Exam 19: Electronic Medical Claims Processing
Exam 1: Introduction to Professional Billing and Coding Careers90 Questions
Exam 2: Understanding Managed Care: Insurance Plans92 Questions
Exam 3: Understanding Managed Care: Medical Contracts and Ethics91 Questions
Exam 4: Hipaa: Health Insurance Portability and Accountability Act of 199691 Questions
Exam 5: ICD-9-CM Medical Coding91 Questions
Exam 6: ICD-10-CM Medical Coding91 Questions
Exam 7: Introduction to Cpt and Place of Service Coding91 Questions
Exam 8: Coding Procedures and Services91 Questions
Exam 9: Hcpcs and Coding Compliance91 Questions
Exam 10: Auditing91 Questions
Exam 11: Physician Medical Billing91 Questions
Exam 12: Hospital Medical Billing90 Questions
Exam 13: Medicare Medical Billing89 Questions
Exam 14: Medicaid Medical Billing91 Questions
Exam 15: Tricare Medical Billing90 Questions
Exam 16: Explanation of Benefits and Payment Adjudication88 Questions
Exam 17: Refunds and Appeals91 Questions
Exam 18: Workers Compensation90 Questions
Exam 19: Electronic Medical Claims Processing91 Questions
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Medical practice management software typically contains a menu of CPT and ICD-9-CM codes.
(True/False)
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After patient demographic, insurance, and encounter-form information has been entered for an office visit, the next step is to create and submit the insurance claim.
(True/False)
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The patient's relationship to the subscriber can be:
A)self.
B)child.
C)spouse.
D)any of the above.
(Short Answer)
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The medical office specialist will post insurance payments and adjustments from:
A)superbills (encounter forms).
B)credit card receipts.
C)explanation of benefits (EOB) forms.
D)bank deposit slips.
(Short Answer)
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If the amounts totaled from superbills and Explanation of Benefits forms (EOBs) do NOT match the report totals, the medical office specialist should:
A)review the report, superbills, and EOBs patient by patient to locate any errors.
B)submit the report to a supervisor with a memo stating the problem.
C)call the computer system repair person to check the program.
D)go home and address the problem the next day with a fresh outlook.
(Short Answer)
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Patient demographic information such as date of birth and address can be found on the patient registration form.
(True/False)
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The name of the physician rendering care to a patient on a specific day would be found on the:
A)registration form.
B)Patient Day Sheet.
C)ledger sheet.
D)encounter form.
(Short Answer)
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The medical office specialist should refer to the Explanation of Benefits (EOB) to make sure all transactions balance each day.
(True/False)
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Detailed information about the subscriber on the insurance plan that will be billed would be found on the:
A)registration form.
B)Explanation of Benefits (EOB).
C)encounter form.
D)ledger sheet.
(Short Answer)
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A detailed accounting of charges that are the patient's responsibility can be found on the:
A)registration form.
B)Explanation of Benefits (EOB).
C)encounter form.
D)Patient Day Sheet.
(Short Answer)
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Patients will provide their demographic information on the patient __________ form.
(Short Answer)
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If a physician has referred the patient to the provider, the physician's name will be listed on the:
A)registration form.
B)Explanation of Benefits (EOB).
C)encounter form.
D)Patient Day Sheet.
(Short Answer)
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Payment posting includes posting all of the following EXCEPT:
A)payments to suppliers.
B)insurance payments.
C)patient payments.
D)contractual adjustments.
(Short Answer)
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When posting charges to a patient account, the medical office specialist should obtain the CPT code(s) from the:
A)patient history.
B)doctor's dictation.
C)encounter form (superbill).
D)progress notes.
(Short Answer)
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The subscriber on an account is the person responsible for paying the bills.
(True/False)
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Medical practice management software allows the user to:
A)submit claims electronically.
B)print paper claims.
C)check claim data onscreen.
D)all of the above.
(Short Answer)
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