Question 1

Which of the following is typically documented in the estimation of benefits (EOB)?

Accepted Answer

A)  Patient's deductible 
B)  Co-insurance 
C)  Co-payment 
D)  Both A and B 
E)  All of the above 
A)  Patient's deductible 
B)  Co-insurance 
C)  Co-payment 
D)  Both A and B 
E)  All of the above D

Question 2

The insurance claim should always be proofread.

Accepted Answer

A) True 
 B)False  True

Question 3

Only physicians can be providers of medical services.

Accepted Answer

A) True 
 B)False  False

Question 4

The abbreviation often used in blocks 12, 13, and 31 is __________.

Accepted Answer

The answer of The abbreviation often used in blocks 12,...

Question 5

Which of the following is a common reason why insurance claims are rejected?

Accepted Answer

A)  When a procedure listed is not an insurance benefit 
B)  Lack of insurance coverage on date of service 
C)  Not obtaining preauthorization for the service 
D)  Claim was sent to the wrong insurance plan 
A)  When a procedure listed is not an insurance benefit 
B)  Lack of insurance coverage on date of service 
C)  Not obtaining preauthorization for the service 
D)  Claim was sent to the wrong insurance plan

Question 6

The federal tax identification number is found in block __________.

Accepted Answer

The answer of The federal tax identification number is found...

Question 7

Patients sign an __________ of benefits form so that the physician will receive payment for services directly.

Accepted Answer

The answer of Patients sign an __________ of benefits form...

Question 8

The medical assistant should always follow office __________ for claim review and signatures.

Accepted Answer

The answer of The medical assistant should always follow office...

Question 9

The medical assistant should __________ the front and back of the patient's insurance card.

Accepted Answer

The answer of The medical assistant should __________ the front...

Question 10

The charges for procedures are listed in column __________ of block 24.

Accepted Answer

The answer of The charges for procedures are listed in...

Question 11

Claims submitted to a(n) __________ are forwarded to individual insurance carriers.

Accepted Answer

The answer of Claims submitted to a(n) __________ are forwarded...

Question 12

A(n) __________ claim has been completed accurately and completely.

Accepted Answer

The answer of A(n) __________ claim has been completed accurately...

Question 13

Block 1 of the CMS-1500 contains what information?

Accepted Answer

A)  Patient's name 
B)  Insured's name 
C)  Type of insurance coverage 
D)  Carrier address 
A)  Patient's name 
B)  Insured's name 
C)  Type of insurance coverage 
D)  Carrier address

Question 14

Preauthorization specifically determines the dollar amount approved for the medical procedure, while precertification gives the provider approval to render the medical service.

Accepted Answer

A)  Both statements are true. 
B)  Both statements are false. 
C)  The first statement is true; the second is false. 
D)  The first statement is false; the second is true. 
A)  Both statements are true. 
B)  Both statements are false. 
C)  The first statement is true; the second is false. 
D)  The first statement is false; the second is true.

Question 15

The primary insurance policy information is contained in block __________.

Accepted Answer

The answer of The primary insurance policy information is contained...

Question 16

A claim that is missing information and is returned to the provider for correction and resubmission is called a(n) __________ claim.

Accepted Answer

The answer of A claim that is missing information and...

Question 17

The medical assistant should do everything possible to prevent claim __________.

Accepted Answer

The answer of The medical assistant should do everything possible...

Question 18

When completing the CMS-1500 Form, which section contains information about the patient and the insured?

Accepted Answer

A)  Section 1 
B)  Section 2 
C)  Section 3 
D)  Section 4 
A)  Section 1 
B)  Section 2 
C)  Section 3 
D)  Section 4

Question 19

Electronic claims are submitted via electronic media.

Accepted Answer

A) True 
 B)False

Question 20

Procedure code modifiers are found in column __________ of block 24.

Accepted Answer

The answer of Procedure code modifiers are found in column...

Exam 15: Medical Billing and Reimbursement

Which of the following is typically documented in the estimation of benefits (EOB)?

The insurance claim should always be proofread.

Only physicians can be providers of medical services.

The abbreviation often used in blocks 12, 13, and 31 is __________.

Which of the following is a common reason why insurance claims are rejected?

The federal tax identification number is found in block __________.

Patients sign an __________ of benefits form so that the physician will receive payment for services directly.

The medical assistant should always follow office __________ for claim review and signatures.

The medical assistant should __________ the front and back of the patient's insurance card.

The charges for procedures are listed in column __________ of block 24.

Claims submitted to a(n) __________ are forwarded to individual insurance carriers.

A(n) __________ claim has been completed accurately and completely.

Block 1 of the CMS-1500 contains what information?

Preauthorization specifically determines the dollar amount approved for the medical procedure, while precertification gives the provider approval to render the medical service.

The primary insurance policy information is contained in block __________.

A claim that is missing information and is returned to the provider for correction and resubmission is called a(n) __________ claim.

The medical assistant should do everything possible to prevent claim __________.

When completing the CMS-1500 Form, which section contains information about the patient and the insured?

Electronic claims are submitted via electronic media.

Procedure code modifiers are found in column __________ of block 24.

Competency-Based Education and the Medical Assistant Student

The Medical Assistant and the Healthcare Team

Professional Behavior in the Workplace

Therapeutic Communications

Medicine and Law

Medicine and Ethics

Technology and Written Communication in the Medical Office

Telephone Techniques

Scheduling Appointments and Patient Processing

Daily Operations in the Ambulatory Care Setting

The Health Record

Basics of Diagnostic Coding

Basics of Procedural Coding

Basics of Health Insurance

Patient Accounts, Collections, and Practice Management

Banking Services and Procedures

Supervision and Human Resources Management

Medical Practice Marketing and Customer Service

Infection Control

Patient Assessment

Patient Education

Nutrition and Health Promotion

Vital Signs

Assisting With the Primary Physical Examination

Principles of Pharmacology

Pharmacology Math

Administering Medications

Safety and Emergency Practices

Assisting in Ophthalmology and Otolaryngology

Assisting in Dermatology

Assisting in Gastroenterology

Assisting in Urology and Male Reproduction

Assisting in Obstetrics and Gynecology

Assisting in Pediatrics

Assisting in Orthopedic Medicine

Assisting in Neurology and Mental Health

Assisting in Endocrinology

Assisting in Pulmonary Medicine

Assisting in Cardiology

Assisting in Geriatrics

Principles of Electrocardiography

Assisting With Diagnostic Imaging

Assisting in the Clinical Laboratory

Assisting in the Analysis of Urine

Assisting in Blood Collection

Assisting in the Analysis of Blood

Assisting in Microbiology and Immunology

Surgical Supplies and Instruments

Surgical Asepsis and Assisting With Surgical Procedures

Career Development and Life Skills

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