Fordneys Medical Insurance 15th Edition Smith

Fordney’s Medical Insurance 15th Edition Smith Test Bank

Chapter 01: Role of an Insurance Billing Specialist

Smith: Fordney’s Medical Insurance, 15th Edition

MULTIPLE CHOICE

• Administrative medical office responsibilities include
• laboratory analyses.
• claims submission.
• taking x-rays.
• venipunctures.

ANS: B DIF: Easy REF: 4 OBJ: 2

• A claims assistance professional
• works for the consumer.
• helps patients file insurance claims.
• neither works for the consumer nor helps patients file insurance claims.
• works for the consumer and helps patients file insurance claims.

ANS: D DIF: Easy REF: 4 OBJ: 2

• What is “cash flow” in a medical practice?
• The actual money available to a medical practice
• The amount of money received by a medical practice in 1 day
• The amount of money received by a medical practice in 1 month
• The amount of outstanding money on the accounts receivable

ANS: A DIF: Moderate REF: 4 OBJ: 2

• Which level of education is generally required for one who seeks employment as an insurance

coder?

• College diploma.
• High school diploma.
• Completion of an accredited program for coding certification.
• No specific level of education is required.

ANS: C DIF: Easy REF: 4 OBJ: 4

• The amount of money an insurance billing specialist earns is dependent on which of the

following factors?

• Knowledge
• Experience
• Size of employing institution
• All are correct

ANS: D DIF: Moderate REF: 9 OBJ: 5

• A billing specialist is entrusted with
• holding patients’ medical information in confidence.
• collecting monies.
• being a reliable resource for co-workers. 1 / 4

• all are correct.

ANS: D DIF: Moderate REF: 13 OBJ: 7

• Medical etiquette refers to
• consideration for others.
• moral principles or practices.
• laws.
• the Oath of Hippocrates.

ANS: A DIF: Moderate REF: 11 OBJ: 9

• Professional ethics include
• state laws.
• federal laws.
• standards of conduct.
• civil torts.

ANS: C DIF: Moderate REF: 13 OBJ: 9

• The earliest written code of ethical principles for the medical profession is the
• Oath of Hippocrates.
• Socratic oath.
• Code of Hammurabi.
• Medicolegal oath.

ANS: C DIF: Easy REF: 13 OBJ: 9

• What is the name of the mTodEeSrnTcBodAeNoKf SetEhiLcsLtEhRat.thCeOAMmerican Medical Association (AMA)

adopted in 1980?

• The Modern Standards of Conduct Code
• The Principles of Medical Ethics
• The Oath of Hippocrates
• The American Medical Association Code of Ethics

ANS: B DIF: Easy REF: 13 OBJ: 9

• A self-employed medical insurance biller who does independent contracting is responsible for
• advertising.
• billing.
• accounting.
• all are correct.

ANS: D DIF: Hard REF: 10 OBJ: 10

• The Internet Health care Coalition has developed
• the AAMA Code of Ethics.
• the eHealth Code of Ethics.
• the AMA Code of Ethics.
• the AHIMA Code of Ethics.

ANS: B DIF: Moderate REF: 13 OBJ: 9 2 / 4

• Reporting incorrect information to government-funded programs is
• unethical.
• illegal.
• abuse.
• fraud.

ANS: B DIF: Moderate REF: 13 OBJ: 9

• The doctrine stating that physicians are legally responsible for both their own conduct and that

of their employees is known as

• respondeat superior.
• let the master answer.
• vicarious liability.
• all are correct.

ANS: D DIF: Hard REF: 14 OBJ: 10

• The AHIMA Code of Ethics is appropriate for
• health information specialists.
• coders.
• insurance billing specialists.
• all are correct.

ANS: D DIF: Easy REF: 14 OBJ: 9

COMPLETION

• TisEtSheTtBotAalNiKncSoEmLe LprEoRdu.cCedObMy a health care organization.

ANS: Revenue

DIF: Moderate REF: 2 OBJ: 1

• An NPP is a .

ANS: non-physician practitioner

DIF: Moderate REF: 3 OBJ: 3

• Charging for services done in hospitals, acute care hospitals, skilled nursing or long-term care

facilities, rehabilitation centers, or ambulatory surgical centers is known as billing.

ANS: facility

DIF: Moderate REF: 3 OBJ: 2

• Obtaining and recording patient data using a questionnaire before that person’s first visit is

known as .

ANS: preregistration

DIF: Easy REF: 3 OBJ: 3 3 / 4

• Individuals who are employed by an insurance carrier and whose role is to analyze and

process incoming claims, checking them for validity and determining if the services were reasonable and necessary are referred to as , or .

ANS:

claims examiners claims adjustors claims representatives claims examiners claims representatives claims adjustors claims adjustors claims representatives claims examiners claims adjustors claims examiners claims representatives claims representatives claims examiners claims adjustors claims representatives claims adjustors claims examiners claims examiners, claims adjustors, claims representatives claims examiners, claims representatives, claims adjustors claims adjustors, claims representatives, claims examiners claims adjustors, claims examiners, claims representatives claims representatives, claims examiners, claims adjustors claims representatives, claims adjustors, claims examiners

DIF: Moderate REF: 3 OBJ: 3

• Patients who do not have any medical insurance and are liable for the entire bill are referred to

as patients.

ANS: self-pay

DIF: Easy REF: T 4

ESTBANKS

O E B L

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LE 3 R.COM

• Transmitting, receiving, storing, and forwarding of text, voice messages, attachments, or

images by computer from one person to another is referred to as mail.

ANS: electronic

DIF: Moderate REF: 12 OBJ: 3

• The Greek physician known as the Father of Medicine devised the .

ANS: Oath of Hippocrates

DIF: Easy REF: 13 OBJ: 2

• Most health care professionals have a well-defined which easily draws a

boundary on things which the professional can do and things they are not supposed to do.

ANS: scope of practice

DIF: Moderate REF: 13 OBJ: 3

• The Greek physician known as the Father of Medicine devised the .

ANS: Oath of Hippocrates

• / 4