Question 1

Since 2005, providers have been urged to:

Accepted Answer

A)  require patients to pay the full balance before leaving the office 
B)  bill patients directly, requiring them to seek reimbursement on their own 
C)  send claims manually 
D)  send claims electronically 
A)  require patients to pay the full balance before leaving the office 
B)  bill patients directly, requiring them to seek reimbursement on their own 
C)  send claims manually 
D)  send claims electronically

Question 2

Match each term with its definition.
-These give you immediate access to the status of a claim or group of claims

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 balance
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 balance
Q)secondary insurance

Question 3

Match each term with its definition.
-Type of payment used for centuries in the past

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 balance
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 balance
Q)secondary insurance

Question 4

Match each term with its definition.
-Book in which a list of insurance claims is kept

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 balance
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 balance
Q)secondary insurance

Question 5

Which form is also known as the UB-40 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 6

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 covered amount
H)total patient cost 
A) patient 
B) insured ID number 
C) claim number 
D) type of service 
E) date of service
F)charge
G)not covered amount
H)total patient cost

Question 7

Match each type of information found on an Explanation of Benefits (EOB) form with its definition.
-Code and brief description of the health-related service a patient received from a provider

Accepted Answer

A) patient 
B) insured ID number 
C) claim number 
D) type of service 
E) date of service
F)charge
G)not covered amount
H)total patient cost 
A) patient 
B) insured ID number 
C) claim number 
D) type of service 
E) date of service
F)charge
G)not covered amount
H)total patient cost

Question 8

Match each term with its definition.
-Private or public company that often serves as the middleman between providers and billing groups, payers, and other health care partners for the transmission and translation of electronic claims information into the specific format required by payers

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 balance
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 balance
Q)secondary insurance

Question 9

Match each type of information found on an Explanation of Benefits (EOB) form with its definition.
-Amount of money that a patient's insurance company did not pay the provider

Accepted Answer

A) patient 
B) insured ID number 
C) claim number 
D) type of service 
E) date of service
F)charge
G)not covered amount
H)total patient cost 
A) patient 
B) insured ID number 
C) claim number 
D) type of service 
E) date of service
F)charge
G)not covered amount
H)total patient cost

Question 10

Match each term with its definition.
-In many instances, this will pay most, if not all, of the balance left over from the primary insurance to your physician and will leave little out-of-pocket expenses for the patient

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 balance
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 balance
Q)secondary insurance

Question 11

Match each type of information found on an Explanation of Benefits (EOB) form with its definition.
-Name of the person who received the service

Accepted Answer

A) patient 
B) insured ID number 
C) claim number 
D) type of service 
E) date of service
F)charge
G)not covered amount
H)total patient cost 
A) patient 
B) insured ID number 
C) claim number 
D) type of service 
E) date of service
F)charge
G)not covered amount
H)total patient cost

Question 12

Which carriers will accept physicians' typed name and credentials as an indication of their signature?

Accepted Answer

A)  Medicare and Medicaid 
B)  private health insurers 
C)  no carriers 
D)  all carriers 
A)  Medicare and Medicaid 
B)  private health insurers 
C)  no carriers 
D)  all carriers

Question 13

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 balance
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 balance
Q)secondary insurance

Question 14

Match each term with its definition.
-Sets forth the very specific requirements a provider must meet in order to submit paper claim forms and receive CMS payment

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 balance
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 balance
Q)secondary insurance

Question 15

When a third-party payer identifies an error on the claim form, the claim is:

Accepted Answer

A)  rejected with a request to resubmit the form with corrections 
B)  rejected and barred from resubmission 
C)  paid, with a penalty fee subtracted for the error 
D)  held indefinitely until the medical office calls to inquire about its status 
A)  rejected with a request to resubmit the form with corrections 
B)  rejected and barred from resubmission 
C)  paid, with a penalty fee subtracted for the error 
D)  held indefinitely until the medical office calls to inquire about its status

Question 16

Match each term with its definition.
-Authorizes benefits to be paid directly from a third-party payer to a provider

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 balance
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 balance
Q)secondary insurance

Question 17

Match each type of information found on an Explanation of Benefits (EOB) form with its definition.
-Beginning and end dates of the health-related service a patient received from a provider

Accepted Answer

A) patient 
B) insured ID number 
C) claim number 
D) type of service 
E) date of service
F)charge
G)not covered amount
H)total patient cost 
A) patient 
B) insured ID number 
C) claim number 
D) type of service 
E) date of service
F)charge
G)not covered amount
H)total patient cost

Question 18

The Remittance Advice form is used when payment is being made from:

Accepted Answer

A)  American Medical Association (AM
A)  
B)  American Heart Association (AH
A)  
C)  Medicare 
D)  Blue Cross Blue Shielf 
A)  American Medical Association (AM
A)  
B)  American Heart Association (AH
A)  
C)  Medicare 
D)  Blue Cross Blue Shielf

Question 19

The phrase _____ was coined to indicate payment of services rendered by someone other than the patient.

Accepted Answer

A)  health care provider 
B)  health maintenance organization 
C)  third-party reimbursement 
D)  two-party system 
A)  health care provider 
B)  health maintenance organization 
C)  third-party reimbursement 
D)  two-party system

Question 20

Match each term with its definition.
-The most common of these are federal and state agencies, insurance companies, and workers' compensation

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 balance
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 balance
Q)secondary insurance

Exam 17: The Immune System

Since 2005, providers have been urged to:

Match each term with its definition. -These give you immediate access to the status of a claim or group of claims

Match each term with its definition. -Type of payment used for centuries in the past

Match each term with its definition. -Book in which a list of insurance claims is kept

Which form is also known as the UB-40 form?

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 each type of information found on an Explanation of Benefits (EOB) form with its definition. -Code and brief description of the health-related service a patient received from a provider

Match each term with its definition. -Private or public company that often serves as the middleman between providers and billing groups, payers, and other health care partners for the transmission and translation of electronic claims information into the specific format required by payers

Match each type of information found on an Explanation of Benefits (EOB) form with its definition. -Amount of money that a patient's insurance company did not pay the provider

Match each term with its definition. -In many instances, this will pay most, if not all, of the balance left over from the primary insurance to your physician and will leave little out-of-pocket expenses for the patient

Match each type of information found on an Explanation of Benefits (EOB) form with its definition. -Name of the person who received the service

Which carriers will accept physicians' typed name and credentials as an indication of their signature?

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

Match each term with its definition. -Sets forth the very specific requirements a provider must meet in order to submit paper claim forms and receive CMS payment

When a third-party payer identifies an error on the claim form, the claim is:

Match each term with its definition. -Authorizes benefits to be paid directly from a third-party payer to a provider

Match each type of information found on an Explanation of Benefits (EOB) form with its definition. -Beginning and end dates of the health-related service a patient received from a provider

The Remittance Advice form is used when payment is being made from:

The phrase _____ was coined to indicate payment of services rendered by someone other than the patient.

Match each term with its definition. -The most common of these are federal and state agencies, insurance companies, and workers' compensation

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 Digestive System

The Urinary System

The Endocrine System

The Reproductive System

Telephone Communications

Written Communications

Operating Computers and Office Equipment

Scheduling Appointments and Receiving Patients

The Medical Record, Documentation, and Filing

Health Insurance

Procedural and Diagnostic Coding

Patient Accounts

Preparing Insurance Claims and Posting Insurance Payments

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

Maintaining the Office Environment

Filters