Computerized Billing--The Medical Office Billing Process

  1. Coding Translates a description of a medical condition in/2 a shorter, standardized code...T/F???
    *TRUE*
  2. Copayments are collected @ the time of an office visit...T/F???
    *TRUE*
  3. Medicare provides coverage 2 persons age 65 & older, persons w/disabilities, & dependent windows...T/F???
    *TRUE*
  4. The fees listed on a provider's fee sched r usually the same as the fees paid by the ins plan...T/F???
    *FALSE*
  5. Peple w/low incomes who can't afford medical care r covered by Medicare...T/F???
    *FALSE*
  6. The Encounter Form includes a pt's personal info, employment, & ins. data needed 2 complete an ins. claim...T/F???
    *FALSE*
  7. Co/Ins. refers to the portion of the charges tht r the pt's responsibility...T/F???
    *TRUE*
  8. A RA(Remittance Advice) is similiar 2 an explanation of benefits {EOB}...T/F???
    *FALSE*
  9. The 1st step in the billling cycle is checkin in pt's ...T/F???
    *FALSE*
  10. TRICARE is the gov't sponsored health care plan 4 veterans & their families...T/F???
    *FALSE*

    "CHAMPVA"
  11. A report tht lists charges, payments, & adjustments during a day is known as a...
    • a. Electronic Remittance Advice
    • b. Superbill
    • c. Encounter Form
    • d. Day Sheet
  12. The ins. program tht provides coverage for dependents of active duty service members is known as:
    • a. CHAMPVA
    • b. TRICARE
    • c. Sponsor
    • d. HIPAA
  13. Members of a ____ typically pay a higher fee if they receive care from a phys outside the network:
    • a. Indemnity plan
    • b. Preferred Provider Org
    • c. Workers Comp plan
    • d. BCBS
  14. Which of the foll refers to monies coming in/2 the practice???
    • a. Electronic Remittance
    • b. Acct's Receivable
    • c. Acct's Payable
    • d. Explanation of Benefits
  15. Which of the following refers 2 DX codes???
    • a.) ICD
    • b.) CPT
    • c.) HCFA/CMS
    • d.) EPB
  16. When a N/P comes in for an office visit, he or she is asked 2 complete a:
    • a.) Ins. Claim Form
    • b.) Superbill
    • c.) Pt. Info Form
    • d.) Pt's Sched of Benefits
  17. The most comomon type of managed care plan 2/day is:
    • a) Health Maintenance Org
    • b) Fee-for-Service
    • c) Preferred Provider Org
    • d) BCBS
  18. Wht is established when the dx & tx of a pt r logically connected???
    • a) Coding
    • b) Adudication
    • c) Med Necessity
    • d) Linkage
  19. An Encounter Form is also known as a:
    • a) Superbill
    • b) Remittance Adv
    • c) Pt. Info Form
    • d) Sched of Benefits
  20. A consumer-driven health plan {CDHP}is a high deductible/_____ type of managed care plan.
    *Low Premium*
  21. A ___ lists the services performed 4 a pt, along w/the charges 4 ea. service.
    *Statement*
  22. When pt payments r overdue, a ___ may be started to collect on the acc't.
    *Collection Process*
  23. A ___ is a standardized code tht specifies the serv's the phys provided.
    *Procedure Code*
  24. Dx codes r listed in the ___.
    *ICD*
  25. An ins carrier, whether a private carrier or gov't program, is referred to as a___???
    *3rd Party Payer*
  26. Payments of fixed amt's paid 2 physicians @ regular intervals 4 providing services to plan members r known as _____ payments.
    *Capitation*
  27. The flow of financial transactions in a business is known as the ___.
    *Accounting Cycle*
  28. The CPT {Current Procedural Terminology}was developed by ____.
    *American Medical Association*
  29. Medical ins represents a contract bet a person, known as ___, & a health plan.
    *Policy Holder*
  30. The steps tht lead 2 masimum, appropriate, timely payment 4 payment 4 pt's medical serv's is the ___.
    *Billing Process*
  31. The Medisoft Program Date can b changed using an option on the Tools menu. T/F???
    *FALSE*
  32. A new ins carrier is added 2 the Medisoft database by selectingan option on the LISTS menu.
    *TRUE*
  33. It is necessary 2 change the medisoft Program Date when entering transactions tht occured on a date other than the on one which the data r entered.
    *TRUE*
  34. Data entered in Medisoft can b deleted by clicking the right mouse button & accessing a shortcut menu.
    *TRUE*
  35. Back-up data can b restored should the current database beocome corrupted.
    *TRUE*
  36. New procedure codes can be added 2 Medisoft by selecting an option on the FILE menu. T/F???
    *FALSE*
  37. The TOOLS menu contains the Medisoft file maintenance utilities. T/F???
    *FALSE*
  38. There r 2 diff methods of changing the Medisoft program Date. T/F???
    *TRUE*
  39. The Medifsoft program provides 3 diff types of help to users. T/F???
    *TRUE*
  40. Medisoft can be exited by clicking the X button in the top right hand corner of the window or by selecting EXIT on the Edit menu. T/F???
    *FALSE*
  41. When backing up data, it is necessary 2 specify the source path & the destination path of the data. T/F???
    *TRUE*
  42. Once data is purged from the program, it can't be retrived except from back-up data. T/F???
    *TRUE*
  43. Indexes can be reuilt for a single database or for all files @ once. T/F???
    *TRUE*
  44. Transactions r entered in Medisoft via the ____.
    • a) File menu
    • b) Reports menu
    • c) Tools menu
    • d) Activities menu
  45. The Medisoft toolbar contains ___ icons.
    • a. 12
    • b. 26
    • c. 18
    • d. 20
  46. Most dates are entered in Medifsoft using the ___ format.
    • a. MMDDCCYY
    • b. MMDDYY
    • c. CCYYMMDD
    • d. DDMMCCYY
  47. The Set Program Date command is found on the ___ menu.
    • a. Tools
    • b. Activities
    • c. Windows
    • d. File
  48. The Medisoft bar contains ___ menus.
    • a. 6
    • b. 9
    • c. 10
    • d. 12
  49. Medisoft's file maintenance utilities r accessed via the __ menu.
    • a. File
    • b. Tools
    • c. Activities
    • d. Window
  50. Ins carrier payments r stored in Medisoft's ___ database.
    *Transaction*
  51. Program security options r set using Medisoft's ___ menu.
    *File*
  52. Collection letters r created in Medisoft using an ooption on the ___ menu.
    *Reports*
  53. Ins claims r created by selecting an option on the __ menu.
    *Activities*
  54. A copy of data files that have been saved on a storage device is known as ___.
    *Back-up Data*
  55. The 3 types of help avail in Medisoft r Balloon Help, Built-in Help, & ___.
    *Online Help*
  56. Off Hrs, Medisoft's built-in app't scheduling program, is accessed via the ___ menu.
    *Activities*
  57. Data abt phys's, such as tax & identifier #'s, r stored in Medisoft's __ databse.
    *Provider*
  58. Medisoft's built-in Calculator is accessed via the __ menu.
    *Tools*
  59. Commands on the ___ menu can be used 2 switch bk & forth bet open windows.
    *Activities*
  60. To turn off Medisoft's Balloon Help feature, the __ shortcut button is clicked.
    *Show/Hide*
Author
BrowneeE
ID
100897
Card Set
Computerized Billing--The Medical Office Billing Process
Description
*FINAL REVIEW*...The Medical Off billing process & Intro 2 Medisoft"
Updated