Deck 1: Introduction to Professional Billing and Coding Careers

Question 1

A centralized billing office (CBO) typically contracts with a physician's office to perform which of the following functions?

A)Scheduling patient appointments
B)Handling claims and/or accounts receivable
C)Verifying insurance coverage
D)Compiling and recording medical charts, reports, and correspondence

Answer 1

Handling claims and/or accounts receivable

Question 2

The healthcare professional who researches data in medical records to accurately document diagnoses and procedures to obtain maximum reimbursement for physicians is the:

A)medical office assistant.
B)medical collector.
C)medical coder.
D)payment poster.

Answer 2

medical coder.

Question 3

Managed care is a system in which physicians contract to participate in a health insurance network and healthcare delivery is:

A)at the discretion of the physician.
B)provided only by in-network physicians.
C)based on the patient's ability to pay.
D)monitored to control costs.

Answer 3

monitored to control costs.

Question 4

It is common for small-group practices to outsource:

A)billing and accounts receivable.
B)insurance coverage verifications.
C)appointment scheduling and patient reminders.
D)medical records management.

Question 5

A large-group practice is a specialized practice that is likely to:

A)employ more nurses than doctors.
B)include a physical therapist as part of the medical team.
C)employ in-house staff to handle claims and accounts receivable.
D)contract with an outside firm to handle claims and accounts receivable.

Question 6

The percentage of all healthcare providers who are physicians and nurses is:

A)25%.
B)40%.
C)50%.
D)60%.

Question 7

All of the following are features of a patient account services (PAS) facility EXCEPT:

A)employing few staff members.
B)having multiple departments.
C)handling claims for hospitals within a state or region.
D)handling hospitals' accounts receivable.

Question 8

A practice with 10 or more physicians would generally be categorized as a:

A)solo practice.
B)private practice.
C)small-group practice.
D)large-group practice.

Question 9

The percentage of all healthcare providers who are allied health professionals is:

A)25%.
B)40%.
C)50%.
D)60%.

Question 10

The responsibilities of a medical biller may include all of the following EXCEPT:

A)scheduling appointments.
B)submitting insurance claims.
C)entering patient charge information.
D)contacting insurance carriers about outstanding claims.

Question 11

A group of physicians with different specialties may practice together at one outpatient facility known as a:

A)free clinic.
B)small-group practice.
C)multispecialty clinic.
D)private hospital.

Question 12

A possible job title for a medical coder position would be:

A)admitting clerk.
B)administrative medical assistant.
C)medical receptionist.
D)health information technician.

Question 13

A medical office assistant may handle all of the following duties in a medical office EXCEPT:

A)scheduling appointments.
B)compiling and recording medical records.
C)interpreting laboratory test results.
D)answering telephones.

Question 14

A practice with three physicians would generally be categorized as a:

A)solo practice.
B)private practice.
C)small-group practice.
D)large-group practice.

Question 15

A PAS facility may include all of the following departments EXCEPT:

A)medical records.
B)government billing.
C)insurance verification.
D)appeals.

Question 16

Most hospitals today are owned by a:

A)single, private owner.
B)nonprofit organization.
C)university.
D)corporation.

Question 17

Before the 1970s, a solo practice included all of the following staff members EXCEPT:

A)physician.
B)nurse.
C)certified medical biller.
D)receptionist.

Question 18

The increased demand for medical billers, medical office assistants, and medical coders can be attributed to:

A)the growth of managed care.
B)physician practices' having more responsibility for filing claims.
C)the need for additional staff to file claims and work to obtain timely payment.
D)all of the above.

Question 19

All of the following changes were a result of managed care EXCEPT:

A)physicians' having to wait 30 days or longer for payment.
B)physicians' having more responsibility for filing claims.
C)patients' having to pay for services when rendered.
D)physicians' having to add to their staff.

Question 20

Before the 1970s, a physician's practice would grow based on:

A)advertising and referrals.
B)managed care contracts.
C)consultations.
D)hospital affiliations.

Question 21

The healthcare professional who contacts patients or insurance carriers to collect money owed to the medical facility is the:

A)medical office assistant.
B)medical coder.
C)payment poster.
D)medical collector.

Question 22

The duties and responsibilities of a medical coder may include all of the following EXCEPT:

A)greeting visitors and directing them to appropriate staff.
B)researching and reference checking of medical records.
C)accurately coding primary and secondary diagnoses.
D)using ICD-9-CM and CPT^® coding books.

Question 23

The duties and responsibilities of a privacy compliance officer may include all of the following EXCEPT:

A)posting payments or making adjustments to patient accounts.
B)answering questions about privacy regulations.
C)explaining DNR orders to patients and their family members.
D)data entry of patient demographics.

Question 24

The Certified Professional Coder (CPC) certification is designed to evaluate a medical coder's knowledge of all of the following EXCEPT:

A)medical terminology.
B)math concepts.
C)coding concepts.
D)human anatomy.

Question 25

Medical coding certifications include all of the following EXCEPT:

A)Certified Medical Billing Specialist (CMBS).
B)Certified Coding Associate (CCA).
C)Certified Professional Coder (CPC).
D)Certified Coding Specialist (CCS).

Question 26

Benefits of professional memberships include all of the following EXCEPT:

A)opportunities for networking with other professionals in your field.
B)automatic job placement.
C)publications that keep you up to date on issues and developments in your field.
D)conferences and professional development opportunities.

Question 27

The healthcare professional who is responsible for answering questions and explaining such topics as HIPAA privacy regulations, living wills, and do-not-resuscitate orders (DNRs) to patients and their family members is the:

A)medical collector.
B)insurance verification representative.
C)admitting clerk.
D)privacy compliance officer.

Question 28

Professional organization conferences can be held on the:

A)state level only.
B)national level only.
C)state and national level only.
D)state, national, or regional level.

Question 29

Coders without much job experience can receive the following certification:

A)National Certified Medical Office Assistant (NCMOA).
B)Certified Medical Administrative Assistant (CMAA).
C)Certified Coding Associate (CCA).
D)Certified Professional Coder (CPC).

Question 30

The healthcare professional who contacts insurance carriers to verify benefit information for patients is the:

A)insurance verification representative.
B)admitting clerk.
C)payment poster.
D)medical collector.

Question 31

The Certified Coding Specialist (CCS) certification is awarded through the:

A)American Health Information Management Association.
B)American Academy of Professional Coders.
C)National Center for Competency Testing.
D)National Healthcareer Association.

Question 32

Important skills required of a payment poster include all of the following EXCEPT:

A)data entry skills.
B)math skills.
C)phlebotomy skills.
D)working knowledge of insurance contracts.

Question 33

A registered health information technician (RHIT) may also be referred to as a(n):

A)payment poster.
B)medical records analyst.
C)medical collector.
D)insurance verification representative.

Question 34

The duties and responsibilities of an admitting clerk may include:

A)registering and greeting patients.
B)having patients complete paperwork.
C)dealing with patients who may be upset or irritable.
D)submitting insurance claims .

Question 35

The duties and responsibilities of a payment poster generally include:

A)greeting visitors and directing them to appropriate staff.
B)reading Explanation of Benefits documents issued by insurance carriers.
C)submitting claims to insurance carriers.
D)scheduling and confirming patients' appointments.

Question 36

The duties and responsibilities of a medical collector may include:

A)contacting patients or insurance carriers to obtain payment of balances owed.
B)compiling medical charts, reports, and correspondence.
C)reviewing medical records for compliance with regulations.
D)accurately coding diagnoses and procedures.

Question 37

The Certified Medical Billing Specialist (CMBS) certification is awarded through the:

A)American Health Information Management Association.
B)Medical Association of Billers.
C)National Center for Competency Testing.
D)National Healthcareer Association.

Question 38

The duties and responsibilities of an insurance verification representative may include all of the following EXCEPT:

A)precertification and/or prior authorization of services.
B)researching and reference checking of medical records.
C)contacting insurance carriers to clarify or confirm benefit information for patients.
D)determining the patient's financial responsibility prior to services rendered.

Question 39

In order to receive the Certified Professional Coder (CPC) certification, you must:

A)have a college degree plus 1 year of experience.
B)have 2 years of work experience and pass the certification exam.
C)pass the certification exam within 12 months of obtaining your first job.
D)have 3 years of work experience and pass the certification exam.

Question 40

To achieve certification as a National Certified Medical Office Assistant (NCMOA), you must have all of the following qualifications EXCEPT:

A)high-school diploma or equivalent.
B)graduation from an approved program of study or 1 year of experience.
C)evaluations of billing performance.
D)a passing grade on the NCMOA exam.

Question 41

The processing of hospital claims often takes place off site.

Question 42

A physician who chooses not to handle billing and insurance claims within his or her facility may contract with a(n):

A)patient account services (PAS) facility.
B)centralized billing office (CBO).
C)small group practice.
D)third party administrator (TPA)

Question 43

A facility that handles hospitals' claims and accounts receivable for a state or region is called a(n) _________________.

A)patient account services (PAS) facility
B)centralized billing office (CBO)
C)hospital billing service (HBS)
D)third party administrator (TPA)

Question 44

It is rare to find a privately owned hospital today.

Question 45

If you want a career that includes opportunities to advance, working for a patient account services (PAS) facility is not ideal.

Question 46

The Certified Professional Coder (CPC) certification is awarded through the:

A)American Academy of Professional Coders.
B)American Health Information Management Association.
C)National Center for Competency Testing.
D)National Healthcareer Association.

Question 47

A large-group practice will frequently contract out its billing and accounts receivable.

Question 48

If you work in a doctor's office, a clinic, or a similar setting, to demonstrate your ability, you should consider obtaining the:

A)Certified Professional Coder-Hospital (CPC-H) certification.
B)Certified Coding Specialist-Physician (CCS-P) certification.
C)Certified Coding Associate (CCA) certification.
D)Certified Medical Administrative Assistant (CMAA) certification.

Question 49

The American Health Information Management Association awards the:

A)National Certified Medical Office Assistant (NCMOA) certificate.
B)Certified Medical Administrative Assistant (CMAA) certificate.
C)Certified Medical Billing Specialist (CMBS) certificate.
D)Certified Coding Associate (CCA) certificate.

Question 50

The Certified Coding Specialist-Physician (CCS-P) demonstrates expertise in all of the following areas EXCEPT:

A)group practices.
B)inpatient hospitals.
C)specialty clinics.
D)solo practice offices.

Question 51

The National Center for Competency Testing awards the:

A)National Certified Medical Office Assistant (NCMOA) certificate.
B)Certified Medical Administrative Assistant (CMAA) certificate.
C)Certified Medical Billing Specialist (CMBS) certificate.
D)Certified Coding Associate (CCA) certificate.

Question 52

A registered health information technician (RHIT) ensures the quality of medical records by verifying that all records are:

A)complete.
B)accurate.
C)compliant with healthcare regulations.
D)reimbursed properly.

Question 53

A candidate for Certified Medical Billing Specialist (CMBS) certification is motivated to:

A)improve his or her medical billing knowledge.
B)assist providers in obtaining maximum reimbursement for services.
C)develop new coding and documentation skills.
D)do all of the above.

Question 54

Allied health employees make up 40% of all healthcare professionals.

Question 55

After 1 year of experience, a medical office assistant can take an exam through the National Center for Competency Testing and be certified as a(n):

A)Certified Coding Associate (CCA).
B)National Certified Medical Office Assistant (NCMOA).
C)Certified Coding Specialist (CCS).
D)Certified Medical Administrative Assistant (CMAA).

Question 56

The Registered Health Information Technician (RHIT) certification proves proficiency in all of the following EXCEPT:

A)patient record maintenance and management.
B)ICD-9-CM and CPT^® coding.
C)medical record analysis.
D)familiarity with regulations regarding patient health information.

Question 57

A small-group practice will frequently contract out its billing and accounts receivable.

Question 58

AACP offers which of the following certifications?

A)Certified Coding Associate (CCA)
B)Certified Coding Specialist-Physician (CCS-P)
C)Certified Professional Cover-Apprentice (CPC-A)
D)Certified Medical Billing Specialist (CMBS)

Question 59

Applicants who are successful in passing the Certified Professional Coder-Hospital (CPC-H) examination, but have not met the required coding work experience, will be awarded:

A)Certified Professional Coder-Hospital (CPC-H) certification.
B)Certified Professional Coder-Physician (CPC-P) certification.
C)Certified Coding Specialist (CCS) certification.
D)Certified Professional Coder-Hospital-Apprentice (CPC-H-A) certificate.

Question 60

The certification offered by the American Medical Billing Association (AMBA) to those who pass their exam is:

A)Certified Medical Billing Specialist.
B)Certified Coding Specialist.
C)Registered Health Information Technician
D)Certified Medical Reimbursement Specialist.

Question 61

Professional memberships can help you keep current with developments in your field.

Question 62

personnel make up 60% of all healthcare professionals.

Question 63

The American Academy of Professional Coders has separate examinations and certifications for physician and hospital services.

Question 64

A Certified Coding Associate (CCA) does not need much job experience.

Question 65

The privacy compliance officer is responsible for answering questions about the Health Insurance Portability and Accountability Act (HIPAA).

Question 66

The individual who contacts insurance carriers to verify benefits is referred to as a(n) __________ .

Question 67

A medical receptionist is considered back office staff in a physician's office.

Question 68

Most of a medical collector's job is performed on the telephone.

Question 69

A(n) __________ contacts patients or insurance carriers to collect money owed to the facility or practice.

Question 70

Certification for medical coding and billing is a requirement for employment in the field.

Question 71

The position of refund specialist requires research and analytical skills.

Question 72

Because of __________ , physicians became responsible for filing health insurance claims.

Question 73

A registered health information technician (RHIT) is not responsible for the quality of medical records.

Question 74

To become a Certified Medical Administrative Assistant (CMAA), you must be a graduate of a healthcare training program or have 1 or more years of full-time job experience.

Question 75

The front office staff member who primarily handles administrative duties is referred to as a(n) __________ .

Question 76

A(n) __________ practice usually consists of three to nine physicians of the same specialty.

Question 77

All facilities will have the same specific job description for a medical biller.

Question 78

To achieve certification as a Certified Medical Billing Specialist (CMBS), an individual must have 5 or more years of job experience.

Question 79

The Certified Professional Coder (CPC) certificate requires 2 years of work experience.

Question 80

A centralized billing office (CBO) specializes in hospital claims.