Exam 19: Electronic Medical Claims Processing

The negative amount of the Total Receipts line of the Patient Day Sheet report should equal: A)charges posted for the day, as totaled from the encounter forms. B)adjustments posted for the day, as totaled from EOBs. C)payments posted for the day, as totaled from EOBs and copays. D)payments and adjustments posted for the day, as totaled from the encounter forms.

The explanation of benefits (EOB) from an insurance company will include: A)payments and adjustments from the carrier. B)payments from the carrier and the patient. C)the fee schedule on which payment was based. D)the per-member-per-month fee.

The report the medical office specialist should run at the end of the day to balance all transactions is the: A)superbills report. B)patient day sheet report. C)general ledger. D)balance report.

New patients should be entered into the provider database.

After batching out the daily transaction(s), the medical office specialist should: A)purge the system of all records. B)print bills to send to patients. C)create and submit insurance claims. D)close the system and log off the computer.

The payments from EOBs and copays that are totaled on the calculator should equal: A)positive amount on the Total Receipts line of the report. B)negative amount on the Total Receipts line of the report. C)total charges and adjustments from the EOBs. D)total amount charged from the superbills.

The process of making sure that the totals of the day's charges, payments, and adjustments match those shown on the Patient Day Sheet report is known as __________ .

Patient information, payment method, and visit information would all be found on the: A)registration form. B)Explanation of Benefits (EOB). C)encounter form. D)ledger sheet.

The department or function in a medical office that is typically responsible for payment posting is: A)receptionist. B)accounts receivable. C)clinical medical assistant. D)medical records.

A contractual adjustment on the EOB is the difference between the charged amount and the carrier's allowed amount for a service.

A list of the supplies used during an office visit can be found on the: A)registration form. B)Explanation of Benefits (EOB). C)encounter form. D)Patient Day Sheet.