MA290
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| 6995896665 | Ajudication | Final determination involving settlement of industrial accident. | 0 | |
| 6995896666 | OSHA | Occupational Safety and Health Administration | 1 | |
| 6995896667 | NPI | National Provider Identifier | 2 | |
| 6995896668 | SOAP | Subjective, Objective, Assessment, & Plan. | 3 | |
| 6995896669 | NOS | Not Otherwise Specified | 4 | |
| 6995896670 | NEC | Not Elsewhere Classified | 5 | |
| 6995896671 | True or False. Are worker's compensation records kept in a separate chart or patient's personal chart if they see their own provider for worker's comp. services? | TRUE | 6 | |
| 6995896672 | What are supplementary reports and when are they filed for temporary disability insurance claims? | They are progress notes which are filed after every visit. | 7 | |
| 6995896673 | In worker's compensation case, the contract and financial responsibility is between who? | Insurance company and the physician | 8 | |
| 6995896674 | True or False. For patients receiving VA medical care, travel expenses to and from a facility is a benefit. | TRUE | 9 | |
| 6995896675 | True or False. California allows for state disability benefits in normal routine pregnancy. | TRUE | 10 | |
| 6995896676 | Where are disability insurance available from, what sources? | Federal, government, state, employer sponsored, and or private insurance. | 11 | |
| 6995896677 | What is one of the most important items needed on a state disability claim from? | Social Security Number | 12 | |
| 6995896678 | Compromise and Release | When a case is rated for permanent disability and settled. | 13 | |
| 6995896679 | What is the simplest type of worker's compensation claim? | Non- disability | 14 | |
| 6995896680 | What do worker's compensation benefits include? | Medical treatment, financial, rehab benefits, disability, death. | 15 | |
| 6995896681 | In many states, worker's compensation laws have exemption for certain occupations such as? | Gardeners, baby sitters,and domestic help. | 16 | |
| 6995896682 | Premiums for worker's compensation insurance are paid by: | The employer. | 17 | |
| 6995896683 | What are the reasons for worker's compensation laws? | Ensure employee returns to work promptly, to provide income, encourage employer interest in safety. | 18 | |
| 6995896684 | A person who is retired from a career in the armed forces is eligible for TRICARE until 65 years of age? | Yes and then at the age of 65 they get Medicare | 19 | |
| 6995896685 | What is CHAMPVA? | A service benefit program. | 20 | |
| 6995896686 | How does a person qualify for CHAMPVA? | Program is for: spouse or kids of veterans with total, permanent service connected disability or surviving spouse or kids of veteran who died from service connected to a disability. | 21 | |
| 6995896687 | Who can treat CHAMPVA patients? | Freedom of choice in selecting their civilian health care providers. VA & military base doctors. | 22 | |
| 6995896688 | How and who administers Medicaid benefits? | The state with federal guidelines handle it. | 23 | |
| 6995896689 | What individuals qualify for Medicaid benefits? | Certain needy and low income people, pregnant, such as elderly (65+), blind, disabled, members of families with dependent kids deprived of support of at least one parent. Only for US citizens. | 24 | |
| 6995896690 | What benefits are available through Medicaid? | Family planning, home health care, immunization, lab, x-ray, hospice, Rx drugs, dental, etc. | 25 | |
| 6995896691 | Who is eligible for Medicare benefits? | 65 and older retired on social security, 65+ retired from railroad/ civil service, disabled, kids or adult with chronic kidney disease, and kidney donors. | 26 | |
| 6995896692 | What are the different types of coverages Medicare provides? | Medicare Part A: hospital coverage, nursing facility, home healthcare services, psychiatric hospital, and respite care. No matter what ,at age 65, you must take this part. Medicare Part B: outpatient coverage or medical advantage. Medicare Part C: supplemental coverage. Covers what other parts doesn't. Medicare Part D: prescription drugs. | 27 | |
| 6995896693 | Who administers Medicare? | The Federal government. | 28 | |
| 6995896694 | What are the two types of bankruptcy? | Chapter 7: can liquidate assets to pay for what you owe. Chapter 13: payment arrangements. Also known as wage earners bankruptcy. | 29 | |
| 6995896695 | What is small claims court? | Gives 'lay' people access to court system without a lawyer. Some advantages are the modest filing fees, less paperwork, no lawyer, and short time frame from filing to actual trial. For amounts less than $5,000. | 30 | |
| 6995896696 | When insurance carriers don't pay claims in a timely manner, what effect does this have on the medical practice? | Decreases cash flow (which is usable cash, money on hand). | 31 | |
| 6995896697 | What does professional courtesy mean? | Discount or exemption for charges at discretion of the doctor. Making no charge to anyone, patients or insurance company for medical care. | 32 | |
| 6995896698 | What is the first level of appeal in the Medicare program? | Redetermination (phone) | 33 | |
| 6995896699 | True or False. Routine use of too many non-specific diagnostic codes may result in downcoding. | True. | 34 | |
| 6995896700 | What are non-specific codes anything other than an injury or illness called? | Z codes | 35 | |
| 6995896701 | An insurance claim submitted with errors is referred to as? | Dirty claim. | 36 | |
| 6995896702 | A code or codes that further explain or add additional detail to a CPT code is known as a: | Modifier | 37 | |
| 6995896703 | What does bundling mean? | Grouping codes that are related to a procedure. | 38 | |
| 6995896704 | Key components that determine an evaluation and management code are documented by who? | The physician | 39 | |
| 6995896705 | How often are CPT & ICD codes updated? | Annually or yearly. | 40 | |
| 6995896706 | What are neoplasms? | New or abnormal growth of tissue. | 41 | |
| 6995896707 | What are codes called that are used primarily by cancer and tumor registries? | Morphology codes | 42 | |
| 6995896708 | True or False. It is possible to for primary diagnosis and the principal diagnosis to be the same. | TRUE | 43 | |
| 6995896709 | True or false. We can code for symptoms. | True. | 44 | |
| 6995896710 | True or false. A condition be both acute and chronic at the same time. | True. | 45 | |
| 6995896711 | What is the term used as a name of a disease, structure, operation, or procedure, usually derived from the name of a place or person who discovered or described it first. | Eponym. | 46 | |
| 6995896712 | True or false. Burns are reported based on the depth & extent of the burn, and the agent that caused the burn. | True. | 47 | |
| 6995896713 | Know the difference between principle, primary, and secondary diagnosis. | Principle diagnosis: comes after further testing. Example: asthma Primary diagnosis: reason why you came in. Example: shortness of breath. Secondary diagnosis: caused by primary diagnosis. Example: wheezing. | 48 | |
| 6995896714 | What do diagnostic codes explain? | What was wrong with the patient. | 49 | |
| 6995896715 | What do procedure codes explain? | What we did for the patient. | 50 | |
| 6995896716 | What is the birthday rule? | Whose ever birthday comes first within the year (by month and day if needed), or whoever had the insurance the longest or first. Determines what is primary and secondary insurance. | 51 | |
| 6995896717 | What is the reason for coordination of benefits statement in a health insurance policy? | To avoid something being billed twice or duplication of claims. | 52 | |
| 6995896718 | When does the physician- patient contract begin? | When the patient makes the appointment! When the doctor accepts and agrees to see the patient. | 53 | |
| 6995896719 | Most physician- patient contracts are: | Implied. | 54 | |
| 6995896720 | True or false. Confidentiality between the doctor and patient is automatically waived when the patient is being treated in a worker's compensation case. | True. | 55 | |
| 6995896721 | Submitting a claim for services thats not medically necessary is a violation of what Act? | False claims act | 56 | |
| 6995896722 | What penalties might be incurred for illegally coding claims? | Jail,fines, lose license/ suspended. | 57 | |
| 6995896723 | True or false. Physicians are legally responsible for any actions of their employees performed within the context of their employment. | true. | 58 | |
| 6995896724 | What does cash flow mean? | Ongoing availing of cash in the medical practice. | 59 | |
| 6995896725 | What does confidential information include? | What's seen, written, or heard. | 60 | |
| 6995896726 | What are medical ethics? | Standards of conduct. | 61 | |
| 6995896727 | What's an encounter form and are there at least two other names it could be called? | Proof of care for the day, like a check off list of what was done. Also known as super-bill and charge slip. | 62 | |
| 6995896728 | What's assignment of benefits? | Transfer of ones legal right to collect an amount payable under an insurance contract. | 63 | |
| 6995896729 | What are the reasons to document patient encounters? | To protect yourself. It is wasn't written, it didn't happen! Support reasons why we are billing what we are billing,g and ensures standards are being met. | 64 | |
| 6995896730 | What are differences between a new patient and an existing patient? | A new patient is somebody who is new to the practice or has not been seen in 3 years. An existing patient has been seen before. Even if they have seen by one doctor in the practice, and sees another before the 3 year mark, Within the same practice. | 65 | |
| 6995896731 | true or false. A problem- focused exam (focus on one thing) is more complex than a detailed exam (more intensive). | False. | 66 | |
| 6995896732 | When a discussion takes place with a patient concerning risks and benefits of treatment options, it is considered what? | Counseling | 67 | |
| 6995896733 | A daily record sheet used to record daily business transactions is called? | A day sheet | 68 | |
| 6995896734 | True or false. An insurance billing specialist can escape liability by pleading ignorance. | False. | 69 | |
| 6995896735 | True or false. Personal insurance is usually less expensive than other health insurance. | False. | 70 | |
| 6995896736 | True or false. Information such as deductible, copayment, pre- approval, and insurance company address and telephone number can USUALLY be found on the insurance card. | True. | 71 | |
| 6995896737 | What information can be found on an insurance card? | Member ID number, insurance billing address & number, insurance name, deductible, copayment, member name. | 72 | |
| 6995896738 | Front office medical duties have become increasingly important because: | Diagnostic and procedure codes must be reviewed for completeness and correctness. | 73 | |
| 6995896739 | True or false. The injured worker, does NOT have the right to be evaluated by a doctor who is NOT assigned by the employer. | False | 74 | |
| 6995896740 | True or false. It is believed that the longer the workers compensation patient is out or work, the better they will get. | False. | 75 | |
| 6995896741 | True or false. It is possible for a Medicaid patient to be on Medicaid one month and off the next. | True. | 76 | |
| 6995896742 | How many payment installations must there be to have full disclosure? | 4 or more. | 77 | |
| 6995896743 | When collecting fees, you goal should be to: | Collect all of it! 100% | 78 | |
| 6995896744 | If you cannot collect the whole fees amount, what amount should you collect? | 90% of it. | 79 | |
| 6995896745 | Who assigns the employer ID number? | IRS | 80 | |
| 6995896746 | What is it called when a group of insurance claims is sent all at once from your office? | Batch | 81 | |
| 6995896747 | E/M. | Evaluation & Management. | 82 | |
| 6995896748 | Why would we use diagnostic codes to describe symptoms? | Because we do not have a definitive diagnosis yet. | 83 | |
| 6995896749 | True or false. Neoplasm is a new growth or abnormal tissue, which can be benign or malignant. | True. | 84 | |
| 6995896750 | What is a person called who is a patient with insurance? | Subscriber, member, insured, or a policy holder. | 85 | |
| 6995896751 | Confidentiality is automatically waived when it comes to: | Gunshot wounds, child abuse, elder abuse, domestic abuse, and extreme contagious diseases. This is done to protect the community. | 86 | |
| 6995896752 | True or false. The patient has the right to get a copy of his or her patient information or record. | True. | 87 | |
| 6995896753 | What is the age limit under the Affordable Care act? | 26 | 88 |
