Question 1

The insurance claim should always be proofread.

Accepted Answer

A) True 
 B)False

Question 2

The physician's signature is located in block

Accepted Answer

A)  12. 
B)  13. 
C)  31. 
D)  33. 
A)  12. 
B)  13. 
C)  31. 
D)  33.

Question 3

The insured's name is found in block

Accepted Answer

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

Question 4

Dirty claims cannot be resubmitted.

Accepted Answer

A) True 
 B)False

Question 5

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 6

Claims that have errors or omissions that must be corrected and resubmitted to receive reimbursement are called _____________ claims.

Accepted Answer

A)  clean 
B)  dirty 
C)  dingy 
D)  incomplete 
A)  clean 
B)  dirty 
C)  dingy 
D)  incomplete

Question 7

Match block 21 with the appropriate content as it relates to completing the CMS-1500 form. (Select all that apply.)

Accepted Answer

A)  National provider identification number 
B)  Preauthorization number 
C)  Date of current illness, injury, or pregnancy 
D)  Diagnosis or nature of illness or injury 
E)  Name of referring provider
F) Hospitalization dates related to current services 
A)  National provider identification number 
B)  Preauthorization number 
C)  Date of current illness, injury, or pregnancy 
D)  Diagnosis or nature of illness or injury 
E)  Name of referring provider
F) Hospitalization dates related to current services

Question 8

Which of the following steps to medical billing should be performed prior to rendering medical services?

Accepted Answer

A)  Verify the patient's eligibility for insurance coverage 
B)  Collect patient insurance information 
C)  Code the diagnosis and procedures 
D)  Complete the CMS-1500 health insurance claim form 
E)  Both A and B 
A)  Verify the patient's eligibility for insurance coverage 
B)  Collect patient insurance information 
C)  Code the diagnosis and procedures 
D)  Complete the CMS-1500 health insurance claim form 
E)  Both A and B

Question 9

The patient's name is found in block

Accepted Answer

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

Question 10

The insured's address in block 7 refers to the __________ address.

Accepted Answer

A)  patient's 
B)  spouse's 
C)  policyholder's 
D)  insurance carrier's 
A)  patient's 
B)  spouse's 
C)  policyholder's 
D)  insurance carrier's

Question 11

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

Accepted Answer

F
The charges for pr

Question 12

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

Accepted Answer

clearinghouse
Claims

Question 13

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

Accepted Answer

policies
The medical assistant

Question 14

Only physicians can be providers of medical services.

Accepted Answer

A) True 
 B)False

Question 15

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

Accepted Answer

copy
The medical ass

Question 16

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 17

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

Question 18

Electronic claims are submitted via electronic media.

Accepted Answer

A) True 
 B)False

Question 19

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

Accepted Answer

assignment
Patients sign an as

Question 20

Match block 17 with the appropriate content as it relates to completing the CMS-1500 form. (Select all that apply.)

Accepted Answer

A)  National provider identification number 
B)  Preauthorization number 
C)  Date of current illness, injury, or pregnancy 
D)  Diagnosis or nature of illness or injury 
E)  Name of referring provider
F) Hospitalization dates related to current services 
A)  National provider identification number 
B)  Preauthorization number 
C)  Date of current illness, injury, or pregnancy 
D)  Diagnosis or nature of illness or injury 
E)  Name of referring provider
F) Hospitalization dates related to current services

Exam 15: Medical Billing and Reimbursement

The insurance claim should always be proofread.

The physician's signature is located in block

The insured's name is found in block

Dirty claims cannot be resubmitted.

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

Claims that have errors or omissions that must be corrected and resubmitted to receive reimbursement are called _____________ claims.

Match block 21 with the appropriate content as it relates to completing the CMS-1500 form. (Select all that apply.)

Which of the following steps to medical billing should be performed prior to rendering medical services?

The patient's name is found in block

The insured's address in block 7 refers to the __________ address.

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

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

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

Only physicians can be providers of medical services.

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

Block 1 of the CMS-1500 contains what information?

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

Electronic claims are submitted via electronic media.

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

Match block 17 with the appropriate content as it relates to completing the CMS-1500 form. (Select all that apply.)

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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