Medical Billing
Quiz by Amanda Desuacido
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- Q1
Samantha is a medical billing specialist who works in a healthcare facility. She is responsible for handling patient records and billing information. One day, Samantha receives a call from a patient's relative asking about the patient's medical history. What is HIPAA and how does it relate to medical insurance and billing?
HIPAA is a law that requires patients to pay their medical bills in a timely manner.
HIPAA is a law that regulates medical billing and coding procedures.
HIPAA is a law that regulates the privacy and security of patient health information
HIPAA is a law that limits the amount of medical procedures that can be performed on a patient.
30s - Q2
What is the primary role of medical billing and coding in the healthcare industry?
To manage patient care
To diagnose and treat medical conditions
To ensure healthcare providers are paid for their services
To market healthcare services to patients
30s - Q3
What is medical coding?
The process of translating medical procedures and diagnoses into codes
The process of diagnosing medical conditions
The process of managing patient care
The process of submitting insurance claims to payers
30s - Q4
How does a medical biller determine which ICD-10 code to use when submitting a claim for reimbursement?
By using a software program that suggests appropriate ICD-10 codes based on the patient's
By consulting with the patient to verify their symptoms and medical history.
By consulting with the healthcare provider to ensure the correct diagnosis is recorded.
By researching the patient's medical records to find the most accurate diagnosis.
30s - Q5
What is a remittance advice (RA) and why is it important in medical billing?
An RA is a document that provides patients with information about their insurance coverage.
An RA is a report that shows the status of a claim and any payments or adjustments made
An RA is a summary of patient demographics and insurance information.
An RA is a record of a patient's medical history and treatment plan.
30s - Q6
How does a medical biller ensure that a claim is submitted accurately and in a timely manner?
By consulting with the healthcare provider to ensure that all necessary information is included.
All of the above
By following up with the insurance company to verify receipt of the claim and track its progress.
By using billing software that checks for errors and flags potential issues.
30s - Q7
How should medical records be organized for easy accessibility?
Alphabetically by patient's first name
By medical condition or diagnosis
Chronologically by date of visit
By insurance provider
30s - Q8
What is the purpose of a superbill in medical billing?
To list all the services provided to the patient during a visit
To submit a claim to the insurance company for reimbursement
To track a patient's insurance coverage and benefits
To request payment from the patient for services rendered
30s - Q9
How can medical staff ensure patient privacy and confidentiality?
Speak loudly and clearly when discussing patient information
Keep patient information confidential and only share it with authorized staff members on a need-to-know basis
Keep patient records in plain sight on desks or in waiting areas
Share patient information freely among staff members
30s - Q10
Hospital beds, wheelchairs, and oxygen equipment would be considered examples of:
DME
Observation
Pain Management
Evaluation and Management
30s - Q11
John has health insurance with a $1,000 deductible. He recently broke his arm and went to the hospital for treatment. The total cost of the treatment was $5,000. What is a deductible in medical insurance and how will it impact John's coverage?
A deductible is the minimum amount of money that the insured person needs to pay for medical expenses before the insurance company starts paying.
A deductible is the amount of money that the insured person pays for medical expenses before the insurance company starts paying.
A deductible is the maximum amount of money that the insured person can claim for medical expenses in a year.
A deductible is the amount of money that the insurance company pays for medical expenses.
30s - Q12
Fixed or flat dollar amount paid by patients per service.
Out of pocket
Deductible
Copay
Coinsurance
30s - Q13
When a claim has been received but has not been approved or denied, finished or completed.
Rejected claim
Invalid claim
Clean claim
Pending claim
30s - Q14
Sarah works as a medical biller at a dental clinic. Her primary responsibility is to collect payments from patients and handle any billing concerns. Sarah receives a call from a patient who received a bill for a recent follow up visit. The patient is confused about the charges and wants to know why their insurance did not cover certain costs. Sarah reviews the patient's bill and insurance information and determines the following:
The patient's insurance did not cover certain procedures performed during the visit.
The patient's insurance was not active at the time of the visit.
The patient's insurance only covers a portion of the total cost of the visit.
The patient's insurance fully covered the cost of the visit.
30s - Q15
David works as a medical billing specialist at a large healthcare organization. David receives a claim for a patient's recent hospital visit. He reviews the claim and discovers that the patient's insurance coverage has changed since their last visit. David needs to verify the patient's new insurance coverage and benefits before resubmitting the claim.
Contacting the patient's previous employer to verify insurance information.
Checking the patient's social media profiles for insurance information.
Searching online for insurance coverage and benefits based on the patient's name.
Calling the insurance company directly to verify coverage and benefits.
30s