What
is a benefit?
a. It is the function that a product
performs
b. It is what a feature does for a
product
c. It is the additional profits
earned by a company
d.
It is the discount that a customer gets on a product
Which
of the following are required to organize your office as a medical biller?
a. Computer
b. CMS- 1500 forms
c. Printed/ online coding resources
d. Patient statement forms
e.
All of the above
What
is not a part of the diagnosis information?
a. Macro Code
b. Description
c. Insurance Information
d. Gender Specific Indication
e. ICD9
Which
of the following is not a feature of Managed Care Plans?
a. Charging a nominal fee from the
members
b. Eradicating unwanted services
c. Charging a standard fee for
healthcare provider and hospital services
d. Itemizing each service and
charging to the patient's account
Which
are the disclosures exempted from minimum necessary?
a. Permissive Disclosures
b. Disclosure of Protected Health
Information
c. Disclosure of de-identified
information
d. None of the above
Which
of these is not a kind of third-party reimbursement?
a. Fee-for-service
b. Capitation
c. Episode of Care
d. Managed care plans
What
do the CPT codes refer to?
a. The disease that the patient is
suffering from
b. The diagnoses performed on the
patient
c. The procedures performed by a
physician or a practitioner
d. The names of the medicines
prescribed by the practitioner
What
is an accident rider?
a. A 100% coverage that is not
subject to co-payment or deductible in the event that the patient seeks
emergency treatment
b. The amount of out-of-pocket
expenses that the insured/patient will have to incur in order for the policy to
begin to pay at 100%
c. The remaining deductible amount
not yet incurred by the insured party or family
d. A specified amount of annual
out-of-pocket expense for covered medical services that the insured must incur
and pay each policy year
In
which of the following methods will you bill your clients for giving your
services as a medical biller?
a. By using a set fee
b. By billing on a percentage of the
claims submitted
c. By percentage of collections
d. All of the above
Electronic
Medical Claims (EMC) help to ___________.
a. get the carrier more quickly than
the paper claims
b. pay more quickly than the paper
claims
c. notify more quickly in case the
claim is rejected
d. All of the above
_____________is
an agreement made between the insurance company and the insured to send
payments directly to the physician.
a. Assignment of Benefits
b. Coordination of Benefits
c. Preauthorization
d. Pre-Existing Conditions
What
is the need for insurance verification?
a. To determine the accuracy of the
patient information and the insurance card
b. To determine how the insurance
will consider and/or pay for the services rendered
c. To charge the patient for their
portion appropriately
d. To make the patient's information
public
Which
of the following is the code for anesthesia (type of service code)?
a. X*
b. 99
c. 07
d. 15
National
Provider Identifier is a _____ digit number.
a. 8
b. 9
c. 10
d. 4
State
whether true or false:
Ideal practice management software should have good reporting and multi-tasking capabilities.
Ideal practice management software should have good reporting and multi-tasking capabilities.
a. True
b. False
The
component 'National Identifier Standards' fall under which of the following
components of HIPAA?
a. Program
b. Administrative Simplification
c. Accountability
d. Portability
Which
of the following information is needed to complete the CMS 1500 form?
a. Patient Information
b. Insurance/Payment Information
c. Guarantor Information
d. Diagnostic Information (ICD-9
Codes)
e. All of the above
What
is the full form of AIDA?
a. Attention, Interest, Desire And
Action
b. Action, Interest, Desire And
Advertising
c.
Action, Interest, Desire And Attention
d. None of the above
Which
of the following components of HIPAA have been put into effect?
a. Portability and Administrative
Simplification
b. Portability and Accountability
c. Accountability and Program
d. Administrative Simplification and
Program
What
are modifiers?
a. They are used to add more
information about a ICD-9 CM
code
b. They help in establishing
"medical necessity"
c. They are used to add more
information about a CPT code
d. They are an indicator to show
that a procedure is linked to more than one diagnosis
The
'Group' in the 'Group Health Insurance Card' refers to the _________.
a.
employer
b. the name of the insured
c. the name of the insurance company
d. third party administrator
What
things should you emphasize on while selecting an attorney when starting your
own medical billing business?
a. You should look at his years of
experience
b. He should be able to develop a
Compliance Plan in accordance with HIPAA protocols
c. You should look at the attorney's
ability to speak legal jargon with you
d. You should look at his knowledge
base about the entire legal system of your country
What
is a write off?
a. It is a percentage of the charge
or the dollar amount that the patient will pay to the provider for every
encounter/visit
b. It is the difference between the
actual fee and the permitted fee
c. It is the denial of a claim
d. It is the ongoing fee paid to the
insurance company by the insured
What
is a covered entity?
a. Any private organization or a
government agency
b. The organizations which maintain
and upgrade ICD-9-CM codes
c. The healthcare providers which
are linked to PPOs
d. The healthcare bodies covered by
HIPAA
Which
is a more efficient and less time consuming method to submit your claims?
a. Through direct submissions
b. Through HIPAA
c. Through clearing houses
d. All of the above
It
is necessary to attach a document called _________ when submitting a secondary
claim.
a. Benefits of Explanation
b. Certificate of Medical Necessity
c. Explanation of Medical Necessity
d. Explanation of Benefits
Which
of these does not cover preventive care services?
a. POS
b. PPOs
c. HMOs
d. None of the above
Which
of the following is not a coding convention?
a. Punctuation
b.
Articles
c. Connecting Words
d. Abbreviations
How
is the patient identified in case of Champva?
a. VA File #
b. Sponsor's SSN
c. SSN
d. Medicare #
CPT
Codes are updated ________.
a. once every 2 years
b. annually
c. whenever changes are necessary
d. None of the above
What
is contained in the release of information (ROI) form?
a. Name and signature of the patient
b. The details of the information
being transmitted
c. The name of the medical biller
d. None of the above
What
is needed to file Worker's Compensation and Auto Insurance Claims?
a. Patient Relationship to Insured
b. Patient's Name
c. Patient Address & Telephone
Number
d. Claim Number
Which
of the following aspects does administrative safeguards focus on?
a. Administrative functions that
ought to be applied to meet security standards
b. Methods that should be applied to
meet physical standards
c. Administrative functions that
prevent access to technical data
d. All of the above
What
is a deductible?
a. A specified amount of annual
out-of-pocket expense for covered medical services that the insured must incur
and pay each policy year
b. The percentage that the policy
will pay for a covered procedure
c. The percentage that the policy
will pay for diagnostic, lab and x-ray procedures
d. The amount of out-of-pocket
expenses that the insured/patient will have to incur in order for the policy to
begin to pay at 100%
Which
of the following is not a part of Patient Condition Information?
a. Name and UPIN of the physician
that was referred
b. Patient date of birth
c. Diagnosis information
d. Insured ID Number
If
the patient deductible is $700, and the deductible met is $685, the coverage is
80/20 and the physician's charge is $75, how much should the patient pay?
a. $26
b. $15
c. $27
d. $60
Which
of the following is the first phase of the insurance claim life cycle?
a. Entering the data about claim
information
b. Entering patient demographics in
the claim form
c. Collecting claim data
d. Stating the name of the guarantor
in the claim form
Identify
the order of events after a claim reaches the insurance carrier:
1.Application
of leftover deductible
2.Examining the procedures performed and the 'medical necessity' on these procedures
3.Application of 'allowable payments options' for every procedure performed
4.Review of the claim for proper formatting and information
2.Examining the procedures performed and the 'medical necessity' on these procedures
3.Application of 'allowable payments options' for every procedure performed
4.Review of the claim for proper formatting and information
a. 4231
b. 4213
c. 3421
d. 3214
State
whether true or false:
HIPAA provides protections for both Group Health Plans and Individual Coverage.
HIPAA provides protections for both Group Health Plans and Individual Coverage.
a. True
b. False
What
is not one of the eligibility criteria for Medicare?
a. You should be 65 or more than 65
years of age
b. You should have retired on Social
Security, Railroad Retirement, or federal government retirement programs
c. It is meant for individuals who
have been legally disabled for more than 2 years or who are suffering from
end-stage renal disease
d. You should be a resident of the United States
Which
of these is not a type of insurance coverage?
a. Medicare
b. Group Health/Medical Insurance
c. Workers Compensation
d. Campus
e. Medical
What
is needed to file Worker's Compensation and Auto Insurance Claims?
a. Patient Relationship to Insured
b. Patient's Name
c. Patient Address & Telephone
Number
d. Claim Number
What
does the bottom of the CMS 1500 Form report?
a. Provider
b. Procedure
c. Diagnostic and Charge Information
d. All of the above
e. None of the above
Who
among the following can also be a guarantor?
a. The patient
b. The physician
c. The insurance company
d. The medical biller
CPT
Codes are updated ________.
a. once every 2 years
b. annually
c. whenever changes are necessary
d. None of the above
Why
was the accountability component added to HIPAA?
a. To increase health care costs so
that health care professionals earn more profits
b. To prevent health care fraud and
abuse
c. To deny coverage to an individual
who moves from one plan to another
d. To ensure that individuals get
renewed coverage if he moves from one plan to another
What
are the main benefits of electronic claims?
a. They provide a quicker means of
reimbursement
b. They facilitate quicker
submission of claims
c. They involve more paper work
d. They lessen the interaction with
the consulting physician
Which
of the following is not a coding convention?
a. Punctuation
b.
Articles
c. Connecting Words
d. Abbreviations
Which
body is responsible for implementing the Privacy Rules
a. The Office of Civil Rights
b. The American Medical Association
c. World Health Organization
d. All of the above
What
is the length of the standard CPT codes?
a. 7
b. 4
c. 5
d. 2
What
does the UB-04 form include?
a. National Provider Identifier
b. Taxonomy
c. Guarantor Information
d. Additional Codes
Why
was HIPAA enacted into a law?
a. To implement portability
requirements for individual and group health insurance plans
b. To decrease administrative cost
and burdens of the legal industry
c. To ensure that individuals moving
from one health plan to another does not get covered under the conditions of
the already existing plan
d. None of the above
_____is
an agreement made between the insurance company and the insured to send
payments directly to the physician.
a. Assignment of
Benefits
b. Coordination of Benefits
c. Preauthorization
d. Pre-Existing Conditions
Which
of these is not a suitable marketing strategy for medical billing business?
a. Door-to-door marketing
b. Cold Calling
c. Mailing List
d. Business Networking
No comments:
Post a Comment