Back to Explore

Module 113 Final Review

Question 1 of 3

Q1 . The document together with the payment voucher that is sent to a physician who has accepted assignment of benefits is referred to as a/an

Q2 . What is the correct procedure to collect a copayment on a managed care plan

Q3 . The total number of levels of redetermination that exist in the Medicare program is

Q4 . Medicare is a

Q5 . If a payment problem develops with an insurance company and the company ignores claims and exceeds time limits to pay a claim, it is prudent to contact the

Q6 . What should be done to inform a new patient of office fees and payment policies

Q7 . When receiving payment from a private insurance carrier, check the amount of payment on the EOB with the

Q8 . Which type of bankruptcy is considered "wage earner's bankruptcy"

Q9 . Medicare Part A is run by

Q10 . Medicare provides a one-time baseline mammographic examination for women ages 35 to 39 and preventive mammograms for women 40 years and older

Q11 . When downcoding occurs, payment will

Q12 . Some senior HMOs may provide services not covered by Medicare, such as

Q13 . Employment of a billing service is called

Q14 . If an insurance company admits that a patient signed an assignment of benefits document and that it inadvertently paid the patient instead of the physician, the insurance company should

Q15 . In a TRICARE case, a request for an independent hearing may be pursued if the amount in question is

Q16 . The patient is likely to be the most cooperative in furnishing details necessary for a complete registration process

Q17 . A medical practice has a policy of billing only for charges in excess of $50. When the medical assistant requests $45 payment for the office visit, the patient states, "just bill me." How should the medical assistant respond

Q18 . When writing a collection letter

Q19 . If an insurance claim has been lost by the insurance carrier, the procedure(s) to follow is to

Q20 . An insurance claim with a bundled service would be

Q21 . How many levels of review exist for TRICARE appeal procedures?

Q22 . What does the insurance billing specialist need to monitor to be able to evaluate the effectiveness of the collection process

Q23 . What is a card called that permits bank customers to make cashless purchases from funds on deposit without incurring revolving finance charges for credit

Q24 . What is the name of the act designed to address the collection practices of third-party debt collectors

Q25 . Pending or resubmitted insurance claims may be tracked through a

Q26 . The correct method to send documents for a Medicare reconsideration (Level 2) is by

Q27 . If an insured is in disagreement with the insurer for the settlement of a claim, a suit must begin within

Q28 . All collection calls should be placed

Q29 . The part of the legal system that allows laypeople to settle a legal matter without use of an attorney is the

Q30 . The first statement should be

Q31 . A significant contribution to HMO development was the

Q32 . Professional courtesy means

Q33 . Accounts receivable are usually aged in time periods of

Q34 . When insurance carriers do not pay claims in a timely manner, what effect does this have on the medical practice

Q35 . What is the name of the federal act that prohibits discrimination in all areas of granting credit

Q36 . In a bankruptcy case, most medical bills are considered

Q37 . When an HMO is paid a fixed amount for each patient served without considering the actual number or nature of services provided to each person, this is known as

Q38 . TRICARE appeals are normally resolved within

Q39 . Cash flow is

Q40 . A plan in which employees can choose their own working hours from within a broad range of hours approved by management is called

Q41 . An organization that gives members freedom of choice among physicians and hospitals and provides a higher level of benefits if the providers listed on the plan are used is called a/an

Q42 . Part B of Medicare covers

Q43 . Medigap insurance may cover

Q44 . An insurance claim with an invalid prodecure code would be

Q45 . A request for a Medicare administrative law judge hearing can be made if the amount in controversy is at least

Q46 . In making collection telephone calls to a group of accounts, how should the accounts be organized to determine where to begin

Q47 . How does an HMO receive payment for the services its physicians provide

Q48 . The letter "D" following the identification number on the patient's Medicare card indicates a

Q49 . Referral of a patient recommened by one specialist to another specialist is known as

Q50 . Part A of Medicare covers

Q51 . When collecting fees, your goal should always be to

Q52 . Messages included on statements to promote payment are called

Q53 . A follow-up effort made to an insurance company to locate the status of an insurance claim is called a/an

Q54 . What should you do if an insurance carrier requests information about another insurance carrier?

Q55 . The first level of appeal in the Medicare program is

Q56 . When a physician sees a patient more than is medically necessary, it is called

Q57 . The part B Medicare annual deductible is

Q58 . Accounts that are 90 days or older should not exceed

Q59 . The reason for a fee reduction must be documented in the patient's

Q60 . How many installments (excluding a down payment) must a payment plan have to require full written disclosure

Q61 . In an independent practice association (IPA), physicians are

Q62 . What is the type of billing system in which practice management software is used

Q63 . The frequency of Pap tests that may be billed for a Medicare patient who is low risk is

Q64 . The average amount of accounts receivable should be

Q65 . When the physician's office receives notice that a check was not honored, the first thing to do is to

Q66 . An insurance claims register provides a/an

Q67 . What should be done if an insurance claim denial is received because a billed service was not a program benefit?

Q68 . The most common method of payment in the medical office is

Q69 . Kaiser Permanente's medical plan is a closed panel program, which means

Q70 . A program that offers a combination of HMO-style cost management and PPO-style freedom of choice is a/an

Q71 . The letters preceding the number on the patient's Medicare identification care indicate

Q72 . When a Medicare beneficiary has employer supplemental coverage that is determined as the primary payer, Medicare is referred to as

Q73 . Which group of accounts would a collector target when he or she begins making telephone calls

Q74 . What should be done if an insurance company denies a service stating it was not medically necessary and the physician believes it was?

Q75 . What plan allows memebers of Kaiser Permanente Medical Care Program to seek medical help from non-Kaiser physicians

Q76 . "Netback" is a term used to describe

Q77 . Practitioners in an HMO program may come under peer review by a professional group called

Q78 . Medicare Part A benefit period ends when a patient

Q79 . America's oldest privately owned, prepaid medical group is the

Q80 . What is the name of an organization of a physicians sponsored by a state or local medical association that is concerned with the development and delivery of medical services and the cost of health care

Q81 . A physician-owned business that has the flexibility to deal with all forms of contract medicine and also offers its own plans is a/an

Q82 . How are physicians paid who work for a prepaid group practice model