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Medical Administrative Certification Practice

Quiz by Elisa Dasalla

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59 questions
Show answers
  • Q1
    You work in a family practice office. A patient comes in with an insurance card that reads: $75 Emergency Room $25 PCP Office Visit $45 Specialist Office Visit $1500 Deductible According to the card, how much would the patient owe you for today’s visit?
    $25
    the cost of the office visit as set by the practice (until the $1500 deductible has been met)
    $45
    0
    30s
  • Q2
    Michelle had a baby, and the total cost was $10,000. If she has a deductible of $1,000, and a co-insurance of 10% thereafter, how much would she owe?
    $1600
    $2000
    $1900
    $1000
    30s
  • Q3
    Which of these best describes the concept of coordination of benefits?
    Coordination of benefits happens when a patient pays for her healthcare via multiple financial sources―insurance, health savings accounts (HSAs), cash, credit card, etc.
    Coordination of benefits happens when a patient has two different health insurance plans. One plan is the primary plan that pays claims first. The secondary plan pays the remaining costs.
    Coordination of benefits happens when a healthcare facility coordinates directly with insurance companies and suppliers to lower costs at their facility.
    Coordination of benefits happens when a patient must pay his deductible before his insurance company will pay for any of his healthcare costs.
    30s
  • Q4
    A doctor asks you to bill for a procedure that would pay out at a higher rate than the one he actually performed. This would be an example of which type of fraudulent claim?
    split billing
    upcoding
    unbundling
    phantom billing
    30s
  • Q5
    Which of the following is false regarding the relationship between medical practices and collection agencies?
    Larger medical practices typically have their own collection agencies.
    Collection agencies attempt to collect money from a patient after they have repeatedly failed to pay a medical practice.
    A collection agency typically takes 50% of the amount collected.
    A medical practice should no longer try and collect for a bill when it has been turned over to a collection agency.
    30s
  • Q6
    A medical office has a monthly income and expenses as follows: Income: $300,000 Expenses: $100,000 Given this information, what would be the net income for the month?
    $400,000
    $100,000
    $200,000
    $300,000
    30s
  • Q7
    A check signed with the words “Pay to the order of” is an example of which type of endorsement:
    registered endorsement
    restrictive endorsement
    open endorsement
    blank endorsement
    30s
  • Q8
    Which of the following is a newborn care CPT code?
    99461
    O30.003
    K21.0
    B01.2
    30s
  • Q9
    Which definition properly describes Relative Value Units (RVUs)?
    money owed to a medical practice for services that have been rendered and billed
    any outstanding money owed by a practice to suppliers
    payments received by a practice, typically from patients or insurance companies
    part of the Medicare system’s assessment of the worth of services rendered
    30s
  • Q10
    Who would request preauthorization from an insurance company for a specific treatment?
    the patient’s employer
    a specialty physician
    the patient
    the treating physician/medical practice
    30s
  • Q11
    Which document is prepared by the insurance company and provided to the patient after treatment is given and includes coverage details?
    Form 941
    Explanation of Benefits (EOB)
    preauthorization
    CMS1500
    30s
  • Q12
    When is an unpaid account typically considered overdue?
    after 30 days
    after 45 days
    after 1 year
    after 90 days
    30s
  • Q13
    Which of the following describes a Point-of-Service (POS) plan?
    an HMO that allows individuals to choose a provider from a list of physicians that have preapproved a discounted payment rate
    groups of providers and facilities that volunteer to provide high-quality treatment for those patients covered by Medicare
    a group of hospitals and physicians contract with an insurance company at a discounted rate
    an integration of physical and mental health by focusing on collaboration between all providers of the patient
    30s
  • Q14
    Which of these insurance companies is a commercial business?
    CHAMPVA
    Tricare
    Medicaid
    Blue Cross Blue Shield
    30s
  • Q15
    What coding system was used by healthcare providers to report diagnoses and procedures on claim forms prior to October 1, 2015?
    ICD-9-CM
    HCPCS Level I (CPT)
    ICD-10-CM
    ICD-10-CM
    30s

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