MDAST 322 CHAPTER 15 EXAM
QUESTIONS AND ANSWERS
Dirty claims cannot be resubmitted. - Correct Answers -False
A set dollar amount that the patient must pay for each office visit is the definition of: -
Correct Answers -copayment
Meeting the stipulated requirements to participate in the healthcare plan is the definition
of: - Correct Answers -eligibility
A(n) __________ claim has been completed accurately and completely. - Correct
Answers -Clean
Abuse is knowingly and willfully executing or attempting to execute a scheme to defraud
any healthcare benefit program. Fraud is an unintended action that results in an
overpayment to the healthcare provider. - Correct Answers -Both statements are false
The medical assistant should __________ the front and back of the patient's insurance
card. - Correct Answers -Copy
The process of determining if a procedure or service is covered by the insurance plan
and what the reimbursement is for that procedure is the definition of: - Correct Answers
-precertification
When reviewing the patient's information for their billing record, what type of information
is not included? - Correct Answers -Credit history
Which of the following methods can be used to determine a patient's eligibility for
insurance? - Correct Answers -Calling the provider services number on the back of the
health insurance ID and using the provider web portal sponsored by the patient's health
insurance company
When tracking a claim, it typically takes 10 to 14 business days for insurance
companies to process insurance it electronically. If no response has been received from
the insurance company after __ days, the medical biller should inquire about the status
of the claim. - Correct Answers -30
Only physicians can be providers of medical services. - Correct Answers -False
QUESTIONS AND ANSWERS
Dirty claims cannot be resubmitted. - Correct Answers -False
A set dollar amount that the patient must pay for each office visit is the definition of: -
Correct Answers -copayment
Meeting the stipulated requirements to participate in the healthcare plan is the definition
of: - Correct Answers -eligibility
A(n) __________ claim has been completed accurately and completely. - Correct
Answers -Clean
Abuse is knowingly and willfully executing or attempting to execute a scheme to defraud
any healthcare benefit program. Fraud is an unintended action that results in an
overpayment to the healthcare provider. - Correct Answers -Both statements are false
The medical assistant should __________ the front and back of the patient's insurance
card. - Correct Answers -Copy
The process of determining if a procedure or service is covered by the insurance plan
and what the reimbursement is for that procedure is the definition of: - Correct Answers
-precertification
When reviewing the patient's information for their billing record, what type of information
is not included? - Correct Answers -Credit history
Which of the following methods can be used to determine a patient's eligibility for
insurance? - Correct Answers -Calling the provider services number on the back of the
health insurance ID and using the provider web portal sponsored by the patient's health
insurance company
When tracking a claim, it typically takes 10 to 14 business days for insurance
companies to process insurance it electronically. If no response has been received from
the insurance company after __ days, the medical biller should inquire about the status
of the claim. - Correct Answers -30
Only physicians can be providers of medical services. - Correct Answers -False
