week 9 study guide M.O.A

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an insurance billing specialist may be employed by a physician, hospital, or other medical facility or may choose to be self employed: T/F

true

A blind mailing means sending information to potential employers who have not advertised a job opening: T/F

true

In completing an application for employment, abbreviations are not used unless space is extremely limited: T/F

true

It is never acceptable to fax a resume to a prospective employer: T/F

false

It is discriminatory for an employer to ask if an applicant smokes: T/F

false

An alien employee must have on file with his or her employer an Employment Eligibility Verification form: T/F

true

An insurance billing specialist should join a professional organization of billers because this helps in organizations: T/F

false

The main goal of a cover letter is to:

secure an interview

Cover letters should be:

customized, typed for neatness, addressed to a specific person

In an interview, a follow up letter should be written to:

thank the employer for the interview,,,, keep the applicant's name at the attention of the potential employer

When an individual wishes to start his or her own medical billing service, he or she should have sufficient funds to run the business for a period of:

1 year or more

An employer may evaluate the application itself to determine wheter the applicant can follow__________

directions

A resume that provides recent experiences first, with dates and descriptive data for each job, is ________

chronologic resume

A resume that states the skills an individual is able to perform is________

functional

A resume that summarizes the applicant job skills, as well as educational and employment history, is the_______

combination

________the resume carefully for spellilng, punctuation, grammatical, and typographic errors

proofread

It has been found that when applicants have similar skills and education, the decisionj to hire has been based on __________the interview

physical apperance

Letters of recommendation, school diplomas or degrees, certificates, names and addresses of references, and some neatly typed insurance claim forms are items an applicant may enclose in an_____________

portfolio

List five ways to search for a job:

attend meetings
tell classmates
visit employment agencies
part time employment
check library

what should a cover letter end with:

requesting an interview

There is more chance for advancement working in a hospital facility than in a private physician's office: T/F

true

Because of the diversity in reimbursement methods, it is very important that the insurance billing specialist have basic knowledge of insurance programs: T/F

true

Emergency department charges are billed along with the inpatient stay on the CMS-1500 claim form: T/F

false

When admitted as a workers compensation case, the patient willnot have an insurance card: T/F

true

A patient has a right to request an itemized bill from a hospital stay with no cost to the patient: T/F

true

The purpose of the DRG-based system is to hold down rising health care costs: T/F

true

Confidential information about patients should never be discussed with:

co workers, family, friends

A patient is considered an inpatient to the hospital on admission:

overnight stay

When a patient who has a managed care contract is admitted to a hospital for an emergency, the managed care program needs to be notified within:

48 hours

The rule stating that when a patient receives outpatinet services within 72 hours of admission, then all outpatient services are combined with inpatient services and become part of the diagnostic-related group rate for admission, is called the:

72 hour rule

The significant reason for which a patient is admitted to the hospital is coded using the:

principal diagnosis

ICD-9-CM procedure codes contain:

at least 2 digits or 2 to 4 digits

the codebook used to list procedures on outpatient hospital claims is:

CPT

the person who interviews the patient and obtains personal and insurance information and the admitting diagnosis is:

admitting clerk

daily progress notes are entered on the patients medical record by a:

nurse

the claim form transmitted to the insurance carrier for reimbursement for inpatient hospital services is called:

UB-04

the form that accompanies the billing claim form for inpatient hospital services is called a:

detail statement

professional services billed by the physician include:

hospital consultaitions, hospital visits, emergency department visits

how many major diagnostic categories (MDCs) are there in the DRG-based system:

25

On the UB-04 claim form, code 6 (transfer from another health care facility) in field 15 is used to indicate:

source of admission

PAT is an abbreviatin for _________

preadmission testing

The hospital department that conducts an admission and concurrent review on all cases and prepares a discharge plan to determine wheter admissions are justified is called the ___________

U.R

The ________is the clinical resume for final progress note

discharge summary

The abbreviation of the phrase that indicates when claims are submitted electronically is__________

e.d.i

what is QIO an abbreviation for:

quality improvement organization

what is the document that needs to be completed and signed by the physician after a patient leaves the hospital before the hospital can receive reimbursement:

discharge summary

what does the abbreviation CC indicate when used with DRGs:

comorbidity and complaints

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