HIM 2133 Quiz 6 Final Exam

HIM 2133 Quiz 6 Final Exam
 Question 1
0 out of 1 points
Which is NOT a reason why an insurance carrier may deny a claim and
require a formal appeal?
Selected A.
Answer: Carrier considers the procedure performed to be
experimental
 Question 2
1 out of 1 points
Which term describes a statement issued to the insured and the provider
by a third-party payer to explain the services provided, charges, and
amount paid?
Selected B.
Answer: Explanation of
benefits
 Question 3
1 out of 1 points
What should a Medicare patient be a given before services are provided if
those services are not covered by Medicare?
Selected A.
Answer: Advance beneficiary
notice
 Question 4
1 out of 1 points
A/an _________ is a communication between the CDI department or Coder
and a provider regarding the completion or clarification of documentation
that is necessary for coding and ensures an accurate accounting of
intensity of services and severity of illness.
Selected B.
Answer: Physician
query
 Question 5
0 out of 1 points
Under the HIPAA Privacy Rule, patients have the right to all of the
following EXCEPT:
Selected C.
Answer: File a
complaint
 Question 6
1 out of 1 points

, Which reimbursement method predetermines the payment for a particular
type of service BEFORE the service is provided to the patient?
Selected B.
Answer: Prospective payment
system (PPS)
 Question 7
1 out of 1 points
Which individual is responsible for responding to inquiries about HIPAA
privacy rules?
Selected C.
Answer: Privacy
Officer
 Question 8
1 out of 1 points
HIPAA laws provide patients with certain rights regarding the use and
disclosure of their personal health information (PHI). Which of the
following is an exception to PHI use and disclosure?
Selected A.
Answer: Request for PHI disclosure for purposes related to
treatment, payment, and operations
 Question 9
1 out of 1 points
Which term describes the insurance carrier’s decision whether or not to
pay a claim?
Selected B.
Answer: Adjudicati
on
 Question 10
0 out of 1 points
Which activity occurs in the Patient Encounter component of the revenue
cycle?
Selected D.
Answer: Scheduli
ng
 Question 11
0 out of 1 points
The key field in the charge description master (CDM) is the _______, which
is the unique identifier for each charge.
Selected A.
Answer: Revenue