Question 1

Which form is also known as the UB-04 form?

Accepted Answer

A)  CMS-1450 
B)  CMS-1500 
C)  Explanation of Benefits (EO
B) form 
D)  FCC Form 159-C 
A)  CMS-1450 
B)  CMS-1500 
C)  Explanation of Benefits (EO
B) form 
D)  FCC Form 159-C

Question 2

Match each type of information found on an Explanation of Benefits (EOB)form with its definition.
-Amount a provider billed the patient's insurance company for a service

Accepted Answer

A) patient 
B) insured ID number 
C) claim number 
D) type of service 
E) date of service
F)charge
G)not allowed amount
H)coinsurance co-payment amount 
A) patient 
B) insured ID number 
C) claim number 
D) type of service 
E) date of service
F)charge
G)not allowed amount
H)coinsurance co-payment amount

Question 3

Match each term with its definition.
-Developed to report the health care provided to the source of payment when third-party reimbursement was created

Accepted Answer

A) bartered goods 
B) claim form 
C) third-party reimbursers 
D) CMS-1500 
E) CMS-1450
F)Explanation of Benefits (EO
B) form
G)Standard Electronic Data Interchange (EDI)Enrollment form
H)Remittance Advice form
I)manual insurance log
J)signature on file
K)assignment of benefits clause
L)Electronic Data Interchange (EDI)transactions
M)Administrative Simplification Compliance Act (ASC
A) 
N)clearinghouse
O)Electronic Claims Tracking (ECT)systems
P)credit column
Q)secondary insurance 
A) bartered goods 
B) claim form 
C) third-party reimbursers 
D) CMS-1500 
E) CMS-1450
F)Explanation of Benefits (EO
B) form
G)Standard Electronic Data Interchange (EDI)Enrollment form
H)Remittance Advice form
I)manual insurance log
J)signature on file
K)assignment of benefits clause
L)Electronic Data Interchange (EDI)transactions
M)Administrative Simplification Compliance Act (ASC
A) 
N)clearinghouse
O)Electronic Claims Tracking (ECT)systems
P)credit column
Q)secondary insurance

Question 4

Match each term with its definition.
-This must be completed before submitting electronic media claims to Medicare

Accepted Answer

A) bartered goods 
B) claim form 
C) third-party reimbursers 
D) CMS-1500 
E) CMS-1450
F)Explanation of Benefits (EO
B) form
G)Standard Electronic Data Interchange (EDI)Enrollment form
H)Remittance Advice form
I)manual insurance log
J)signature on file
K)assignment of benefits clause
L)Electronic Data Interchange (EDI)transactions
M)Administrative Simplification Compliance Act (ASC
A) 
N)clearinghouse
O)Electronic Claims Tracking (ECT)systems
P)credit column
Q)secondary insurance 
A) bartered goods 
B) claim form 
C) third-party reimbursers 
D) CMS-1500 
E) CMS-1450
F)Explanation of Benefits (EO
B) form
G)Standard Electronic Data Interchange (EDI)Enrollment form
H)Remittance Advice form
I)manual insurance log
J)signature on file
K)assignment of benefits clause
L)Electronic Data Interchange (EDI)transactions
M)Administrative Simplification Compliance Act (ASC
A) 
N)clearinghouse
O)Electronic Claims Tracking (ECT)systems
P)credit column
Q)secondary insurance

Question 5

​Information required to file a third-party claim on the CMS-1500 form includes all but:

Accepted Answer

A)  access to a photocopy of the patient's insurance card 
B)  the co-pay receipt given to patient at time of visit 
C)  ​the insured's name,full address,and telephone number 
D)  ​the relationship to the insured 
A)  access to a photocopy of the patient's insurance card 
B)  the co-pay receipt given to patient at time of visit 
C)  ​the insured's name,full address,and telephone number 
D)  ​the relationship to the insured

Question 6

When a patient's health insurance plan supports the ability to check electronically the amount of copayment a patient will be responsible for and the amount of payment the insurance company will make;this is known as:

Accepted Answer

A)  ​real-time assessment 
B)  ​electronic eligibility 
C)  ​real-time adjudication 
D)  ​electronic funds transfer 
A)  ​real-time assessment 
B)  ​electronic eligibility 
C)  ​real-time adjudication 
D)  ​electronic funds transfer

Question 7

Which of the following is not an advantage of using an Electronic Claims Tracking (ECT)system?

Accepted Answer

A)  Claims can be tracked online. 
B)  All claims are guaranteed to be paid if the forms are filled out correctly. 
C)  Far fewer phone calls need to be made to track unpaid claims. 
D)  The use of 24-hour rolling claims problem alerts reduces lost time. 
A)  Claims can be tracked online. 
B)  All claims are guaranteed to be paid if the forms are filled out correctly. 
C)  Far fewer phone calls need to be made to track unpaid claims. 
D)  The use of 24-hour rolling claims problem alerts reduces lost time.

Question 8

Match each type of information found on an Explanation of Benefits (EOB)form with its definition.
-Number that identifies or refers to the claim that either the patient or the health provider submitted to the insurance company

Accepted Answer

A) patient 
B) insured ID number 
C) claim number 
D) type of service 
E) date of service
F)charge
G)not allowed amount
H)coinsurance co-payment amount 
A) patient 
B) insured ID number 
C) claim number 
D) type of service 
E) date of service
F)charge
G)not allowed amount
H)coinsurance co-payment amount

Question 9

Match each type of information found on an Explanation of Benefits (EOB)form with its definition.
-Amount of money a patient owes as a share of the bill

Accepted Answer

A) patient 
B) insured ID number 
C) claim number 
D) type of service 
E) date of service
F)charge
G)not allowed amount
H)coinsurance co-payment amount 
A) patient 
B) insured ID number 
C) claim number 
D) type of service 
E) date of service
F)charge
G)not allowed amount
H)coinsurance co-payment amount

Question 10

​Match the type of insurance to its description.Note: Answers may be used more than once.
-​A type of insurance in which contracted services are provided by providers who maintain their own offices

Accepted Answer

A) ​IPA 
B) ​HMO 
C) ​PPO 
A) ​IPA 
B) ​HMO 
C) ​PPO

Question 11

Match the following definition of claims tracking to "Manual" or "Electronic." Note: answers may be used more than once.
-​Requires office collection staff to perform the extra task of making phone calls to key payers to determine whether claims are being processed

Accepted Answer

A) ​manual claims tracking 
B) ​electronic claims tracking 
A) ​manual claims tracking 
B) ​electronic claims tracking

Question 12

Match each term with its definition.
-This amount is posted from the insurance payment or insurance adjustment

Accepted Answer

A) bartered goods 
B) claim form 
C) third-party reimbursers 
D) CMS-1500 
E) CMS-1450
F)Explanation of Benefits (EO
B) form
G)Standard Electronic Data Interchange (EDI)Enrollment form
H)Remittance Advice form
I)manual insurance log
J)signature on file
K)assignment of benefits clause
L)Electronic Data Interchange (EDI)transactions
M)Administrative Simplification Compliance Act (ASC
A) 
N)clearinghouse
O)Electronic Claims Tracking (ECT)systems
P)credit column
Q)secondary insurance 
A) bartered goods 
B) claim form 
C) third-party reimbursers 
D) CMS-1500 
E) CMS-1450
F)Explanation of Benefits (EO
B) form
G)Standard Electronic Data Interchange (EDI)Enrollment form
H)Remittance Advice form
I)manual insurance log
J)signature on file
K)assignment of benefits clause
L)Electronic Data Interchange (EDI)transactions
M)Administrative Simplification Compliance Act (ASC
A) 
N)clearinghouse
O)Electronic Claims Tracking (ECT)systems
P)credit column
Q)secondary insurance

Exam 31: Preparing Insurance Claims and Posting Insurance Payments

Which form is also known as the UB-04 form?

Match each type of information found on an Explanation of Benefits (EOB)form with its definition. -Amount a provider billed the patient's insurance company for a service

Match each term with its definition. -Developed to report the health care provided to the source of payment when third-party reimbursement was created

Match each term with its definition. -This must be completed before submitting electronic media claims to Medicare

​Information required to file a third-party claim on the CMS-1500 form includes all but:

When a patient's health insurance plan supports the ability to check electronically the amount of copayment a patient will be responsible for and the amount of payment the insurance company will make;this is known as:

Which of the following is not an advantage of using an Electronic Claims Tracking (ECT)system?

Match each type of information found on an Explanation of Benefits (EOB)form with its definition. -Number that identifies or refers to the claim that either the patient or the health provider submitted to the insurance company

Match each type of information found on an Explanation of Benefits (EOB)form with its definition. -Amount of money a patient owes as a share of the bill

​Match the type of insurance to its description.Note: Answers may be used more than once. -​A type of insurance in which contracted services are provided by providers who maintain their own offices

Match the following definition of claims tracking to "Manual" or "Electronic." Note: answers may be used more than once. -​Requires office collection staff to perform the extra task of making phone calls to key payers to determine whether claims are being processed

Match each term with its definition. -This amount is posted from the insurance payment or insurance adjustment

The Medical Assistant

The Health Care Team and the Medical Environment,past and Present

Legal Issues

Ethical Issues

Verbal and Nonverbal Communications

Applying Communication Skills

Introduction to Medical Terminology

Understanding and Building Medical Terms of Body Systems

Anatomic Descriptors and Fundamental Body Structure

The Nervous System

The Senses

The Integumentary System

The Skeletal System

The Muscular System

The Respiratory System

The Circulatory System

The Immune System

The Digestive System

The Urinary System

The Endocrine System

The Reproductive System

Telephone Communications

Written Communications

The Office Environment, computers, and Equipment

Scheduling Appointments and Receiving Patients

The Medical Record,documentation,and Filing

Health Insurance

A Icd-10 Update: Procedural and Diagnostic Coding

Procedural and Diagnostic Coding

Patient Accounts

Patient Billing,posting Patient Payments,and Collecting Fees

Banking Procedures

Accounts Payable and Accounting Procedures

Infection Control and Medical Asepsis

The Medical History and Patient Screening

Body Measurements and Vital Signs

Preparing for Examinations

The Physical Exam

Specialty Exams and Other Procedures

Obgyn Examinations

Pediatric Examinations

The Physicians Office Laboratory

Specimen Collection and Processing

Blood Specimen Collection

Diagnostic Testing

Cardiology Procedures

Radiology Procedures

Preparing for Surgery

Assisting With Minor Surgery

Pharmacology Fundamentals

Measurement Systems,basic Mathematics,and Dosage Calculations

Administering Oral and Non-Injectable Medications

Administering Injections and Immunizations

Emergencies in the Medical Office and the Community

First Aid for Accidents and Injuries

Rehabilitation

Nutrition,exercise,and Healthy Living

Practicum and the Job Search

Managing the Office

Filters

Information required to file a third-party claim on the CMS-1500 form includes all but:

Match the type of insurance to its description.Note: Answers may be used more than once. -A type of insurance in which contracted services are provided by providers who maintain their own offices

Match the following definition of claims tracking to "Manual" or "Electronic." Note: answers may be used more than once. -Requires office collection staff to perform the extra task of making phone calls to key payers to determine whether claims are being processed