Test Bank for Fordney-s Medical Insurance and Billing, 16th Edition by Linda Smith.pdf

TEST BANK Fordney's Medical Insurance and Billing 16/E Linda Smith
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Chapter m01:mRolemofmanmInsurance mBilling mSpecialist
Smith:mFordney’s mMedicalmInsurance mandmBilling,m16thmEdition

MULTIPLEmCHOICE

1. Themprimarymgoalmof manminsurancembillingmspecialist mis:
a. tommanagemthemhealthmcaremorganization’smbillingmoffice
b. tomensuremthemcashmflow mof mamhealthmcaremorganizationmthroughmrevenuemcyc
lemmanagement
c. tomsend mbillsmtompatientsmformservicesmtheymreceive
d. tompost mpaymentsmreceived mfrommpatientsmand minsurancemcarriers
ANS:m B DIF: Moderate OBJ:m m 2

2. Facilitymbillingmincludesmchargingmformmedicalmservicesmprovided mby:
a. physicians
b. laboratorymservices
c. ambulancemservices
d. ambulatorymsurgicalmcenters

ANS:m D DIF: Easy OBJ:m m 2

3. A mclaimsmassistancemprofessional
a. worksmformthemconsumer.
b. worksmformthemhealthmcaremorganization.
c. worksmformanminsurancemcompany.
d. worksmformthemfederalmgovernment.
ANS:m A DIF: Easy OBJ:m m 2

4. What mism“cashmflow”minmammedicalmpractice?
a. Themactualmmoneymavailablemtomammedicalmpractice
b. Themamount mof mmoneymreceived mbymammedicalmpracticeminm1mday
c. Themamount mof mmoneymreceived mbymammedicalmpracticeminm1mmonth
d. Themamount mof moutstandingmmoneymonmthemaccountsmreceivable

ANS:m A DIF: Moderate OBJ:m m 2

5. Whichmlevelmof meducationmismgenerallymrequired mformonemwhomseeksmemployment masmanm insuran
cemcoder?
a. Collegemdiploma
b. Highmschoolmdiploma
c. Completionmof manmaccredited mprogrammformcodingmcertification
d. Nomspecificmlevelmof meducationmismrequired

ANS:m C DIF: Easy OBJ:m m 4

6. Themamount mof mmoneymanminsurancembillingmspecialist mearnsmismdependent monmwhichmof mt
hemfollowingmfactors?
a. Knowledge
b. Experience

, c. Sizemof memployingminstitution
d. Allmaremcorrect
ANS:m D DIF: Moderate OBJ:m m 5

7. A mself-employed mmedicalminsurancembillermwhomdoesmindependent mcontractingmismresponsiblemfor
a. advertising.
b. billing.
c. accounting.
d. Allmaremcorrect.

ANS:m D DIF: Hard OBJ:m m 2

8. Medicalmetiquettemrefersmto
a. considerationmformothers.
b. moralmprinciplesmormpractices.
c. laws.
d. themOathmof mHippocrates.
ANS:m A DIF: Moderate OBJ:m m 9

9. Themprocessmof mshorteningmwordsmand musingmabbreviationsmthat mdomnot mfollow mstandard mgra
mmar,mspellingmand mpunctuationmwhenmwritingmelectronicmmailmcommunicationsmism referred mt
omas:
a. emoticons
b. abbreviations
c. text mspeak
d. short mtext
ANS:m C DIF: Easy OBJ:m m 9

10. Professionalmethicsminclude
a. statemlaws.
b. federalmlaws.
c. standardsmof mconduct.
d. civilmtorts.
ANS:m C DIF: Moderate OBJ:m m 9

11. Themearliest mwrittenmcodemof methicalmprinciplesmformthemmedicalmprofessionmismthe
a. Oathmof mHippocrates.
b. Socraticmoath.
c. Codemof mHammurabi.
d. Medicolegalmoath.

ANS:m C DIF: Easy OBJ:m m 9

12. What mismthemnamemof mthemmodernmcodemof methicsmthat mthemAmericanmMedicalmAssociationm(AM
A)madopted minm1980?
a. ThemModernmStandardsmof mConduct mCode
b. ThemPrinciplesmof mMedicalmEthics
c. ThemOathmof mHippocrates
d. ThemAmericanmMedicalmAssociationmCodemofmEthics

, ANS:m B DIF: Easy OBJ:m m 9

13. Reportingmincorrect minformationmtomgovernment-funded mprogramsmis
a. unethical.
b. illegal.
c. abuse.
d. fraud.

ANS:m B DIF: Moderate OBJ:m m 9

14. Themdoctrinemstatingmthat mphysiciansmaremlegallymresponsiblemformbothmtheirmownmconduct mand mt
hat mof mtheirmemployeesmismknownmas
a. respondeatmsuperior.
b. let mthemmastermanswer.
c. vicariousmliability.
d. Allmaremcorrect.
ANS:m D DIF: Hard OBJ:m m 10

15. What mismthemindependent mcontractor’smliabilitymif mtheymoperatemtheirmownmmedicalminsuran
cembillingmcompany?
a. None.mThemprofessionalmliabilityminsurancemof mthemcompany mtheymcontract mwithmw
illmcovermthem.
b. Themindependent mcontractormismliablemand mshould mpurchasemerrorsmand momissio
nsminsurance.
ANS:m B DIF: Moderate OBJ:m m 10

COMPLETION

1. ismthemtotalmincomemproduced mbymamhealthmcaremorganization.

ANS:m Revenue

DIF: Moderate OBJ:m m 1

2. Anmindividualmhealthmcaremprovider’smpatient mchartsmwhichmincludesmnotesmand minformati
onmcollected mbymthemmismreferred mtomasmthe:m

ANS:m Medicalmrecord

DIF: Moderate OBJ:m m 3

3. Informationmcollected mfrommcliniciansm inmallmhealthmcaremorganizationsmwhomarem involved min
a patient’smcaremwhichm ismmademavailablemtomallmauthorized mcliniciansmtomaccessmwhenmprov
m m

idingmpatient m carem ism the:m m m m

ANS:m Healthmrecord

DIF: Moderate OBJ:m m 3

, 4. Chargingmformservicesmdoneminmhospitals,macutemcaremhospitals,mskilled mnursingmormlong-
termmcaremfacilities,mrehabilitationmcenters,mormambulatorymsurgicalmcenters mismknownmasm
billing.

ANS:m facility

DIF: Moderate OBJ:m m 2

5. Chargingmformservicesmperformed mbymphysicians,mnursempractitioners,mlicensed mclinicalmsoci
almworkersmand mphysicalmtherapistsmismknownmasm billing.

ANS:m professional

DIF: Moderate OBJ:m m 2

6. Individualsmwhomarememployed mbymanminsurancemcarriermand mwhosemrolemismtomanalyzeman
d mprocessmincomingmclaims,mcheckingmthemmformvaliditymand mdeterminingmif mthemservicesm
weremreasonablemand mnecessarymaremreferred mtomasm .

ANS:m claimsmexaminers

DIF: Moderate OBJ:m m 3

7. Individualsmwhomworkmformconsumersmand mhelpmpatientsmorganize,mfilemand mnegotiatemheal
thminsurancemclaims.m

ANS:m Claimsmassistancemprofessionals

DIF: Easy OBJ:m m 3

8. Patientsmwhomdomnot mhavemanymmedicalminsurancemand maremliablemformthementirembillmaremreferred
mtomasm patients.

ANS:m self-pay

DIF: Easy OBJ:m m 3

9. Transmitting,mreceiving,mstoring,mand mforwardingmof mtext,mvoicemmessages,mattachments,m
ormimagesmbymcomputermfrommonempersonmtomanothermismreferred mtomasm mail.

ANS:m electronic

DIF: Moderate OBJ:m m 3

10. Standardsmof mconduct mbymwhichmanminsurancembillingmspecialist mdeterminesmthemproprietymof m
hismormhermbehaviorminmamrelationshipmare mknownmasmmedicalm .

ANS:m ethics

DIF: Moderate OBJ:m m 9

11. ThemGreekmphysicianmknownmasmthemFathermof mMedicinemdevised mthem .