"Which of the following does NOT qualify a patient for coverage under Medicare?", "Low-income individual" "Patient insurance card will contain vital information that will allow a claim to be processed. Which of the following is NOT provided on the insurance card?", "Claim #, CPT code, Diagnosis" "What is a claim that is sent for reimbursement that contains all the required data elements to process the claim referred to as?", "Clean claim" "HIPAA Section 164.508 states that covered entities may not use or disclose protected information without a valid authorization. In what circumstances can a practice NOT release protected information with a signed authorization?", "Records requested for life insurance" "Child presents for care with the father. Both parents have coverage, date of birth for mother is 3/21 and date of birth for father is 6/20. The mother is covered by a COBRA. What is the primary coverage for the child?", "The father’s insurance is primary because the mother has COBRA" "A child is brought in by the mother to be seen. The mother (DOB 02/08/93) is the custodial parent and is remarried. She has an individual policy. The father (DOB 10/10/92) is covered by a policy from work. The step-father is also covered at work. Which of the following is correct?", "The mother's insurance is primary." "Which of the following statements is TRUE regarding patient demographics?", "Patient demographic information entered incorrectly can result in claim denials" "The parent with whom the child resides is identified as which of the following?", "custodial parent" "Listed below are examples of patient reminders for appointments. Which one is HIPAA compliant?", ""This is the doctor’s office calling to remind you of your appointment Tuesday, April 12 at 9 am."" "The patient encounter begins with what step?", "scheduling an appt" "When reading an insurance card what information should the receptionist or front office person look for?", "Policy holder name, ID number, benefits" "When insurance coverage is being verified, which of the following is NOT a method on which to rely?", "Patient" "Which of the following is true when entering patient data information into a PMS?", "Enter the patient information accurately from the insurance card and patient registration form" "Information about deductibles, copays, eligibility dates, and benefit plans is completed during what step?", "verification of benefits" "9-year-old is brought in by her father for a sore throat. The patient has insurance coverage through both the mother and father. Which coverage is considered primary?", "The primary insurance is determined by the birthday rule" "How do most practices submit claims to the insurance company?", "through a clearinghouse" "Which of the following lists the life cycle of a claim?", "Claims submission, claims processing, claims adjudication, payment/denial" "What authorizes information to be sent to the insurance payer so payment of medical benefits can be processed?", "consent for payment" "Which of the following processes could result in lost charges?", "Posting charges and payment in different batches with no balancing" "The back of the health insurance card includes what information?", "Phone or contact information for eligibility" "What is a deductible?", "Amount of expenses that must be paid before any payment is made by the insurance company" "Which statement is TRUE regarding appointment reminders?", "Appointment reminders can be sent via text." "Patient is seen and billed for a 99213 for $75.00. She has a policy that pays 80% of the allowable amount which is $68.00. What is the patient responsibility and amount to collect for the visit?", "$13.60" "A female patient is covered by her employer and her husband’s insurance plan. His birthday is 3/21 and hers is 6/18. Which insurance is considered primary?", "The patient’s insurance because she is the primary subscriber" "What information can be released based on this Disclosure form?<br /> AAPC Physician Practice are authorized to make the disclosure. The type of information to be used or disclosed is as follows:<br /> ____ Problem list ____ Medication list<br /> ____ List of allergies ____ Immunization records<br /> ____ Most recent history __X_ Most recent discharge summary<br /> __X__ Lab results (dates or types) ______________________<br /> __X__ X-Ray and imagining reports (dates or types) _________________<br /> ____ Consultation reports from ___________________________________<br /> ___ Entire record", "Discharge summary, lab, and X-ray" "Patient types help to classify the patients based on which of the following?", "payer" "Verification of insurance will allow the practice to know the amount to collect from the patient at the time of visit. Which of the following is TRUE?", "If the insurance is unable to be verified, the patient is offered an option to reschedule the appointment or proceed with the current appointment as a self-pay patient." "When a fee ticket (encounter form) is not completed, what procedure would NOT be acceptable?", "Post the service as a no charge" "Which statement regarding patient demographic information is correct?", "Patients can provide information by completing a paper form or by completing online registration." "When does the processing of an insurance claim for a patient begin?", "When the appt is scheduled" "The type of coverage that a patient has and what services are covered is defined as the patient’s insurance ___________.", "benefits" "In what circumstance would the check-out process be unnecessary?", "The patient made a copay during the check-in process and no follow up appointment is necessary" "What process would NOT be performed at the check-out process?", "Patient registration process" "Which of the following is NOT considered a part of the authorized process when the patient signs the consent for payment?", "Authorization for treatment"
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