Navigation » List of Schools » Glendale Community College » Medical Office Administration » MOA 183 – Intro to Health Insurance » Fall 2022 » Weekly Quiz 7 Chapter 9 & 16
Below are the questions for the exam with the choices of answers:
Question #1
A fraud.
B conversion.
C embezzlement.
D retention.
Question #2
A 180 days.
B 1 year.
C 3 years.
D 5 years.
Question #3
A Department of Labor.
B carrier president.
C carrier legal department.
D Department of Insurance.
Question #4
A 30 days.
B 120 days.
C 90 days.
D 60 days.
Question #5
A redetermination by the carrier.
B review by the state insurance commissioner.
C review by a qualified independent contractor.
D review by an administrative law judge.
Question #6
A review by the state insurance commissioner.
B review by an administrative law judge.
C redetermination by the carrier.
D review by a qualified independent contractor.
Question #7
A review by the state insurance commissioner.
B review by a qualified independent contractor.
C review by an administrative law judge.
D redetermination by the carrier.
Question #8
A 30 days after denial.
B 180 days after denial.
C 60 days after denial.
D 90 days after denial.
Question #9
A HIPAA.
B Title XXI of the Social Security Act.
C ERISA.
D FECA.
Question #10
A a billing error was made by the medical office assistant.
B the patient had a routine service covered by the policy.
C the claim was for services related to an accident.
D the carrier requested information from the patient that was not received.
Question #11
A sending a form letter.
B rebilling the claim.
C telephone or fax.
D sending a copy of pertinent court decisions.
Question #12
A a modifier was used to indicate multiple procedures that the carrier bundled.
B the patient had a routine service covered by the policy.
C the claim was considered not medically necessary.
D the carrier requested information from the patient that was not received.
Question #13
A from the patient medical record.
B about why the patient cannot afford to pay more.
C about payment from other carriers for the reported service.
D about the physician’s financial situation.
Question #14
A newsletters from the carrier.
B All of these.
C an administrative manual.
D phone calls to the carrier.
Question #15
A part of the plan.
B part of the assessment.
C objective information.
D subjective information.
Question #16
A assessment information.
B objective information.
C subjective information.
D the plan.
Question #17
A subjective information.
B objective information.
C the plan.
D assessment information.
Question #18
A patient should be contacted to confirm the service was rendered.
B physician should verbally verify that the service was provided.
C medical office specialist should be contacted to modify the record.
D service was not performed and cannot be billed.
Question #19
A claims processing.
B medical transcription.
C documentation.
D encounter form completion.
Question #20
A explain in simple language why the insurance carrier denied payment.
B use respect and care when explaining policy benefits.
C if the denial was due to a need for additional information, submit the additional documentation immediately and let the patient know it has been done.
D ask the patient to call the insurance carrier to try to get them to reconsider.
Question #21
A adjudication.
B reconsideration.
C appeal.
D audit.
Question #22
A peer review.
B utilization review.
C appeal committee review.
D routine examination of claims.
Question #23
A write off the entire amount.
B submit the required information and follow up with the carrier.
C bill the patient.
D ask the patient to write a letter explaining the situation.
Question #24
A negotiate with the patient for partial payment.
B bill the patient.
C file an appeal with the insurance carrier.
D write off the entire amount.
Question #25
A the patient was not eligible when the initial claim was filed.
B the medical office specialist made a mistake on the claim.
C charges on the original claim were not detailed.
D some of the services provided to a patient were not billed on prior claims.
Question #26
A bundling.
B upcoding.
C unbundling.
D downcoding.
Question #27
A False
B True
Question #28
A a new patient office visit.
B an established patient office visit.
C subsequent in-hospital care.
D critical care services.
Question #29
A CPT Guidelines.
B CPT Appendix A.
C CPT Appendix C.
D CPT Index.
Question #30
A the presenting problems.
B the possible management options.
C All of these.
D the diagnostic procedures.
Question #31
A minimal.
B high.
C moderate.
D low.
Question #32
A must be part of the HPI.
B can be stated or implied.
C must be explicitly stated.
D must be coded.
Question #33
A comprehensive exam.
B problem-focused exam.
C expanded problem-focused exam.
D detailed exam.
Question #34
A tissue systems.
B body organs.
C body areas.
D organ systems.
Question #35
A general organ system exam.
B general multisystem exam.
C multibody-area exam.
D single organ system exam.
Question #36
A family history.
B HPI.
C social history.
D past history.
Question #37
A comprehensive.
B pertinent.
C detailed.
D complete.
Question #38
A brief or comprehensive.
B brief or extended.
C brief or detailed.
D brief or complicated.
Question #39
A three HPI elements.
B one HPI element.
C four HPI elements.
D two HPI elements.
Question #40
A quality.
B severity.
C associated signs and symptoms.
D context.
Question #41
A severity.
B timing.
C quality.
D duration.
Question #42
A history of present illness (HPI).
B past, family, and social history (PFSH).
C review of systems (ROS).
D chief complaint (CC).
Question #43
A comprehensive.
B detailed.
C expanded problem focused.
D problem focused.
Question #44
A unbundle the service.
B pay the service as billed.
C upcode the service.
D deny payment.
Question #45
A extent of the exam documented.
B complexity of the diagnosis.
C complexity of the medical decision making.
D extent of the history documented.
Question #46
A the provider.
B all office staff.
C the office manager.
D the provider and the office manager.
Question #47
A bundling.
B downcoding.
C unbundling.
D upcoding.
Question #48
A private payer.
B All of these.
C practice employee.
D government investigator.
Question #49
A prospectively only.
B either prospectively or retrospectively.
C retrospectively only.
D neither prospectively or retrospectively.
Question #50
A completeness of progress reports.
B accurate coding and billing.
C appropriate documentation of the visit.
D the date of service and the patient’s insurance identification number.