Medical Insurance, 8e (Valerius)
Chapter 1 Introduction to the Revenue Cycle
1) The employment forecast for well-trained medical insurance and coding specialists is/are
A) decreasing opportunities.
B) staying the same as today.
C) increasing opportunities.
D) remaining stagnant.
Answer: C
Explanation: Knowledgeable medical office employees are in demand.
Difficulty: 1 Easy
Topic: Working in the Medical Insurance Field
Learning Objective: 01.01
Bloom's: Remember
ABHES: 1.a Graduates will be able to: Describe the current employment outlook for the medical
assistant
CAHIIM: VI.E.2 Explain return on investment for employee training/development
2) Medical insurance specialists ensure financial success of the medical practice by
A) using health information technology.
B) setting their own rules and regulations.
C) failing to communicate effectively.
D) recording only cash payments.
Answer: A
Explanation: Providers must compete in a complex environment of various health plans,
managed care contracts, and federal and state regulations.
Difficulty: 2 Medium
Topic: Working in the Medical Insurance Field
Learning Objective: 01.01
Bloom's: Understand
ABHES: 7.b Graduates will be able to: Navigate electronic health records systems and practice
management software
CAHIIM: III.A.1 Utilize software in the completion of HIM processes
1
Copyright 2020 © McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior
written consent of McGraw-Hill Education.
,3) According to the textbook, pick the rising occupation in the health care industry that requires
the employee to have the highest level of proficiency in dealing with the public professionally
and pleasantly.
A) health information technician
B) medical assistant
C) lab technician
D) radiology technician
Answer: B
Explanation: Medical assistants who are expected to excel are those best fit to deal with the
public through a courteous, pleasant manner and a professional demeanor.
Difficulty: 2 Medium
Topic: Working in the Medical Insurance Field
Learning Objective: 01.01
Bloom's: Understand
ABHES: 1.a Graduates will be able to: Describe the current employment outlook for the medical
assistant; 1.b Graduates will be able to: Compare and contrast the allied health professions and
understand their relation to medical assisting
CAHIIM: VI.E.2 Explain return on investment for employee training/development
4) A computerized lifelong health care record for an individual that incorporates data from all
sources is known as a(n)
A) electronic health record (EHR).
B) practice management program (PMP).
C) computerized health record (CHR).
D) lifelong health care record (LHR).
Answer: A
Explanation: Electronic health record (EHR) is a computerized lifelong health care record for an
individual that incorporates data from all sources.
Difficulty: 1 Easy
Topic: Working in the Medical Insurance Field
Learning Objective: 01.01
Bloom's: Remember
ABHES: 4.b.2 Institute federal and state guidelines when: Entering orders in and utilizing
electronic health records; 7.b Graduates will be able to: Navigate electronic health records
systems and practice management software
CAHIIM: III.A.1 Utilize software in the completion of HIM processes
2
Copyright 2020 © McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior
written consent of McGraw-Hill Education.
,5) In a medical practice, cash flow is required to
A) pay for office expenses.
B) pay for hospital supplies.
C) pay for nursing home employees.
D) pay for the staff of an insurance company.
Answer: A
Explanation: Cash flow, the movement of monies into and out of the practice, is needed in order
to pay for office expenses such as salaries and overhead.
Difficulty: 1 Easy
Topic: Working in the Medical Insurance Field
Learning Objective: 01.01
Bloom's: Remember
ABHES: 7.c Graduates will be able to: Perform billing and collection procedures
CAHIIM: IV.A.2 Evaluate the revenue cycle management processes; IV.A.1 Apply policies and
procedures for the use of data required in healthcare reimbursement
6) What is the definition of revenue cycle?
A) clinical care provided for patients, from appointment to discharge
B) all administrative and clinical functions which ensure that sufficient monies flow into the
practice to pay bills
C) all coding and billing steps involved in preparing correct claims
D) complete documentation that is submitted to third-party payers
Answer: B
Explanation: The revenue cycle includes all administrative and clinical functions that ensure
sufficient monies flow into the practice to pay bills.
Difficulty: 1 Easy
Topic: The Revenue Cycle
Learning Objective: 01.08
Bloom's: Remember
ABHES: 7.c Graduates will be able to: Perform billing and collection procedures
CAHIIM: IV.A.2 Evaluate the revenue cycle management processes; IV.A.1 Apply policies and
procedures for the use of data required in healthcare reimbursement
3
Copyright 2020 © McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior
written consent of McGraw-Hill Education.
, 7) Medical insurance specialists use practice management programs to
A) schedule patients.
B) collect data on patients' diagnoses and services.
C) record payments from insurance companies.
D) All of these are correct.
Answer: D
Explanation: Expertise in the use of practice management programs is an important skill in the
medical practice. Medical insurance specialists use them to
• Schedule patients.
• Organize patient and insurance information.
• Collect data on patients' diagnoses and services.
• Generate, transmit, and report on the status of health care claims.
• Record payments from insurance companies.
• Generate patients' statements, post payments, and update accounts.
• Create financial and productivity reports.
Difficulty: 1 Easy
Topic: Working in the Medical Insurance Field
Learning Objective: 01.01
Bloom's: Remember
ABHES: 7.b Graduates will be able to: Navigate electronic health records systems and practice
management software
CAHIIM: III.A.1 Utilize software in the completion of HIM processes
8) Examine the list of services in the answer choices below and determine which one would most
likely be considered a noncovered service at a primary care medical office.
A) emergency medical care
B) employment-related injuries
C) surgical procedures
D) annual physical examinations
Answer: B
Explanation: Most medical insurance policies do not cover employment-related injuries;
emergency care and surgical procedures are generally covered services, while annual physical
examinations are often covered as preventive medical services.
Difficulty: 1 Easy
Topic: Medical Insurance Basics
Learning Objective: 01.02
Bloom's: Remember
ABHES: 7.d Graduates will be able to: Process insurance claims
CAHIIM: IV.A.1 Apply policies and procedures for the use of data required in healthcare
reimbursement
4
Copyright 2020 © McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior
written consent of McGraw-Hill Education.
Chapter 1 Introduction to the Revenue Cycle
1) The employment forecast for well-trained medical insurance and coding specialists is/are
A) decreasing opportunities.
B) staying the same as today.
C) increasing opportunities.
D) remaining stagnant.
Answer: C
Explanation: Knowledgeable medical office employees are in demand.
Difficulty: 1 Easy
Topic: Working in the Medical Insurance Field
Learning Objective: 01.01
Bloom's: Remember
ABHES: 1.a Graduates will be able to: Describe the current employment outlook for the medical
assistant
CAHIIM: VI.E.2 Explain return on investment for employee training/development
2) Medical insurance specialists ensure financial success of the medical practice by
A) using health information technology.
B) setting their own rules and regulations.
C) failing to communicate effectively.
D) recording only cash payments.
Answer: A
Explanation: Providers must compete in a complex environment of various health plans,
managed care contracts, and federal and state regulations.
Difficulty: 2 Medium
Topic: Working in the Medical Insurance Field
Learning Objective: 01.01
Bloom's: Understand
ABHES: 7.b Graduates will be able to: Navigate electronic health records systems and practice
management software
CAHIIM: III.A.1 Utilize software in the completion of HIM processes
1
Copyright 2020 © McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior
written consent of McGraw-Hill Education.
,3) According to the textbook, pick the rising occupation in the health care industry that requires
the employee to have the highest level of proficiency in dealing with the public professionally
and pleasantly.
A) health information technician
B) medical assistant
C) lab technician
D) radiology technician
Answer: B
Explanation: Medical assistants who are expected to excel are those best fit to deal with the
public through a courteous, pleasant manner and a professional demeanor.
Difficulty: 2 Medium
Topic: Working in the Medical Insurance Field
Learning Objective: 01.01
Bloom's: Understand
ABHES: 1.a Graduates will be able to: Describe the current employment outlook for the medical
assistant; 1.b Graduates will be able to: Compare and contrast the allied health professions and
understand their relation to medical assisting
CAHIIM: VI.E.2 Explain return on investment for employee training/development
4) A computerized lifelong health care record for an individual that incorporates data from all
sources is known as a(n)
A) electronic health record (EHR).
B) practice management program (PMP).
C) computerized health record (CHR).
D) lifelong health care record (LHR).
Answer: A
Explanation: Electronic health record (EHR) is a computerized lifelong health care record for an
individual that incorporates data from all sources.
Difficulty: 1 Easy
Topic: Working in the Medical Insurance Field
Learning Objective: 01.01
Bloom's: Remember
ABHES: 4.b.2 Institute federal and state guidelines when: Entering orders in and utilizing
electronic health records; 7.b Graduates will be able to: Navigate electronic health records
systems and practice management software
CAHIIM: III.A.1 Utilize software in the completion of HIM processes
2
Copyright 2020 © McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior
written consent of McGraw-Hill Education.
,5) In a medical practice, cash flow is required to
A) pay for office expenses.
B) pay for hospital supplies.
C) pay for nursing home employees.
D) pay for the staff of an insurance company.
Answer: A
Explanation: Cash flow, the movement of monies into and out of the practice, is needed in order
to pay for office expenses such as salaries and overhead.
Difficulty: 1 Easy
Topic: Working in the Medical Insurance Field
Learning Objective: 01.01
Bloom's: Remember
ABHES: 7.c Graduates will be able to: Perform billing and collection procedures
CAHIIM: IV.A.2 Evaluate the revenue cycle management processes; IV.A.1 Apply policies and
procedures for the use of data required in healthcare reimbursement
6) What is the definition of revenue cycle?
A) clinical care provided for patients, from appointment to discharge
B) all administrative and clinical functions which ensure that sufficient monies flow into the
practice to pay bills
C) all coding and billing steps involved in preparing correct claims
D) complete documentation that is submitted to third-party payers
Answer: B
Explanation: The revenue cycle includes all administrative and clinical functions that ensure
sufficient monies flow into the practice to pay bills.
Difficulty: 1 Easy
Topic: The Revenue Cycle
Learning Objective: 01.08
Bloom's: Remember
ABHES: 7.c Graduates will be able to: Perform billing and collection procedures
CAHIIM: IV.A.2 Evaluate the revenue cycle management processes; IV.A.1 Apply policies and
procedures for the use of data required in healthcare reimbursement
3
Copyright 2020 © McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior
written consent of McGraw-Hill Education.
, 7) Medical insurance specialists use practice management programs to
A) schedule patients.
B) collect data on patients' diagnoses and services.
C) record payments from insurance companies.
D) All of these are correct.
Answer: D
Explanation: Expertise in the use of practice management programs is an important skill in the
medical practice. Medical insurance specialists use them to
• Schedule patients.
• Organize patient and insurance information.
• Collect data on patients' diagnoses and services.
• Generate, transmit, and report on the status of health care claims.
• Record payments from insurance companies.
• Generate patients' statements, post payments, and update accounts.
• Create financial and productivity reports.
Difficulty: 1 Easy
Topic: Working in the Medical Insurance Field
Learning Objective: 01.01
Bloom's: Remember
ABHES: 7.b Graduates will be able to: Navigate electronic health records systems and practice
management software
CAHIIM: III.A.1 Utilize software in the completion of HIM processes
8) Examine the list of services in the answer choices below and determine which one would most
likely be considered a noncovered service at a primary care medical office.
A) emergency medical care
B) employment-related injuries
C) surgical procedures
D) annual physical examinations
Answer: B
Explanation: Most medical insurance policies do not cover employment-related injuries;
emergency care and surgical procedures are generally covered services, while annual physical
examinations are often covered as preventive medical services.
Difficulty: 1 Easy
Topic: Medical Insurance Basics
Learning Objective: 01.02
Bloom's: Remember
ABHES: 7.d Graduates will be able to: Process insurance claims
CAHIIM: IV.A.1 Apply policies and procedures for the use of data required in healthcare
reimbursement
4
Copyright 2020 © McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior
written consent of McGraw-Hill Education.
