HIM 110 - Chapter 5 Homework

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Tomas Bridgewater

What is the member's name?

2003.4916

What is the member's ID number?

$50

What is the amount of the copayment due when the patient goes to the emergency room?

05/01/2016

What is the date on which the coverage became effective?

$5

What is the copayment for generic prescriptions?

HMO

What type of insurance plan does the patient have?

No

Is the following routinely collected upon registration of a new patient:
Notice of Privacy Practices

Yes

Is the following routinely collected upon registration of a new patient:
medical history

Yes

Is the following routinely collected upon registration of a new patient:
insurance information

No

Is the following routinely collected upon registration of a new patient:
copy of last bank statement

Yes

Is the following routinely collected upon registration of a new patient:
copy of insurance card

No

Is the following routinely collected upon registration of a new patient:
copy of living will

No

Is the following routinely collected upon registration of a new patient:
advance beneficiary notice

Yes

Is the following routinely collected upon registration of a new patient:
financial agreement and authorization for treatment

Yes

Is the following routinely collected upon registration of a new patient:
assignment of benefits statement

No

Is the following routinely collected upon registration of a new patient:
National Provider Identifier (NPI)

Yes

Is the following routinely collected upon registration of a new patient:
Acknowledgment of Receipt of Notice of Privacy Practices

No

Is the following routinely collected upon registration of a new patient:
HIPAA X12 837 transaction

No

Is the following routinely collected upon registration of a new patient:
assignment of health care proxy

...

The Account tab contains basic information about a patient and his or her employment. (T/F)

false

On the patient registration form, the patient and the insured must always refer to the same person. (T/F)

...

The Acknowledgment of Receipt of Notice of Privacy Practices states that the patient has received the document that states how the provider intends to protect the patient's rights to privacy under HIPAA. (T/F)

true

Under the HIPAA Privacy Rule, providers do not need specific authorization to release patients' PHI for treatment, payment, and health care operations purposes. (T/F)

...

When laboratory claims are billed electronically, the Clinical Laboratory Improvement Act (CLIA) number must be included in the claim. (T/F)

...

Primary and secondary insurance claims are filed simultaneously to ensure prompt payment to the medical practice. (T/F)

...

If a patient qualifies for Medicaid and Medicare, Medicaid is always considered the primary carrier and is billed accordingly. (T/F)

...

An insurance carrier will not accept and process insurance claims for patients whose signatures are not on file with the medical practice. (T/F)

...

Information about a patient's health is recorded in the Diagnosis and Condition tabs in Medisoft Network Professional. (T/F)

...

Some medical offices are now asking patients for partial payment of the office visit charges during check-in to increase cash flow. (T/F)

coordination of benefits

guidelines that ensure that when a patient has more than one policy, maximum appropriate benefits are paid, but without duplication

financial policy

explains who is responsible for charges not paid by the carrier

birthday rule

the parent whose day of birth is earlier in the calendar year holds the primary plan

guarrantor

subscriber

assignment of benefits

authorization to allow benefits to be paid directly to a provider

chart number

a unique alphanumeric code the identifies a patient

case

a grouping of transactions that relate to a specific medical condition

primary insurance plan

first plan to be billed

patient information form

patient registration form

registration

process of gathering personal and insurance information about a patient at check-in

...

________ are used during patient encounters to track where patients are during the different steps of the encounter.

...

The medical history form contains all of the following EXCEPT ________. (lifestyle factors, medical conditions of family members, details of prior surgeries, previous occupations held)

...

The ________ form is used to collect basic demographic information about the patient.

preferred provider

Each of the terms below refers to the insured EXCEPT ________. (guarantor, policyholder, subscriber, preferred provider)

assignment of benefits

The policyholder authorizes the physician to submit insurance claims for patients and receive payments directly by signing the ________ statement.

advance beneficiary notice of noncoverage

If a provider thinks that a procedure will not be covered by Medicare, the patient is notified of this before the treatment by means of the _________ form.

coordination of benefits guidelines

________ ensure that when patients have more than one policy, maximum appropriate benefits are paid.

birthday rule

The process used to determine the primary insurance carrier if both parents cover dependents on their health insurance plans is called the ________.

...

The financial policy of the practice addresses all of the following topics EXCEPT ________. (assigned claims, unassigned claims, copayments, referred claims)

...

Which of the following options is not used for conducting searches in Medisoft Network Professional? (Search for box, Field box, Locate buttons, Quick Search button)

Appointment

The ________ Book option on the Activities menu is used to open Office Hours.

provider

To view information about a patient's appointment in Office Hours, you must first select the patient's ________.

Remainder

If the patient has a balance due on the account, the amount appears in the ________ field.

eight

How many characters are used to assign a Medisoft chart number?

zero

What character is always the final number in a Medisoft chart number?

patient's last name

The first five characters of a Medisoft chart number repeat the first five letters of the ________.

chart number

Completing the Patient/Guarantor dialog box for a new patient begins with creating a ________.

Other Information

The code for the assigned provider who will care for a new patient is selected in which tab of the Patient/Guarantor dialog box?

Insurance carrier

The Flag box in the Other Information tab of the Patient/Guarantor dialog box is used to indicate a patient's ________.

Search for

When the Patient List dialog box is opened, the cursor is blinking in the ________ field.

first letter of patient's last name

If Last Name, First Name is selected as the sort option in the Patient List Field box, what is the first character entered in the Searcu for box to locate a particular patient?

enter the second letter of the patient's last name

If Last Name, First Name is the sort option in the Patient List Field box, and entering the first letter of the patient's last name in the Search for box results in a display of more than one patient name, what is the next step to locate a particular patient in the Medisoft Network Professional?

true

When entering phone numbers in Medisoft Network Professional, the program automatically enters the hyphens. (T/F)

Edit Patient

When a patient's name appears alone in the Patient List window following a Search, to display and change that patient's information, either double click the patient's name or click the ________ button.

Case

The ________ radio button is clicked to activate the case portion of the Patient List dialog box in Medisoft Network Professional.

true

Medisoft Network Professional copies employment information for the Personal tab of a case fie from the data previously entered in the Patient/Guarantor dialog box. (T/F)

...

Arrange the steps ou would follow to look up a patient's information and create a new case.

Edit Case

The ________ button is clicked to enter additional information in an existing case in Medisoft Network Professional.

true

Medisoft Network Professional copies the Assigned Provider information for the Account tab of a case from the data previously entered in the Patient/Guarantor dialog box. (T/F)

Account tab on the Case dialog box

When case information is entered in Medisof Network Professional, where is the data on a referring provider entered?

Policy 1 tab on the Case dialog box

When case information is entered in Medisoft Network Professional, where is the data on the patient's primary insurance plan entered?

chart number

If in the Policy 1 tab the Relationship to Insured is "self", the patient's ________ will appear in the Policy Holder 1 field.

Insurance Carrier List dialog box

To add an insurance carrier to the database, click Insurance on the Lists menu and then click Carriers on the submenu to disply the ________.

Electronic Encounter form

The diagnosis that is entered in the Diagnosis tab of the Case folder is located on the ________ for the visit.

false

Only one diagnosis code can be entered in Diagnosis Tab of the Case folder. (T/F)

Diagnosis tab

The information about a patient's allerfies from the patient information form is posted to the Allergies and Notes box on which tab of the Case dialog box?

Condition tab

The information about a patient's disability is posted to which tab of the Case dialog box?

Condition tab

the information about a patient's accident is posted to which tab of the Case dialog box?

Physician's notes

What resource is used to locate the hospitalizatino dates to complete the Condition tab of the Case dialog box?

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