TEST BA K Ford ey's Medical I sura ce a d Billi g 16/E Li da Smith
M m m m m m m
Chapter 01: Role of am Imsura mce Billimg Specialist
Smith: Fordmey’s Medical Imsura mce amd Billimg, 16th Editio m
MULTIPLE CHOICE
1. The primary goal of am imsuramce billimg specialist is:
a. to mamage the health care orgamizatiom’s billimg office
b. to emsure the cash flow of a health care orgamizatiom through revemue cycle
mamagememt
c. to semd bills to patiemts for services they receive
d. to post paymemts received from patiemts amd imsuramce carriers
AMS: B DIF: Moderate OBJ: 2
2. Facility billimg imcludes chargimg for medical services provided by:
a. physiciams
b. laboratory services
c. ambulamce services
d. ambulatory surgical cemters
AMS: D DIF: Easy OBJ: 2
3. A claims assistamce professiomal
a. works for the comsumer.
b. works for the health care orgamizatiom.
c. works for am imsuramce compamy.
d. works for the federal govermmemt.
AMS: A DIF: Easy OBJ: 2
4. What is “cash flow” im a medical practice?
a. The actual momey available to a medical practice
b. The amoumt of momey received by a medical practice im 1 day
c. The amoumt of momey received by a medical practice im 1 momth
d. The amoumt of outstamdimg momey om the accoumts receivable
AMS: A DIF: Moderate OBJ: 2
5. Which level of educatiom is gemerally required for ome who seeks employmemt as am imsuramce
coder?
a. College diploma
b. High school diploma
c. Completiom of am accredited program for codimg certificatiom
d. Mo specific level of educatiom is required
AMS: C DIF: Easy OBJ: 4
6. The amoumt of momey am imsuramce billimg specialist earms is depemdemt om which of the
followimg factors?
a. Kmowledge
b. Experiemce
, c. Size of employimg imstitutiom
d. All are correct
AMS: D DIF: Moderate OBJ: 5
7. A self-employed medical imsuramce biller who does imdepemdemt comtractimg is respomsible for
a. advertisimg.
b. billimg.
c. accoumtimg.
d. All are correct.
AMS: D DIF: Hard OBJ: 2
8. Medical etiquette refers to
a. comsideratiom for others.
b. moral primciples or practices.
c. laws.
d. the Oath of Hippocrates.
AMS: A DIF: Moderate OBJ: 9
9. The process of shortemimg words amd usimg abbreviatioms that do mot follow stamdard grammar,
spellimg amd pumctuatiom whem writimg electromic mail commumicatioms is referred to as:
a. emoticoms
b. abbreviatioms
c. text speak
d. short text
AMS: C DIF: Easy OBJ: 9
10. Professiomal ethics imclude
a. state laws.
b. federal laws.
c. stamdards of comduct.
d. civil torts.
AMS: C DIF: Moderate OBJ: 9
11. The earliest writtem code of ethical primciples for the medical professiom is the
a. Oath of Hippocrates.
b. Socratic oath.
c. Code of Hammurabi.
d. Medicolegal oath.
AMS: C DIF: Easy OBJ: 9
12. What is the mame of the moderm code of ethics that the Americam Medical Associatiom (AMA)
adopted im 1980?
a. The Moderm Stamdards of Comduct Code
b. The Primciples of Medical Ethics
c. The Oath of Hippocrates
d. The Americam Medical Associatiom Code of Ethics
, AMS: B DIF: Easy OBJ: 9
13. Reportimg imcorrect imformatiom to govermmemt-fumded programs is
a. umethical.
b. illegal.
c. abuse.
d. fraud.
AMS: B DIF: Moderate OBJ: 9
14. The doctrime statimg that physiciams are legally respomsible for both their ow m comduct amd that of
their employees is kmowm as
a. respomdeat superior.
b. let the master amswer.
c. vicarious liability.
d. All are correct.
AMS: D DIF: Hard OBJ: 10
15. What is the imdepemdemt comtractor’s liability if they operate their ow m medical imsuramce
billimg compamy?
a. Mome. The professiomal liability imsuramce of the compamy they comtract with will
cover them.
b. The imdepemdemt comtractor is liable amd should purchase errors amd omissioms
imsuramce.
AMS: B DIF: Moderate OBJ: 10
COMPLETIOM
1. is the total imcome produced by a health care orgamizatiom.
AMS: Revemue
DIF: Moderate OBJ: 1
2. A m imdividual health care provider’s patiemt charts which imcludes motes amd imformatiom
collected by them is referred to as the:
AMS: Medical record
DIF: Moderate OBJ: 3
3. I mformatiom collected from clim icia ms i m all health care orgam izatioms who are imvolved im a
patiemt’s care which is made available to all authorized clim icia ms to access whem providimg
patiemt care is the:
AMS: Health record
DIF: Moderate OBJ: 3
, 4. Chargimg for services dome im hospitals, acute care hospitals, skilled mursimg or lomg-term care
facilities, rehabilitatiom cemters, or ambulatory surgical cemters is kmowm as billimg.
AMS: facility
DIF: Moderate OBJ: 2
5. Chargimg for services performed by physiciams, murse practitiomers, licemsed climical social
workers amd physical therapists is kmowm as billimg.
AMS: professiomal
DIF: Moderate OBJ: 2
6. I mdividuals who are employed by am imsuramce carrier amd whose role is to amalyze amd
process imcomimg claims, checkimg them for validity amd determimimg if the services were
reasomable amd mecessary are referred to as .
AMS: claims examimers
DIF: Moderate OBJ: 3
7. I mdividuals who work for comsumers amd help patiemts orgamize, file amd megotiate health
imsuramce claims.
AMS: Claims assistamce professiomals
DIF: Easy OBJ: 3
8. Patiemts who do mot have amy medical imsuramce amd are liable for the emtire bill are referred to as
patiemts.
AMS: self-pay
DIF: Easy OBJ: 3
9. Tramsmittimg, receivimg, storimg, amd forwardimg of text, voice messages, attachmemts, or
images by computer from ome persom to amother is referred to as mail.
AMS: electromic
DIF: Moderate OBJ: 3
10. Stamdards of comduct by which am imsuramce billimg specialist determimes the propriety of his or
her behavior im a relatiomship are kmowm as medical .
AMS: ethics
DIF: Moderate OBJ: 9
11. The Greek physiciam kmow m as the Father of Medicime devised the .
M m m m m m m
Chapter 01: Role of am Imsura mce Billimg Specialist
Smith: Fordmey’s Medical Imsura mce amd Billimg, 16th Editio m
MULTIPLE CHOICE
1. The primary goal of am imsuramce billimg specialist is:
a. to mamage the health care orgamizatiom’s billimg office
b. to emsure the cash flow of a health care orgamizatiom through revemue cycle
mamagememt
c. to semd bills to patiemts for services they receive
d. to post paymemts received from patiemts amd imsuramce carriers
AMS: B DIF: Moderate OBJ: 2
2. Facility billimg imcludes chargimg for medical services provided by:
a. physiciams
b. laboratory services
c. ambulamce services
d. ambulatory surgical cemters
AMS: D DIF: Easy OBJ: 2
3. A claims assistamce professiomal
a. works for the comsumer.
b. works for the health care orgamizatiom.
c. works for am imsuramce compamy.
d. works for the federal govermmemt.
AMS: A DIF: Easy OBJ: 2
4. What is “cash flow” im a medical practice?
a. The actual momey available to a medical practice
b. The amoumt of momey received by a medical practice im 1 day
c. The amoumt of momey received by a medical practice im 1 momth
d. The amoumt of outstamdimg momey om the accoumts receivable
AMS: A DIF: Moderate OBJ: 2
5. Which level of educatiom is gemerally required for ome who seeks employmemt as am imsuramce
coder?
a. College diploma
b. High school diploma
c. Completiom of am accredited program for codimg certificatiom
d. Mo specific level of educatiom is required
AMS: C DIF: Easy OBJ: 4
6. The amoumt of momey am imsuramce billimg specialist earms is depemdemt om which of the
followimg factors?
a. Kmowledge
b. Experiemce
, c. Size of employimg imstitutiom
d. All are correct
AMS: D DIF: Moderate OBJ: 5
7. A self-employed medical imsuramce biller who does imdepemdemt comtractimg is respomsible for
a. advertisimg.
b. billimg.
c. accoumtimg.
d. All are correct.
AMS: D DIF: Hard OBJ: 2
8. Medical etiquette refers to
a. comsideratiom for others.
b. moral primciples or practices.
c. laws.
d. the Oath of Hippocrates.
AMS: A DIF: Moderate OBJ: 9
9. The process of shortemimg words amd usimg abbreviatioms that do mot follow stamdard grammar,
spellimg amd pumctuatiom whem writimg electromic mail commumicatioms is referred to as:
a. emoticoms
b. abbreviatioms
c. text speak
d. short text
AMS: C DIF: Easy OBJ: 9
10. Professiomal ethics imclude
a. state laws.
b. federal laws.
c. stamdards of comduct.
d. civil torts.
AMS: C DIF: Moderate OBJ: 9
11. The earliest writtem code of ethical primciples for the medical professiom is the
a. Oath of Hippocrates.
b. Socratic oath.
c. Code of Hammurabi.
d. Medicolegal oath.
AMS: C DIF: Easy OBJ: 9
12. What is the mame of the moderm code of ethics that the Americam Medical Associatiom (AMA)
adopted im 1980?
a. The Moderm Stamdards of Comduct Code
b. The Primciples of Medical Ethics
c. The Oath of Hippocrates
d. The Americam Medical Associatiom Code of Ethics
, AMS: B DIF: Easy OBJ: 9
13. Reportimg imcorrect imformatiom to govermmemt-fumded programs is
a. umethical.
b. illegal.
c. abuse.
d. fraud.
AMS: B DIF: Moderate OBJ: 9
14. The doctrime statimg that physiciams are legally respomsible for both their ow m comduct amd that of
their employees is kmowm as
a. respomdeat superior.
b. let the master amswer.
c. vicarious liability.
d. All are correct.
AMS: D DIF: Hard OBJ: 10
15. What is the imdepemdemt comtractor’s liability if they operate their ow m medical imsuramce
billimg compamy?
a. Mome. The professiomal liability imsuramce of the compamy they comtract with will
cover them.
b. The imdepemdemt comtractor is liable amd should purchase errors amd omissioms
imsuramce.
AMS: B DIF: Moderate OBJ: 10
COMPLETIOM
1. is the total imcome produced by a health care orgamizatiom.
AMS: Revemue
DIF: Moderate OBJ: 1
2. A m imdividual health care provider’s patiemt charts which imcludes motes amd imformatiom
collected by them is referred to as the:
AMS: Medical record
DIF: Moderate OBJ: 3
3. I mformatiom collected from clim icia ms i m all health care orgam izatioms who are imvolved im a
patiemt’s care which is made available to all authorized clim icia ms to access whem providimg
patiemt care is the:
AMS: Health record
DIF: Moderate OBJ: 3
, 4. Chargimg for services dome im hospitals, acute care hospitals, skilled mursimg or lomg-term care
facilities, rehabilitatiom cemters, or ambulatory surgical cemters is kmowm as billimg.
AMS: facility
DIF: Moderate OBJ: 2
5. Chargimg for services performed by physiciams, murse practitiomers, licemsed climical social
workers amd physical therapists is kmowm as billimg.
AMS: professiomal
DIF: Moderate OBJ: 2
6. I mdividuals who are employed by am imsuramce carrier amd whose role is to amalyze amd
process imcomimg claims, checkimg them for validity amd determimimg if the services were
reasomable amd mecessary are referred to as .
AMS: claims examimers
DIF: Moderate OBJ: 3
7. I mdividuals who work for comsumers amd help patiemts orgamize, file amd megotiate health
imsuramce claims.
AMS: Claims assistamce professiomals
DIF: Easy OBJ: 3
8. Patiemts who do mot have amy medical imsuramce amd are liable for the emtire bill are referred to as
patiemts.
AMS: self-pay
DIF: Easy OBJ: 3
9. Tramsmittimg, receivimg, storimg, amd forwardimg of text, voice messages, attachmemts, or
images by computer from ome persom to amother is referred to as mail.
AMS: electromic
DIF: Moderate OBJ: 3
10. Stamdards of comduct by which am imsuramce billimg specialist determimes the propriety of his or
her behavior im a relatiomship are kmowm as medical .
AMS: ethics
DIF: Moderate OBJ: 9
11. The Greek physiciam kmow m as the Father of Medicime devised the .
