishes to end a relationship with a patient must | notify the patient of this decision and give the patient a reasonable amount of time to find another physician |
| Making false statements to patients about the benefits of a particular drug is and example of | fraud |
| Safeguards against litigation include | exercising complete confidentiality, not discussing a patient's condition, and obtaining proper authorizations for release |
| The following term describes a computer designed to store massive databases | mainframe |
| The following terms describes a mid-level computer that is not as expensive as a mainframe, while offering many similar features | minicomputer |
| Monitors and printers are examples of | output devices |
| A program used to display moving images on the screen if no input is received for a period of time is called a | screen saver |
| What type of software is used to periodically search for the presence of programs intended to destroy data | virus checker |
| To determine whose condition requires immediate medical attention,assistants use a process called | triage |
| What steps should be completed before placing an outgoing call | gather the necessary information, outline the question to ask, and have important papers at hand |
| The files of medical records for patients who are currently seeing the physician are called | active files |
| Files of patients who terminated their relationship with physician are called | closed files |
| The correct order of the steps in filing is | inspecting, indexing, coding, sorting, and storing |
| The proper order for indexing individual names is | surname, given name, middle name |
| Hyphenated names are indexed as | one unit |
| The traditional method of paying physicians, in which payment is made after services are provided, is | fee-for-service |
| The HCPCS codes are used for | Medicare claims |
| The abbreviation PPO stands for | preferred provider organization |
| The abbreviation PCP stands for | primary care physician |
| A provider is a | physician or other health care professional |
| Fee-for-service payments are made in which type of insurance plan | indemnity |
| The RBRVS scale is used in which program | Medicare |
| Reference that contains diagnosis codes | ICD |
| The insured may be | the person who owns an insurance policy, the spouse of the person who owns an insurance policy, the dependent of the person who owns an insurance policy |
| Capitation payments are made in what type of insurance plan | managed care |
| Which type of ICD code is used for factors that affect health status when there is no diagnosis or disease, such as for annual exams | V codes |
| The administrative medical assistant calculates the total due for a patient visit based on the | patient encounter form |
| Billing software generates what daily report to show all charges, payments, and adjustments for that day | day sheet |
| The process of comparing the balance on the practice's monthly bank statement with the checkbook balance is called the | bank reconciliation |
| When charges for services are recorded as income when the payment is received, rather than when the bill is sent out, what accounting method is being used | cash |
| Salaries paid to employees are | direct earnings |
| Benefits and amounts paid to employees for other than salaries are | indirect earnings |
| When the employer and employee pay the FICA amount, what percentage is paid by the employer | 50 percent |
| A document that outlines a meeting's location,time,date, and topics is | an agenda |
| A document that lists the daily schedule for a traveler is | an itinerary |
| A document that is official record of a meeting is | meeting minutes |
| Office management tasks include | making travel arrangements, editorial research projects, policy and procedures manual, and patient information materials |
| A description of the services offered by the practice is found in the | patient information brochure |
| The RBRVS fees are usually_____than UCR fees | lower |
| Under RBRVS, the nationally uniform relative value is based on | the provider's work,practice cosr, and malpractice insurance costs |
| The purpose of the GPCI is to account for | regional differences in costs |
| What is the main methods payers use to pay provider | allowed charges, contracted fee schedule, and capitation |
| If a provider's charge is higher than the allowed amount, the provider's reimbursement is based on | the amount allowed |
| If the provider's charge is lower than the allowed amount, the reimbursement is based on | the amount billed |
| The medicare allowed charge for a procedure is $150, and a PAR provider's usual charge is $200. What amount must the provider write off? | $50 |
| The Medicare allowed charge is $240 and the PAR provider's usual charge is $600. What amount does the patient pay? | $48 |
| The deductibles, coinsurance, and copayments patients pay are called their | out-of-pocket expenses |
| If a nonparticipating provider's usual fee is $600, the allowed amount is $300, and balance billing is permitted, what amount is written off? | $0 |
| A physician practice that uses a billing service to send its claims is the | pay-to-provider |
| On a HIPPA claim, which of these is assigned to a claim by the sender | claim control number |
| The provider who provides the procedure on a claim if other than the pay-to-provider is called the | rendering provider |
| A physician's state license number is an example of a(n) | secondary identification number |
| The payer's processing of claims is called | adjudication |
| A payer's automated claim edits may result in claim denial because of | lack of eligibility for a reported service, lack of medical necessity, lack of required preauthorization |
| When a claim is pulled by a payer for a manual review, the provider may be asked to submit | clinical documentation |
| If a provider has accepted assignment, the payer sends the RA to | the provider |
| If the provider has not accepted assignment, the payer sends the payment to | the patient |
| The advantages of EFT for practices is | funds are available immediately and the transfer is less costly than check deposits |
| What document is used by the medical insurance specialist to update the patient billing program with the payer's payments and the amount due from the patient? | RA |
| Which HIPAA transactions is used by medical offices to ask payers about the status of submitted claims | 276 |
| Which of these HIPAA transactions is sent by a payer to answer a question about a submitted claim? | 277 |
| Which of these HIPAA transactions is sent by a payer to explain a claim payment? | 835 |
| The federal law that protects companies which set up employee health and pension plans is know as | ERISA |
| The health insurance program for federal government employees is | FEHBP |
| Eligible members of a capitated plan are listed on the | monthly enrollment list |
| The terms of an insurance contract can be modified in a | rider |
| Stop-loss provisions protect providers against | extreme financial loss |
| Which section of a manged care participation contract covers balance-billing rules? | compensation and billing guidelines |
| A plan pays 50 percent of the provider's usual charge and requires the copayment of $5 to be applied toward the provider's payment.What does the plan pay the provider when the usual charge is $200? | $95 |
| What percentage of the fee on the Medicare Fee Schedule is the limiting charge? | 115 percent |
| Anyone over age 65 who receives Social Security benefits is automatically | enrolled in Medicare Part A and eligible for Medicare Part B |
| A report that lists charges, payments, and adjustments during a day is known as a | day sheet |
| Monies coming into the practice are | accounts receivable |
| Diagnosis codes are | ICD |
| When a new patient comes in for an office visit, he or she is asked to complete a(n) | patient information form |
| Electronic information created or received by a health care provider that can be used to identify a person is | protected health information (PHI) |
| An encounter form is also known as a | superbill |
| The fixed amount paid to providers under a managed care plan is known as | capitation |
| The following is not an advantage of using electronic claims instead of paper claims | increased data security |
| The use of computers in the medical office has led to significant increases in productivity, primarily because computers | process large amounts of information more efficiently |
| The electronic claim format used to bill for a physician's services is known as | 837P |
| A document given to a patient at the conclusion of an office visit if a payment has been made is called a(n) | walkout statement |
| Transactions are entered in Medisoft via the | Activities menu |
| The Medisoft menu bar contains______menus | 9 |
| A patient's assigned provider is designated in the ______ tab | Other information |
| The following is not an acceptable chart number in Medisoft | SANDRO.0 |
| The status field in the Other information tab of the Patient Guarantor dialog box is used to indicate whether the patient | is employed or in school |
| The following is the correct chart number for Daniel HO? | HODANIE0 |
| Codes assigned to employers in the Address dialog box must be no more than____characters in length | five |
| The designation of an individual as a patient or guarantor is made in the following field in the Patient/Guarantor dialog box | Type |
| There are___tabs in the case folder | eleven |
| The case number is located in the____tab of the Case folder | Personal |
| Up to_____diagnoses codes can be entered in one Medisoft case, | four |
| A TRICARE sponsor is | an active-duty armed services member |
| To create a new case for an existing patient, the______command is used | Copy Case |
| If a patient's treatment is only authorized through a certain date, this date is entered in the_____tab of the Case folder | Account |
| The abbreviation TOS stands for | type of service |
| If a CPT code does not appear in the drop-down list n the Procedure field, it can be added to the database quickly by pressing the____key and entering the new code number and description | F8 |
| The total field in the Carges section of the Transaction Entry dialog box is the result of multiplying the number in the Amount field by the number in the | Units field |
| New Multilink codes can be created by selecting an option on the | lists |
| The Pay code drop-down list indicates | the type of payment made, such as cash, check, etc |
| The Apply Payment to charges dialog box contains information about all___charges for a patient | unpaid |
| The choices in the Payment Method field in the Deposit dialog box include cash, credit card, check, and | electronic |
| Payment methods that can be selected in the Deposit dialog box include check, cash, credit card, or | electronic |
| The following are buttons in the Patient Recall List dialog box | Edit, Sort by, and Search |
| In the New Break Entry dialog box_____lists the types of breaks already created in Medisoft | Resource |
| In Office Hours, the Go to a Date shortcut button displays options for searching for an appointment a number of days, weeks, months, and_____in the future | years |
| A condition that data must meet to be included in a selection is known as a | filter |
| The following is not an option in the Claim Status list in the List Only Claims that Match dialog box | Denied |
| The report that can be displayed to check electronic claims before transmitting them is called a(n) | Batch Verification report |
| If an electronic claim requires an attachment, where is this noted in Medisoft | Diagnosis Tab of Case dialog box |
| The Status column in the Statement Management dialog box can indicate Ready to Send,Sent,or | Done |
| The Type column in the Statement Management dialog box can contain either Standard or | Remainder |
| In this type of billing system, patients statements are created and sent on a staggered basis rather than all at once | cycle |
| A condition that must be met n order for data to be included in a selection is called a | filter |
| the following is not a category on the patient aging report | 91-120 |
| A______report lists the financial activity in a patient's account | patient ledger |
| On a procedure day sheet report, procedures are listed in___order | numerical |
| Medisoft provides three insurance aging reports: primary,secondary,and | tertiary |
| The Practice Totals section of a Practice Analysis report lists total charges, payments, adjustments, and | procedures |
| Medisoft's file maintenance utilities are accessed via the____menu | File |
| In the United States, rising medical costs are due to | increased spending on drugs,increased use of alternative treatments and advances in technology |
| A capitated rate is called a | prospective payment |
| Under a capitated rate for each plan member, the following the provider share with the third-party payer | risk |
| Patients who enroll in an HMO may use the services of | only HMO network providers |
| Patients who enroll in a point-of-service type of HMO may use the services of | HMO network or out-of-network providers |
| The four models of health maintenance organizations are | staff,group,IPA,and POS |
| The following characteristics is most important when medical insurance specialists work with patients' records and handle finances | honesty and integrity |
| When medical insurance specialists work with patient billing programs, they need | computer skills |
| The title of Certified Coding Specialist (CCS) and Certified Coding Specialist-Physician based (CCS-P) is awarded by | AHIMA's Society for Clinical Coding |
| The statement that "coding professionals should not change codes, so that meanings are misinterpreted" is an example of | professional ethics |
| The employment forecast for well-trained medical insurance and coding specialists is | increasing opportunities |
| The following is the correct order for documentation | CC, history and exam, diagnosis, and treatment |
| The following represents the correct format for recording dates on patient information and claims forms | MM/DD/YY |
| The following claims-processing steps is the payer's decision about paying claims made | adjudication |
| Libel is what type of information | written |
| A court order to appear, testify, and bring specified documents or items is a | subpoena duces tecum |
| Information about a patient must be kept confidential because | it is the physician's duty to do so and the information is potentially harmful to the patient |
| The cross-reference See in the ICD-9-CM means that the coder | must refer to the term that follows |
| The term Blackfan-Diamond anemia is an example of a(n) | eponym |
| How many codes does the entry Cataract,myotonic 359.2[366.43] in the ICD-9-CM's Alphabetic index require | two codes |
| A condition that arises because of an injury or illness in the patient's medical history is called a(n) | late effect |
| An adverse effect is the result of | unintentional poisoning |
| What is the main term in the diagnostic statement "localized salmonella infection,unspecifeid"? | salmonella |
| The diagnostic statement is "patient has found a mass in the upper quadrant of the left breast; carcinoma is suspected and an immediate workup is scheduled." What main term is coded? | mass |
| In the diagnostic statement "tuberculous rheumatism," which is the main term? | tuberculous or rheumatism |
| In CPT-4, what procedure is bundled with the arthroscopy in the following entry? 29860 Arthroscopy, hip, diagnostic with or without synovial biopsy | a synovial biopsy |
| Durable medical equipment (DME) such as wheelchairs covered by the Medicare program are reported using | HCPCS codes |
| Under CPT-4's definition, after a referral, who takes responsibility for the patient's care? | the physician to whom the patient is referred |
| Routine annual physical examinations are reported using CPT-4's | Preventive Medicine Services codes |
| What is required of the physician in order to report the professional component of a CPT-4 code from the Radiology section? | reading the radiological examination and writing a report of interpretation |
| If a payer judges that too high a code level has been assigned by a practice for a reported service, the payer may | downcode the reported procedure code |
| What type of audit is performed internally before claims are reported? | prospective audit |
| What document is received before a retrospective audit of a claim is performed? | explanation of benefits from the payer |
| Which member of the medical practice is ultimately responsible for proper documentation and correct coding? | physician |
| Some possible consequences of inaccurate coding and incorrect billing in a medical practice are | denied claims and reduced payments, prison sentences, and fines |
| A provider billing the Medicare program for a cosmetic procedure intended to enhance the patient's appearance is a possible situation of | downcoding |
| Which is not a characterisitic of correctly linked codes? | the procedure codes have correct modifiers |
| An important part of a compliance plan is a commitment to keep both physicians and medical office staff current by providing | ongoing training |
| A medical practice's signature log shows the legal name, credentials, and signature of each person who | makes entries in patient medical records |
| The statement,"All entries in the medical record must contain the author's identification" is from the NCQA's | Documentation Guidelines |
| In urinalysis, bilirubin in the urine may indicate disease of the | Liver |
| A renogram is used to study the function of the | Kidney |
| The artificial maintenance of kidney function is | Dialysis |
| Cystitis is an inflammation of the | bladder |
| Kidney failure may result in | uremia |
| A diuretic can reduce | edema |
| Lactation occurs | after birth |
| A Pap smear can detect | cervical cancer |
| Excessive menstrual bleeding is | menorrhagia |
| A sexually transmitted disease is | gonorrhea, syphilis, and chlamydia |
| Sperm are produced in the | testes |
| Impotence is | the inability to maintain an erection |
| Tests for prostate cancer include a | urethrogram, PSA, and DRE |
| The solid part of blood contains | red blood cells, white blood cells, and platelets |
| One type of plasma protein is | fibrinogen |
| Eosinophils stain is | bright red |
| A type of bleeding disorder is | thrombocytopenia |
| Genetic characteristics provide | natural immunity |
| Metastasis means | a disease has spread |
| A lymphadenectomy is the | removal of a lymph node |
| The alimentary canal includes the | esophagus |
| The taste buds are contained in the | papillae |
| The liver secretes | bile |
| Antiemetics relieve or prevent | regurgitation |
| Calcitonin is secreted by | thyroid cells |
| Acromegaly is an abnormality of the | pituitary glands |
| Symptoms of diabetes include | polydipsia and polyuria |
| The cornea | has no blood supply and is transparent |
| Hearing can be damaged at or above | 130dB |
| The urinary is also known as the renal or | excretory system |
| The inner portion of the kidney is the | medulla |
| Painful urination is | dysuria |
| Pus in the urine is | Pyuria |
| The 40 weeks of fetal development are known as | gestation |
| Cryptorchism is a birth defect in which one or more of the testicles has failed to | descend |
| The cells in blood that destroy foreign substances are | Leukocytes |
| The fluid that circulates through the lymph system is | lymph |
| Hormones released by the hypothalamus have either a releasing or a(n) | inhibiting factor |
| The inner portion of each adrenal gland is the adrenal | medulla |
| The pancreas helps maintain proper levels of blood | glucose |
| Hypoadrenalism is also known as | Addison's disease |
| The nervous tissue in the retina is called the | neuroretina |
| Taste buds are contained within | papillae |
| Deviation of one eye outward is | exotropia |
| The cell includes the | cell membrane, nucleus, and cytoplasm |
| Tendons are type of | connective tissue |
| The middle layer of skin is called the | corium and dermis |
| alopecia may result from | chemotherapy, heredity, and disease |
| Exocrine glands | secrete outward |
| A test for tuberculosis is the | Mantoux test |
| A type of secondary lesion is a(n) | crust |
| A type of vascular lesion is a(n) | ecchymosis |
| German measles is a rashed caused by | rubella |
| Chicken pox is a rash caused by | varicella |
| A type of vascular disorder is | rosacea |
| Herpes viruses can cause | cold sores, fever blisters, and shingles |
| The overproduction of sebum can cause | seborrhea |
| A graft that uses skin from one's own body is a(n) | autograft |
| Red blood cells start to develop in | bone marrow |
| The spinal column includes the | lumbar vertebrae |
| The bones of the extremities include the | femur, tibia, and patella |
| The mandible is a bone that forms the | jaw |
| A type of bone operation is a(n) | osteoplasty |
| Compression fractures usually occur in the | spine |
| A type of musculoskeletal injury is a(n) | sprain |
| The cardiovascular system includes | coronary circulation, pulmonary circulation, and systemic cirulatior |
| A myocardial infarction is also known as a(n) | heart attack |
| A type of surgery on blood vessels is an | endarterectomy, arteriotomy, and angioplasty |
| The outer covering of the heart is the | pericardium |
| Fatty substances are also known as | lipids |
| Diuretics are used to treat | hypertension and edema |
| The point at which the trachea divides is known as the | mediastinum |
| Most of the thoracic cavity is occupied by the | lungs |
| Tapping over the lung area to see if the lungs are clear is called | percussion |
| Hiccuping is also known as | singultus |
| Abnormally fast breathing is | tachypnea |
| Asthma can be caused by | anxiety, allergy and infection |
| Pneumonia is a general term for infection of the | alveoli |
| A part of a neuron is a(n) | dendrite, cell body and axon |
| Amino acids are neurotransmitters that | excite brain activity |
| A type of neuroglia that is a phagocyte is a(n) | microglia |
| A symptom of Alzheimer's disease is | amnesia, apraxia, and agnosia |
| A neurological symptom is | paralysis |
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