Question 1

This type of statement prints the patient statement and return envelope in a continuous form.

Accepted Answer

A self-mailer is a statement that includes both the patient statement and return envelope in a continuous form that can be folded and mailed without an additional envelope.

Question 2

Patient fees are based on three commodities the physician provides: time, services, and ____.

Accepted Answer

The three commodities that patient fees are based on are time, services, and counseling. Expertise and judgment are typically considered part of the physician's overall service, and diagnosis is considered part of the overall service and may be included in the fee for services rendered. Therefore, choice C, counseling, is the correct answer.

Question 3

Monthly billing means ____________.

Accepted Answer

Monthly billing refers to billing all patients at a designated time of the month, usually at the end of the month, regardless of when the service was originally provided.

Question 4

The reimbursement rate for nonparticipating physicians is slightly higher than those who are PAR.

Accepted Answer

The reimbursement rate for nonparticipating physicians is generally lower than those who are participating physicians (PAR). Nonparticipating physicians may charge their own fees, which may exceed the allowable amount set by the insurance company, and patients may be responsible for paying the difference as out-of-pocket expenses.

Question 5

The collection ratio measures the amount owed versus the amount collected.

Accepted Answer

The collection ratio measures the amount collected versus the amount owed, not the other way around.

Question 6

In an effort to get the patient's attention, it is recommended to put "Past Due" on the mailing envelope of a statement.

Accepted Answer

It is not recommended to use "Past Due" on the mailing envelope as it can be seen as confrontational and potentially embarrassing for the patient. It is better to use a more neutral message such as "Payment Reminder" or "Account Statement".

Question 7

The RBRVS assigns an RVU to each CPT code to reflect the physician's skill, time, and ____.

Accepted Answer

The RBRVS assigns an RVU (Relative Value Unit) to each CPT code to reflect the physician's skill, time, and judgment. It does not take into account geographical location, experience, or degree.

Question 8

The main objective of accurately coding diagnoses and procedures and submitting claims is to receive reimbursement.

Accepted Answer

The main objective of accurately coding diagnoses and procedures and submitting claims is to receive reimbursement for services provided to patients.

Question 9

Once an account is turned over to a collection agency, the office cannot accept any payments from the patient.

Accepted Answer

Once an account is turned over to a collection agency, the office cannot accept any payments from the patient because the collection agency is now responsible for collecting the debt.

Question 10

The Medicare Physician Fee schedule is updated annually on January 1.

Accepted Answer

The answer of The Medicare Physician Fee schedule is updated...

Question 11

The Fair Debt Collection Practice Act is meant to assist the physician in collecting outstanding debt from patients.

Accepted Answer

The Fair Debt Collection Practice Act is actually meant to protect consumers from abusive debt collection practices. It outlines specific guidelines and restrictions on how debt collectors can communicate with and pursue payments from consumers. It is important for physicians to understand and abide by these guidelines when collecting outstanding debt from patients to avoid any legal issues.

Question 12

Physician services listed on the Medicare Fee Schedule are paid at 80% of the allowed amount.

Accepted Answer

Physician services listed on the Medicare Fee Schedule are paid at 80% of the allowed amount. The remaining 20% may be paid by the patient or through supplemental insurance such as Medigap.

Question 13

____ is a classification and reimbursement system grouping inpatients in relation to the diagnosis and treatment during hospitalization.

Accepted Answer

DRG (Diagnosis-Related Group) is a classification and reimbursement system grouping inpatients in relation to the diagnosis and treatment during hospitalization. It is used to determine the amount of Medicare payment to hospitals based on the resources necessary to treat patients with similar diagnoses. RBRVS (Resource-Based Relative Value Scale) is a fee schedule used by Medicare to reimburse physicians, APC (Ambulatory Payment Classification) is a grouping system used to classify outpatient services for reimbursement, and RVU (Relative Value Unit) is a measure of the value of medical services used to determine physician compensation.

Question 14

The Medicare Fee Schedule is the method of payment for physicians' services, outpatient physical and occupational therapy, diagnostic tests, and ____.

Accepted Answer

The Medicare Fee Schedule covers payment for various services including radiology services, among others listed. It does not directly cover home health services, blood bank services, or inpatient speech therapy in the same manner.

Question 15

The billing and collections process begins the first time the patient presents to the office and completes a registration form.

Accepted Answer

The billing and collections process starts with patient registration which includes capturing demographic and insurance information. This information is then used to bill the patient and insurance company for services provided.

Question 16

Patient demographics and copy of driver's license is collected during the ____ process.

Accepted Answer

Patient demographics and copy of driver's license are collected during the registration process when a patient first arrives at a healthcare facility to receive services. This information is used to create a patient record and verify the patient's identity. Collections, billing, and payment processes come later in the healthcare process.

Question 17

When to mail out statements to patients is determined by the size of the medical practice and _______.

Accepted Answer

The economic status of the community can determine when patients are more likely to have funds available to pay their medical bills. For example, if a practice is located in an area where most people are paid bi-weekly, it may be more effective to send statements out on the weeks when people are more likely to have money available. However, the size of the medical practice and other factors may also impact when statements are mailed out.

Question 18

A/R is the amount of outstanding money owed to a practice by patients and insurance companies.

Accepted Answer

A/R stands for Accounts Receivable, which is the amount of outstanding money owed to a practice by patients and insurance companies.

Question 19

Fair Credit Billing Act allows a ____-day time limit for patients who have a complaint with a bill to inquire about the error.

Accepted Answer

The Fair Credit Billing Act allows a 60-day time limit for patients who have a complaint with a bill to inquire about the error.

Question 20

______________________________ is the maximum amount the insurance or government program will cover for a specified service.

Accepted Answer

The answer of ______________________________ is the maximum amount the insurance...

Quiz 13: Modifiers a Practical Understanding