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171 terms

Medical Data Entry Final Exam (MULTIPLE CHOICE)

Computers in the Medical Office Student Data for Medisoft
STUDY
PLAY
What document list all services performed, along with the charges for each service?
STATEMENT
The provider's fees for services are listed on the medical practice's
FEE SCHEDULE
Which of the following refers to procedure codes?
CPT
Which of the following uses diagnosis and procedure code information as well as administrative and financial information to generate health care claims?
THE PRACTICE MANAGEMENT PROGRAM (PMP)
The most common type of managed care plan today is a
PREFERRED PROVIDER ORGANIZATION (PPO)
What term refers to an individual who may not be a patient of the practice but who is financially responsible for a patient account?
GUARANTOR
Medisoft will ask for a confirmation before
DELETING DATA
The set program date command is found on the
FILE MENU
Transactions are entered in Medisoft via the
ACTIVITIES MENU
Electronic data interchange involves sending information from computer to
COMPUTER
When a new patient comes in for an office visit, he or she is asked to complete
A PATIENT INFORMATION FORM
Medisoft is exited by
CLICKING EXIT ON THE FILE MENU
CLICKING THE CLOSE BOX
BOTH A AND B ANSWERS ARE CORRECT
Payments made to the health plan by the policyholder for insurance coverage are called
PREMIUMS
Which of these are computerized records of one physician's encounters with a patient over time?
ELECTRONIC MEDICAL RECORDS (EMRs)
The patients/guarantors and cases command is selected from the__________to change information about a patient
LIST MENU
The process of deleting files of patients who are no longer seen by a provider in a practice is called
PURGING DATA
A report that lists the charges, payments, and adjustment made during a day is known as
A DAY SHEET
If incorrect dates are used when entering data, the information in reports will be
INACCURATE
Where can a calculator tool be found in Medisoft?
TOOLS MENU
Which of the following is the correct chart number for Daniel Ho?
HODANIE0
Which of these is a collection of related pieces of information?
DATABASE
Which of the following refers to money coming into the practice?
ACCOUNTS RECEIVABLE
The HIPAA security standards comprise
ALL OF THESE ANSWERS ARE CORRECT
What process checks and verifies data and corrects any internal problems with the data?
REBUILDING INDEXES
Which of the following workflows might providers use?
ALL OF THESE ANSWERS ARE CORRECT
The National Provider Identifier (NPI) is a ten-position identifier consisting of
ALL NUMBERS
What type of patient has received services from a physician within the last three years?
ESTABLISHED PATIENT
Medisoft's file maintenance utilities are accessed via the ______menu
FILE
The use of computers and handheld devices to transmit prescriptions to pharmacies in digital format is called
ELECTRONIC PRESCRIBING
Copayments are routinely collected during
CHECK-IN
Which of these is accessed through the patient list dialog box?
PATIENT INFORMATION
The deletion of vacant slots from the database is known as
PACKING DATA
What is established when the diagnosis and treatment of a patient are logically connected?
MEDICAL NECESSITY
The process of retrieving data from backup storage devices is referred to as
RESTORING DATA
How many different methods of changing the date in the program are available in Medisoft?
TWO
A new patient is a patient who has not received services from the same provider or a provider of the same specialty within the same practice for a period of
THREE YEARS
HIPAA was designed to
ENSURE THE SECURITY AND PRIVACY OF HEALTH INFORMATION
Clicking the button displays the Patient/Guarantor dialog box, where changes can be made
THE EDIT BUTTON
The insurance program that provides coverage for dependents of active-duty services members is known as
TRICARE
Which of the following refers to diagnosis codes?
ICD
The status field in the other information tab of the patient/guarantor dialog box is used to indicate whether the patient
IS EMPLOYED OR IN SCHOOL
Which of the following can be used in a chart number?
LETTERS
If the patient's employer does not appear on the Employer drop-down list in the other information tab, it must be entered using the
ADDRESS FEATURE
What is a series of steps designed to judge whether a claim should be paid?
ADJUDICATION
The extra copy of data files made at a specific point in time is known as
BACKUP DATA
The patient information form contains
ALL OF THESE ANSWERS ARE CORRECT
Each charge, or fee, for a visit is represented by a specific
PROCEDURE CODE
Every time a patient is treated by a health care provider, a record is made of the encounter. This record is known as
DOCUMENTATION
Which of the following is a feature provided by Medisoft to assist in maintaining data files stored in a system?
ALL OF THESE ANSWERS ARE CORRECT
Where are data saved in most medical practices?
NETWORK DRIVE
An encounter form is also known as a
SUPERBILL
What type of patient has been seen by a provider in the practice in the same specialty within three years?
ESTABLISHED PATIENT
According to the Institute of Medicine, which of the following core functions should be included in an EHR?
ALL OF THESE ANSWERS ARE CORRECT
What tools that are common in EHRs make documenting patient encounters more efficient for providers?
ALL OF THESE ANSWERS ARE CORRECT
Health information that can be used to find out a person's identification is referred to as
PROTECTED HEALTH INFORMATION
EHRs are most frequently praised for providing
ALL OF THESE ANSWERS ARE CORRECT
The ten-step cycle that results in the timely payment for patients' medical services is the
BILLING CYCLE
Which term refers to the acquisition, access, use or disclosure of unsecured PHI in a manner not permitted under the HIPAA Privacy Rule, thus compromising the security or privacy of the PHI?
BREACH
What report lists charges, payments, and adjustments and the total accounts receivable for the month?
MONTHLY REPORT
Most dates are entered in Medisoft using the ____format
MMDDCCYY
What is a collection of up-to-date technical information about Medisoft products called?
KNOWLEDGE BASE
Where are the electronic data in the remittance advice automatically posted through the process of autoposting?
THE PRACTICE MANAGEMENT PROGRAM
Which records offer a broad focus on a patient's total health experience over the lifespan, rather than the documentation of episodes of illness or injury?
ELECTRONIC HEALTH RECORDS (EHRs)
Information in the patient window is
COLOR-CODED
When a locate button is clicked, what is displayed?
LOCATE DIALOG BOX
The last character in a chart number is always a
ZERO
During check-in, it is also common practice to photocopy the patient's insurance identification card and a
PHOTO ID
The process of updating balances to reflect the most recent changes made to the data is referred to as
RECALCULATING BALANCES
Medisoft does not offer any shortcuts to make searching easier
FALSE
A remittance advice (RA) is similar to an explanation of benefits (EOB)
TRUE
An audit/edit report is sent from the clearinghouse to the practice before the basic edit can be completed
FALSE
A major advantage of computerized scheduling is the ability to easily locate scheduled appointments
TRUE
A walkout statement lists the procedures performed, the charges for the procedures, and the amount paid by the patient
TRUE
The HIPAA Privacy Rule protects individually identifiable health information
TRUE
The accounting cycle is the flow of financial transactions in a business
TRUE
Medisoft's search feature can be used to look for information on patients, insurance carriers, procedure codes and employers
TRUE
A monthly report summarizes the financial activity of the entire month
TRUE
Chart numbers cannot contain special characters such as a hyphen or semicolon
TRUE
An option for finding information in Medisoft is to use the Locate buttons
TRUE
HIPAA stands for the Health Insurance Portability and Accountability Act of 1996
TRUE
EHRs allow two or more people to work with a patient's record at the same time
TRUE
An edit trail is a report that shows who has accessed information and when
FALSE
A statement lists all services performed, along with the charges for each service
TRUE
A clearinghouse is a company that collects electronic insurance claims from medical practices and forwards the claim to the appropriate health plans
TRUE
A collection process is often started when patient payments are later than permitted under the practice's financial policy
TRUE
Once created, a chart number cannot be edited
TRUE
Within the Claim Management area of Medisoft, insurance claims are
ALL OF THESE ANSWERS ARE CORRECT
What is the maximum fee a participating provider can collect for the service?
MEDICARE ALLOWED CHARGE
What type of report lists a patient's balance by age, date and amount of the last payment, and telephone number?
PATIENT AGING REPORT
What is a physician who recommends that a patient see a specific other physician called?
REFERRING PROVIDER
If claims are being sent to a_______, more than one insurance carrier code can be entered in the Primary Insurance box
CLEARINGHOUSE
In this type of billing system, patient statements are created and sent on a staggered basis rather than all at once
CYCLE
Payments are color-coded to indicate______status
PAYMENT
How many cases is a patient allowed to have per office visit in Medisoft?
THERE IS NO SET LIMIT
If the patient's account has a positive balance because the patient overpaid, the overpayment is color-coded_____in the Transaction Entry dialog box
YELLOW
Payments are entered in________different areas of the Medisoft program
TWO
Medisoft's Report Designer allows users to
ALL OF THESE ANSWERS ARE CORRECT
Information in an existing case is modified by selecting the case and clicking the____button at the bottom of the Patient List dialog box
EDIT CASE
What type of report shows how long a payer has taken to respond to each claim?
INSURANCE AGING REPORT
Any claims prepared for submission to an insurance carrier must be selected and then reviewed for
COMPLETENESS
ACCURACY
BOTH A AND B ANSWERS ARE CORRECT
The______is the most important document for correct reimbursement
INSURANCE CLAIM
Claims are created in the_______dialog box
CREATE CLAIMS
What step in reviewing a remittance advise comes after comparing the RA to the original insurance claim?
REVIEW THE PAYMENT AMOUNT AGAINST THE EXPECTED AMOUNT
What patient information is stored in the Case dialog box?
ALL THESE ANSWERS ARE CORRECT
Payment information located on the remittance advice is entered in Medisoft through the Enter Deposits/Payments option on the
ACTIVITIES MENU
A walkout receipt is also known as a(n)
WALKOUT STATEMENT
The_____report lists patients sorted by provider or facility, and then by their insurance carrier
PATIENT BY INSURANCE CARRIER
The_____is where information about a patient's primary insurance carrier and coverage is recorded
POLICY 1 TAB
The primary insurance carrier is the______ carrier to whom claims are submitted
FIRST
The Medisoft Reports menus choices include
ALL OF THESE ANSWERS ARE CORRECT
Payments that have been_____are not colored and appear white
FULLY APPLIED
A_______is a document that specifies the amount a provider bills for provided services
FEE SCHEDULE
What type of patient statements are sent electronically to a processing center, which prints and mails them?
ELECTRONIC
A_____is a document that specifies the amount the payer agrees to pay the provider for a service, based on a contracted rate of reimbursement
PAYMENT SCHEDULE
The Claim Management dialog box is accessed via the_______menu in Medisoft
ACTIVITIES
The chart is a folder that contains all records pertaining to a
PATIENT
What are claims with all the information necessary for payer processing called?
CLEAN CLAIMS
Patient accounts must be adjusted to a zero balance in the
APPLY PAYMENT/ADJUSTMENTS TO CHARGES DIALOG BOX
In the Transaction Entry dialog box, walkout receipts are created via the _______button
PRINT RECEIPT
If a patient is being treated for injuries related to an automobile accident, information about the accident must be entered in the______tab of the Case folder
CONDITION
The abbreviation TOS stands for
TYPE OF SERVICE
What type of payment is made to physicians on a regular basis?
CAPITATION
The______is used to enter case notes
COMMENT TAB
Which of the following would likely be a reason to set up a new case for a patient?
THE PATIENT CHANGES INSURANCE CARRIERS
THE PATIENT HAS DEVELOPED A NEW MEDICAL CONDITION
BOTH A AND B ANSWERS ARE CORRECT
The______is the paper claim approved by the NUCC
CMS-1500
In order to adjust the patient accounts of those covered by the capitated plan, a second deposit is entered with a
ZERO AMOUNT
When all necessary information has been entered in the Create Claims dialog box, clicking the_______button creates the claims
CREATE
The data stored in the Patient/Guarantor dialog box is primarily
DEMOGRAPHIC INFORMATION
The HIPAA standard transaction for electronic claims is the
HIPAA X12 837 HEALTH CARE CLAIM
EQUIVALENT ENCOUNTER INFORMATION (837P)
BOTH A AND B ANSWERS ARE CORRECT
The Type column in the Statement Management dialog box can contain either Standard or
REMAINDER
Up to____diagnoses codes can be entered in one Medisoft case
FOUR
Under_______a flat fee is paid to the physician no matter how many times a patient receives treatment, up to the maximum number of treatments allowed per year
CAPITATED PLAN
In Medisoft, a_________is a condition that data must meet to be selected
FILTER
Which type of report lists the amount of money owed to the practice organized by the amount of time the money has been owed?
ALL OF THESE ANSWERS ARE CORRECT
Medicare uses its own payment schedule, known as the
MEDICARE PHYSICIAN FEE SCHEDULE (MPFS)
A remittance advice lists
ALL OF THESE ANSWERS ARE CORRECT
The information in the Condition tab is used by_________to process claims
INSURANCE CARRIERS
Which of the tabs in the Claim dialog box displays information about claims being submitted to a patient's primary insurance carrier?
CARRIER 1 TAB
How can a custom report be printed in Medisoft?
BY DOUBLE CLICKING THE REPORT TITLE
BY HIGHLIGHTING THE TITLE OF THE REPORT..........
BOTH A AND B ANSWERS ARE CORRECT
What is the first step in processing a remittance advice?
COMPARE THE RA TO THE ORIGINAL INSURANCE CLAIM
In the Sort By field of the Deposit List dialog box, the default is sorting payments by
AMOUNT
What are the amounts a provider bills for the services performed?
CHARGES
The choices in the Payment Method field in the Deposit dialog box include cash, credit card, check and
ELECTRONIC
What type of patient statements are printed and mailed by the practice?
PAPER
When claims are transmitted electronically, the Claims Status for each claim automatically changes from Ready to Send to_____
SENT
NSF checks are also called
BOUNCED CHECKS
RETURNED CHECKS
BOTH A AND B ANSWERS ARE CORRECT
Payments are entered in the______section of the Transaction Entry dialog box
PAYMENTS, ADJUSTMENTS AND COMMENTS
Once all the necessary information is entered in the Payments, Adjustments and Comments section, the payment is applied to specific charges using the______button
APPLY
TRICARE is the government insurance program that serves
ALL OF THESE ANSWERS ARE CORRECT
What type of report is used to compare the response time with the terms of the contract the practice has with the payer?
INSURANCE AGING REPORT
Patient payments made at the time of an office visit are entered in the
TRANSACTION ENTRY DIALOG BOX
In what kind of plan are payments made to the physician from a managed care company for patients who select the physician as their primary care provider, regardless of whether the patients visit the physician or not?
CAPITATED PLAN
In this type of billing system, patient statements are printed and mailed all at once
ONCE-A-MONTH
What contains the physician's notes about a patient's condition and diagnosis?
THE RECORD OF TREATMENT AND PROGRESS
Medisoft's Report Designer feature makes which of the following formatting styles available?
ALL OF THESE ANSWERS ARE CORRECT
The_______section of the Transaction Entry dialog box displays account aging information for the patient and the insurance carrier
AGING, COPAY AND DEDUCTIBLE INFORMATION
A TRICARE sponsor is
AN ACTIVE-DUTY ARMED SERVICES MEMBER
The______button removes a case from the system if the case has no open transactions
DELETE CASE
Most often, transactions are grouped into cases based on the_____for which a patient seeks treatment
MEDICAL CONDITION
What are changes to patients' accounts?
ADJUSTMENTS
A walkout receipt includes information on the______of a visit
ALL OF THESE ANSWERS ARE CORRECT
Which button in the Claim Management dialog box reprints a claim that has already been printed?
REPRINT CLAIM
Which of the following reasons might cause an insurance carrier to deny a claim?
ALL OF THESE ANSWERS ARE CORRECT
Once the payment has been applied in the Apply Payment to Charges dialog box, the amount in the________column changes
UNAPPLIED
The Place of Service code for services performed in a provider's office is
11
The Medicare Physician Fee Schedule (MPFS) is updated
ANNUALLY
If a patient's treatment is only authorized through a certain date, this date is entered in the______tab of the Case Folder
ACCOUNT
Which statements are a list of the amount of money a patient owes, organized by the amount of time the money has been owed, the procedures performed, and the dates the procedures were performed?
ALL OF THESE ANSWERS ARE CORRECT
Capitation payments are entered in the
DEPOSIT LIST DIALOG BOX
Which statements show all charges regardless of whether the insurance has paid on the transactions?
STANDARD STATEMENTS
When the_______button is clicked in the Deposit List dialog box, the Deposit dialog box appears
NEW