Medical Coding & Billing Final Review
(updated) questions and answers
In an HMO with a gatekeeper system a _____ coordinates the patient's care and provides
referrals. - correct answer ✔✔PCP
Combines a health plan that has a high deductible and low premiums w/ a special "savings
account" that is used to pay medical bills before deductible has been met. - correct answer
✔✔CDHP
Health plans pay for ____ services. - correct answer ✔✔Covered
In an HMO, securing ____ may be required before services are provided. - correct answer
✔✔Preauthorization
A self-insured health plan may use its own _____ - correct answer ✔✔Funds
Unlike an HMO, a PPO permits its members to use ______ providers, but at a higher cost. -
correct answer ✔✔Out-of-network
The major government-sponsored health programs - correct answer ✔✔TRICARE, CHAMPVA,
Medicare and Medicaid
Coinsurance is calculated based on ____ - correct answer ✔✔Percentage of a charge
When a patient has insurance coverage for which the practice will create a claim, the patients
bill is usually done ___ - correct answer ✔✔After encounter/after payers payment is posted
, If a patient's payment is later than permitted under the financial policy of the practice, the
______ may be started. - correct answer ✔✔Collection Process
File containing the documentation of a patient's medical history and related information. -
correct answer ✔✔Medical record
Failure to use professional skill when given medical services that results in injury or harm. -
correct answer ✔✔Malpractice
Recording of a patient's health status in a medical record. - correct answer ✔✔Documentation
State-specified performance measures for the delivery of healthcare. - correct answer
✔✔Medical standards of care
Visit between a patient and a medical professional. - correct answer ✔✔Evaluation &
management
Process by which a patient authorizes medical treatment after a discussion with a physician. -
correct answer ✔✔Informed consent
How using EHRs is integrated with practice management programs - correct answer ✔✔Medical
documentation & billing cycle
Federal agency that runs Medicare, Medicaid, clinical laboratories and other government health
programs. - correct answer ✔✔Centers for Medicare and Medicaid services
Enables the sharing of health-related information among provider organizations - correct
answer ✔✔Health information exchange
(updated) questions and answers
In an HMO with a gatekeeper system a _____ coordinates the patient's care and provides
referrals. - correct answer ✔✔PCP
Combines a health plan that has a high deductible and low premiums w/ a special "savings
account" that is used to pay medical bills before deductible has been met. - correct answer
✔✔CDHP
Health plans pay for ____ services. - correct answer ✔✔Covered
In an HMO, securing ____ may be required before services are provided. - correct answer
✔✔Preauthorization
A self-insured health plan may use its own _____ - correct answer ✔✔Funds
Unlike an HMO, a PPO permits its members to use ______ providers, but at a higher cost. -
correct answer ✔✔Out-of-network
The major government-sponsored health programs - correct answer ✔✔TRICARE, CHAMPVA,
Medicare and Medicaid
Coinsurance is calculated based on ____ - correct answer ✔✔Percentage of a charge
When a patient has insurance coverage for which the practice will create a claim, the patients
bill is usually done ___ - correct answer ✔✔After encounter/after payers payment is posted
, If a patient's payment is later than permitted under the financial policy of the practice, the
______ may be started. - correct answer ✔✔Collection Process
File containing the documentation of a patient's medical history and related information. -
correct answer ✔✔Medical record
Failure to use professional skill when given medical services that results in injury or harm. -
correct answer ✔✔Malpractice
Recording of a patient's health status in a medical record. - correct answer ✔✔Documentation
State-specified performance measures for the delivery of healthcare. - correct answer
✔✔Medical standards of care
Visit between a patient and a medical professional. - correct answer ✔✔Evaluation &
management
Process by which a patient authorizes medical treatment after a discussion with a physician. -
correct answer ✔✔Informed consent
How using EHRs is integrated with practice management programs - correct answer ✔✔Medical
documentation & billing cycle
Federal agency that runs Medicare, Medicaid, clinical laboratories and other government health
programs. - correct answer ✔✔Centers for Medicare and Medicaid services
Enables the sharing of health-related information among provider organizations - correct
answer ✔✔Health information exchange
