Question 1

Another name for a patient encounter form is:

Accepted Answer

The correct term for a patient encounter form is "Charge slip," which is also commonly known as a "Superbill."

Question 2

Forms used by the medical practice should be updated __________ and the codes verified with the current year's diagnostic and procedural codes.

Accepted Answer

Forms used in medical practices should be updated annually to ensure they are in compliance with the current year's diagnostic and procedural codes. This helps in maintaining accuracy in billing and record-keeping.

Question 3

Which item does not go on the patient encounter form?

Accepted Answer

The patient encounter form typically includes the patient's address, date of service, and insurance information, but not a detailed list of previous services.

Question 4

Dr. Adams has rendered a non-covered procedure to Mrs. Johnson, who is covered by Medicare. She was not advised before the procedure that it is not covered, and she did not sign the ABN. The medical office should:

Accepted Answer

Since Mrs. Johnson was not informed beforehand through an Advance Beneficiary Notice (ABN) that the procedure was not covered by Medicare, she cannot be held financially responsible. The medical office should adjust the charge off her account.

Question 5

An appointment was scheduled for a new patient, who asked how much the fee would be for the visit. What should the administrative medical assistant do?

Accepted Answer

Providing an estimate with a disclaimer about potential additional services ensures transparency and sets realistic expectations for the patient.

Question 6

Paper insurance claim forms will produce which of the following?

Accepted Answer

Paper insurance claim forms will produce an Explanation of Benefits (EOB). The EOB is a document provided to the policyholder by the insurance company, detailing what was covered for a medical service, and what the patient's financial responsibility is. ERA (Electronic Remittance Advice), EHR (Electronic Health Records), and PAR (Prior Authorization Request) are not directly produced by paper insurance claim forms.

Question 7

Which of the following is not necessary information on an insurance claim form?

Accepted Answer

Patient's sexual orientation is generally not necessary information on an insurance claim form, as it does not typically affect the coverage or processing of most medical claims. Insurance claim forms usually require information directly related to the patient's identity, the medical services provided, and the costs involved.

Question 8

To complete the insurance form, the medical biller/coder needs the dates when James Roberts was unable to work. To find this information, the coder would refer to the:

Accepted Answer

The patient's chart contains comprehensive medical information, including diagnoses, treatment plans, and notes on the patient's condition and progress, which would likely include documentation of periods when the patient was unable to work due to medical reasons.

Question 9

Before mailing patient statements, which of the following reports should be reviewed for delinquent accounts?

Accepted Answer

The aging report is specifically designed to show the status of accounts receivable, including delinquent accounts, making it the correct report to review before mailing patient statements.

Question 10

At the end of her visit, Sarah was asked to pay $15, which is her cost for today's visit through her managed care health plan. The $15 represents Sarah's:

Accepted Answer

The $15 represents Sarah's copayment, which is a fixed amount paid by a patient for receiving a healthcare service, with the rest covered by their insurance.

Question 11

Listed on an account are the father, the mother, and two minor children. One insurance policy, held by the mother, covers all four family members. Who is the guarantor on the account?

Accepted Answer

The guarantor on the account is the individual who holds the insurance policy covering the account, which in this case is the mother.

Question 12

What type of agreement becomes a permanent part of the medical record?

Accepted Answer

The answer of What type of agreement becomes a permanent...

Question 13

Adult children covered under a patient's policy may continue being covered under the parent's medical insurance policy up to the age of

Accepted Answer

Under the Affordable Care Act, adult children can stay on their parent's health insurance plan until they turn 26 years old.

Question 14

Attempted collection of a debt by telephone cannot be made after:

Accepted Answer

Under the Fair Debt Collection Practices Act (FDCPA), debt collectors are prohibited from contacting consumers by telephone after 9 p.m. local time.

Question 15

Attempted collection of a debt by telephone cannot be made before:

Accepted Answer

According to the Fair Debt Collection Practices Act (FDCPA), debt collectors are not allowed to call debtors before 8 a.m. or after 9 p.m. local time of the debtor, unless they have permission from the debtor to do so. This means that attempted collection of a debt by telephone cannot be made before 8 a.m.

Question 16

You should not call a patient for the purpose of debt collection on a:

Accepted Answer

Debt collection calls to a patient should avoid Sundays, as it is commonly recognized as a day of rest and family time in many cultures, making such calls potentially intrusive and inappropriate.

Question 17

The administrative medical assistant must call patients whose accounts are 30 to 60 days past due. All of the following are recommended phone strategies except

Accepted Answer

Discussing results of lab tests and/or procedures is not appropriate when calling about past due accounts, as the call should focus on the financial aspect and respect patient confidentiality regarding medical information.

Question 18

Statutes of limitations for collecting debt:

Accepted Answer

Statutes of limitations for collecting debt are determined by each state, not federally, and can vary significantly from one state to another. This means that the rules governing how long a creditor has to sue for an unpaid debt are set by state laws.

Question 19

When a physician finds it impossible to extract payment from a patient, the account is then referred to as a __________ account.

Accepted Answer

The answer of When a physician finds it impossible to...

Question 20

A __________ is attached to the patient's file when the patient registers for a visit.

Accepted Answer

A patient encounter form, also known as a superbill, is attached to the patient's file during registration to document the services provided, diagnoses, and charges for the visit.

Quiz 8: Billing, Reimbursement, and Collections