AHL 110 Final Exam
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| What is "cash flow" in a medical practice? | show 🗑
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| show | Completion of an accredited program for coding certification.
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| Medical etiquette refers to: | show 🗑
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| Medical ethics refers to: | show 🗑
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| The earliest written code of ethical principles for the medical profession is the: | show 🗑
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| Confidential information includes: | show 🗑
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| What is the correct response when a relative calls asking about a patient? | show 🗑
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| show | City of residence.
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| Exceptions to the right of privacy rule include: | show 🗑
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| Confidentiality is automatically waived in cases of: | show 🗑
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| Most physician/patient contracts are: | show 🗑
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| show | The physician and the patient.
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| show | A person younger than the age of 18 who lives independently.
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| show | To prevent duplication or overlapping of payments for the same medical expense.
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| show | Pre-existing.
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| The SOAP in a patient medical record charting is defined as: | show 🗑
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| show | Has previously received professional services from a physician or another physician of the same specialty who belongs to the group practice within the past 3 years.
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| show | Right lower quadrant.
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| When is exclusion from program participation mandatory? | show 🗑
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| All of the following cases should NOT use fax transmission: | show 🗑
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| What level of education is generally required for entry into an insurance billing or coding specialist accredited program? | show 🗑
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| To ensure continuous cash flow, what is an ideal amount of time in which an insurance claim should be submitted? | show 🗑
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| show | Multiskilled health practioner.
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| show | Vicarious liability or respondeat superior.
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| show | Claims submission.
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| In 1980, the American Medical Association (AMA) adopted a modern code of ethics called: | show 🗑
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| Medical ____________ are not laws, but generally accepted standards of conduct. | show 🗑
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| One of the eight C's of effective caller service is Contagious. This means to: | show 🗑
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| Compliance is the process of: | show 🗑
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| show | E-health Information Management (eHIM).
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| An intentional misrepresentation of the facts to deceive or mislead another is called: | show 🗑
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| What is the primary purpose of HIPAA Title I: Insurance Reform? | show 🗑
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| show | Clearinghouse.
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| If a physician contracts with an outside billing company to manage claims and accounts receivable under HIPAA guidelines, the billing company is considered: | show 🗑
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| A confidential communication realated to the patient's treatment and progress that may be disclosed only with the patient's permission is known as: | show 🗑
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| The Office of Civil Rights enforces: | show 🗑
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| If you give, release, or transfer information to another entity, this is known as: | show 🗑
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| show | Avoided.
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| show | HMO.
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| show | For medical research, evaluation of hospital use, and for the process of tracking diseases.
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| What must be paid each year by the policy holder before the insurance policy benefits begin? | show 🗑
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| show | It affects the physician's level of reimbursement for inpatient claims, claims can be denied, and fines or penalties can be levied.
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| show | An encounter form.
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| The_______ is a concise statement describing the symptom, problem, condition, diagnosis, physician-recommended return, or other factor that is the reason for the encounter. | show 🗑
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| show | Annually, 3.
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| show | First.
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| show | Primary diagnosis.
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| The largest section in the CPT book is the: | show 🗑
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| show | 7-10 years.
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| show | Supporting documentation in the health record.
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| The chronologic recording of pertinent facts and observations about the patient's health is known as: | show 🗑
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| show | Defense of a professional liability claim and because insurance carriers require accurate documentation that supports procedure and diagnostic codes.
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| When a patient fails to return for needed treatment, documentation should be made: | show 🗑
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| How should an entry in a patient's medical record be corrected? | show 🗑
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| A diseased condition or state is known as: | show 🗑
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| What does comorbidity mean? | show 🗑
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| A new patient is one who: | show 🗑
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| Who may accept a subpoena? | show 🗑
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| show | Done.
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| show | Excluded.
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| show | Adverse affect.
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| The main code book used for reporting clinical information is called the: | show 🗑
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| What type of code may be used when two diagnoses or a diagnosis with a secondary process is present? | show 🗑
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| show | Poisoning.
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| show | Inpatient hospital coding.
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| show | Volumes 1 and 2.
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| What is the table that contains a classification of substances for identifying poisoning states and external causes of adverse effects? | show 🗑
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| Carcinoma in situ is used to describe: | show 🗑
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| show | New growths, may be malignant, and they may be benign.
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| The term "malignant" in relation to blood pressure means: | show 🗑
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| show | Sterilization.
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| Diagnostic codes have from ___ to ___ digits. | show 🗑
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| Always code to the highest degree of: | show 🗑
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| show | Fee schedule, usual, customary and reasonable, relative value of schedules.
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| show | Current Procedural Terminology.
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| show | Critical care.
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| Included in a global surgery policy and a surgical package is/are: | show 🗑
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| A clean claim: | show 🗑
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| show | Invalid claim.
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| show | Private insurance carriers, Medicaid and Medicare, and worker's compensation.
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| show | "N/A and DNA".
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| A(n) _______ claim is submitted to the insurance carrier via a CPU, tape diskette direct data entry, direct wire, dial-in telephone, or personal computer via modem. | show 🗑
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| show | Primary, secondary.
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| OCR guidelines for the CMS-1500 claim form state: | show 🗑
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| To conform to CMS-1500 OCR guidelines: | show 🗑
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| A health insurance claim form (CMS-1500) is known as the: | show 🗑
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| show | A physically clean claim form.
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| If you receive a request, accompanied with the correct authorization, asking to abstract medical information from a patient's medical record: | show 🗑
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| show | A dirty claim.
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| Office visits may be grouped on the insurance claim form if each visit: | show 🗑
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| show | Leave the blcok blank.
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| An electronic claims professor (ECP) is: | show 🗑
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| The brain of the computer is called: | show 🗑
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| show | Back up.
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| The most important function of a practice management system is: | show 🗑
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| show | The Internal Revenue Service
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| A clearinghouse: | show 🗑
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| A modem is a device used to: | show 🗑
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| The Health Insurance Portability and Accountability Act (HIPAA) does not establish guidelines for: | show 🗑
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| show | Superbill.
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| The insurance claim was rejected because of an incorrect modifier, so: | show 🗑
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| A group of insurance claims sent at the same time from on facility is known as a: | show 🗑
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| Insurance claims transmitted electronically are usually paid in: | show 🗑
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| Back-up copies of office records should be stored: | show 🗑
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| Assigning a code to represent data is known as: | show 🗑
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| A combination of letters, numbers, or symbols that each individual is assigned to access the computer system is called a/an: | show 🗑
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| show | Primary diagnosis.
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| show | Inpatient hospital coding.
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| When coding x-ray films taken of both knees, list: | show 🗑
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| The health insurance claim form (CMS-1500) is known as the: | show 🗑
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| The CPT publication is updated: | show 🗑
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| show | A physically clean claim.
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| show | Send only the th information requested.
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| show | Bundle.
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| A clearinghouse is a/an: | show 🗑
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| show | Accounts receivable.
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| If a payment problem develops with an insurance company and the company ignores claims and exceeds time limits to pay a claim, it is prudent to contact the: | show 🗑
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| show | Ask if there is a backlog of claims at the insurace office.
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| show | Provide the information.
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| show | Be less.
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| show | Redetermination.
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| How many levels of review exist for TRICARE appeal procedures? | show 🗑
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| What should be done to inform a new patient of office fees and payment policies? | show 🗑
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| show | Before any services are provided.
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| The reason for a fee reduction must be documented in the patient's: | show 🗑
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| show | Writing off the balance of an account after an insurance company has paid its portion.
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| When collecting fees, your goal should always be to: | show 🗑
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| Accounts receivable are usually aged in time periods of: | show 🗑
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| show | Dun messages.
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| A significant contribution to HMO development was the: | show 🗑
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| show | Prepaid health plan.
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| show | Salary paid by independent group.
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| In an independent practice association (IPA), physicians are: | show 🗑
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| show | Preferred Provider Organization (PPO).
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| When a physician sees a patient more thatn is medically necessary, it is called: | show 🗑
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| Referral of a patient recommended by one specialist to another specialist is known as: | show 🗑
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| What is the correct procedure to collect a copayment on a managed care plan? | show 🗑
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| show | Capitation.
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| Practitioners in an HMO program may come under peer review by a professional group called a: | show 🗑
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| show | The Centers for Medicare and Medicaid services.
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| show | Federal health insurance program.
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| Medicare provides a one-time baseline mammographic examination for women ages 35 to 39 and preventive mammogram screenings for women 40 years and older. | show 🗑
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| show | Every other year.
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| show | Eyeglasses and prescription drugs.
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| show | Identifies claims to review for medical necessity, and monitors the number of times given procedures can be billed during a specific time frame.
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| show | May act on the Medicare beneficiary's behalf as a client representative.
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| show | Post each patient's name and the amount of payment on the day sheet and the patient's ledger card.
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| show | Deposit the check and then write to Medicare to notify them of the overpayment.
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| show | Widow.
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| show | Set up the public assistance programs.
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| The federal Emergency Relief Administration made funds available to pay for: | show 🗑
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| The medically needy aged: | show 🗑
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| The federal aspects of Medicaid are the responsibilty of the: | show 🗑
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| show | State government with partial federal funding.
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| State children's health insurance programs (SCHIPs) | show 🗑
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| show | The blind, the diabled, the aged (65 and older).
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| show | The medicaid-allowed amount.
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| To control escalating health care costs by curbing unnecessary emergency department visits and emphasizing preventive care, Medicaid reform has involved. | show 🗑
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| show | Congress.
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| The health maintenance organization provided for dependents of active duty military personnel is called: | show 🗑
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