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328 terms

HIM 110 - Final Exam Review

STUDY
PLAY
health information technology (HIT)
The use of computers and electronic communications to manage medical information and its secure exchange is known as
computer skill, knowledge of health care reform, health care skill (all of the above)
For the greatest career opportunities for advancement in health technology, new employees need
practice management program
What type of software program is widely used in the medical office to bill patients and health plans?
20%
The Bureau of Labor Statistics predicts that the field of health informatics will grow by what percent through 2018?
Physician Quality Reporting Initiative (PQRI)
What program gives bonuses to physicians when they use treatment plans and clinical guidelines that are based on scientific evidence?
The Medicare Improvements for Patients and Providers Act of 2008 (MIPPA)
What provides financial incentives for practitioners who use electronic prescribing?
National Health Information Network (NHIN)
What key component of the government's HIT strategy enables a common platform for health information exchange by providing a set of standards, services, and policies that enable the secure exchange of health information over the Internet?
encounter
What is the meeting of a patient with a physician or other medical professional for the purpose of providing health care?
eight
How many data points are included in an ambulatory-care medical record?
all of the above
A medical record may have (the physician's assessment, diagnosis, and treatment plan, the patient's medical history, results of laboratory work)
all of the above
Clinical information may be used for: (legal issues, public health and homeland security, billing and reimbursement)
inaccurate
Payment from a health plan may be denied if clinical information is incomplete or ___________.
medical malpractice
The provision of medical services at a less than acceptable level of professional skill that results in injury or harm to a patient is known as
electronic medical records (EMRs)
What are computerized records of one physician's encounters with a patient over time?
personal health records (PHRs)
What are private, secure electronic files that are created, maintained, and owned by the patient?
practice management programs
The process of autoposting is handled by
less
An electronic funds transfer takes ______ time to put revenue in a bank than does receiving and depositing manual checks.
all of the above
What type of information about the business is entered in a PM? (provider data, transaction data, patient data)
similarly
While medical practices use a number of different practice management (PM) programs, they all usually operate __________.
follow up patient payments and collections
The final step in the medical documentation and billing cycle is to
revenue cycle management (RCM)
Managing the activities associated with a patient encounter to ensure that the provider receives full payment for services is known as
flowing into the practice
Accounts receivable are monies
scheduling and registration
Back office staff handle billing, insurance, and collections; front office staff usually handle
medical assistants (MAs)
__________ perform both administrative and certain clinical tasks in physician offices.
most
Certification is offered in __________ allied health specialties.
lifelong learning
In the health care field, a commitment to ____________ is a key component of success.
all of the above
The migration from paper to electronic records has been slow because of (high cost of EHRs, lack of digital information exchange standards, privacy concerns)
the course of care
Medical records, or charts, are created and shared to help make accurate diagnoses of patients' conditions and to trace
documentation
__________ means organizing a patient's health record in chronological order, using a systematic, logical, and consistent method.
legal documents
Patient medical records are
patient
The term medical professional liability describes this responsibility that __________have.
may be
The documentation of diagnoses and treatments ___________used as proof of billed services.
CMS
The main federal government agency responsible for health care is the
provider
The information in a patient's medical record belongs to the
Acknowledgment
The ___________________ of Receipt of Notice of Privacy Practices states that the patient has read the privacy practices and understands how the provider intends to protect the patient's rights to privacy under HIPAA.
all of the above
PHI can be used and disclosed by providers without the patient's permission in situations involving (treatment, health care operations, payment)
protection of health information on computer networks, the Internet, and electronic storage media
The HIPAA Security rule was enacted specifically to provide guidelines for the
Passwords
____________ are specific codes that are required for gaining access to information on a computer or network.
technical safeguards
__________ are the technology and related policies and procedures used to protect electronic data and control access to it. (administrative safeguards, physical safeguards, technical safeguards)
business associates
Covered entities and their _____________ are responsible for determining whether a breach has occurred to which the notification obligations apply.
60
The HITECH act requires breach notifications to be made no later than _________ calendar days after discovery of the breach under normal circumstances.
five
There are __________ components that must be included in a breach notification.
all of the above
The HIPAA Electronic Health Care Transactions and Code Sets (TCS) standards apply to (electronic formats, code sets, identifiers)
all of the above
Examples of HIPAA standard transactions are ( electronic claims, health plan payments, health plan eligibility inquires/responses)
NPI
The __________ is the standard for the identification of providers when filing claims and other transactions.
HCPCS
The HIPAA code set for specific products, supplies, and services that are not included in the CPT code set is ___________.
not necessarily intentional
Abuse is __________; it may be the result of ignorance of a billing rule or of inaccurate coding.
abuse
In federal law, __________ is an action that misuses money that the government has allocated.
OCR
Enforcing civil violations of HIPAA privacy and security rules is the job of
process
A compliance plan is a __________for finding, correcting, and preventing illegal medical office practices.
all of the above
Compliance plans cover (coding, billing, all areas of government regulation of medical practices)
four
The HIPAA Security Rule requires covered entities to conduct __________ types of audits.
unauthorized
The use of user names and passwords prevents _________ access to the program, safeguards critical patient information, and protects patient confidentiality.
asterisks (*)
As passwords are entered, the characters are replaced with __________ on the screen so there is no chance that someone will see the actual password characters.
Park
The privacy and security feature in MCPR known as __________ allows a user to leave a workstation for a brief time without having to exit the program.
chart
The term __________ refers to a patient's medical record.
menu
On the main MCPR window, the _______bar contains the menus of commands.
Lab Review
Use the _________section of the Dashboard to store items the provider needs to review.
all of the above
The main window in Medisoft Network Professional contains the (title bar, toolbar, menu bar)
all of the above
Physician practices use Medisoft Network Professional to (enter charges, follow up on accounts, create statements)
frequently used menu commands
Buttons on the toolbar located on the Medisoft Network Professional window work as shortcuts for ________.
New Patient button
To enter preregistration information about a new patient in Medisoft Network Professional, click the
none of the above (used for all steps)
Computer software is used for ______the steps in the medical documentation and billing cycle. (only two of, incorrect the first eight of, only the middle four of)
Lists
Demographic information is entered in Medisoft Network Professional in the Patient/Guarantor dialog box, which is accessed via the ________ menu.
SOAP notes
A problem-oriented medical record contains
checks out
The encounter steps include all activities that take place from the time the patient arrives for an office visit until the patient ________.
Problem List
The chief complaint/reason for the visit is recorded in the _______ folder in Medisoft Network Professional.
A task that follows next after the visit and its documentation is _________.
coding
Transaction Entry
Patient payments made at the time of service are entered in the _______ dialog box.
Activities menu
In Medisoft Network Professional, claim functions are located on the
Activities and Reports menus
In Medisoft Network Professional, collection functions are located on the
Claim Management
In Medisoft Network Professional, the _________ dialog box lists current claims.
balances
After payments from health plans have been received, patients are billed for _________.
very similar
The steps required to restore a backup file are __________ to the steps used to back up a file.
Disaster recovery
__________________ refers to an action for resuming normal operations after a situation such as a fire or a computer malfunction.
all of the above
The Medisoft Clinical Help Feature ( provides detailed explanations of program features, offers tips designed to improve user productivity, lists common errors)
knowledge base
The Medisoft Clinical website contains a searchable __________ , which is a collection of up-to-date technical information about Medisoft Clinical products.
first-come, first-served
In urgent care clinics and many walk-in clinics, patients may not have the option of making appointments; instead, they are seen on a _______ basis.
new patient (NP)
A(n) __________ is someone who has not received any services from the provider within the past three years.
preregistration
The process of gathering new patient information before an appointment is known as
participating (PAR) provider
A __________ agrees to provide medical services to a payer's policyholders according to the terms of the plan's contract.
established patient (EP)
When a(n) __________ contacts the office for an appointment, the receptionist verifies that the information on file for the patient is still correct.
eligibility
To establish financial responsibility for insured patients, first verify the patient's
premium
A specified amount of money for a health insurance contract, usually paid monthly, is called a __________.
all of the above
Types of providers include (long-term care facilities, physicians, hospitals)
coinsurance
__________ is the percentage of each claim that the insured pays.
Benefits
________are defined by the Health Insurance Association of America as payments for covered medical services.
Preventive
___________ medical services include annual physical examinations, pediatric and adolescent immunizations, prenatal care, and routine screening procedures such as mammograms.
out-of-pocket; benefits
The phrase __________ means expenses the insured must pay before _______ begin.
Capitation
_____________ is a fixed prepayment to a medical provider for all necessary contracted services provided to each patient who is a plan member.
preferred provider organizations (PPOs)
What is the most popular type of health plan?
all of the above
If the patient's plan is an HMO requiring a primary care provider (PCP), the administrative staff must verify that the (provider is a plan participant, patient is assigned to the primary care physician as of the date of service, patient is listed on the plan's enrollment master list)
percentage
If a plan requires coinsurance, the ______________of coinsurance the patient must pay should be verified.
preauthorization
Managed care plans usually require __________ before a patient sees a specialist, is admitted to the hospital, or has a particular procedure.
referring; referred
A referral number is an authorization number given by a ______physician to the ____________physician.
provider's daily schedule
The __________, shown in the right half of the Office Hours window, is a listing of time slots for a particular day for a specific provider.
Office Hours; Medisoft Network Professional
When a new patient phones the office for an appointment, it can be scheduled in ___________before the patient information is entered in ____________.
Go To a Date
The best way to create follow-up appointments is to use the ________shortcut button on the Office Hours toolbar.
mouse
A quick way to change or delete an appointment is to select the appointment and press the right ________button to display a shortcut menu with options such as Cut, Copy, and Delete.
Medisoft Network Professional
The patient recall feature is located in which software program?
the types of breaks already set up in Office Hours
On the New Break Entry dialog box, what information is displayed on the drop-down list in the Resource box?
patient information form
The __________ is used to collect information about the patient, including employment and insurance data needed to complete an insurance claim.
registration
The patient information form is also known as a ______ form.
assignment of benefits
A(n) ______________is an authorization by a policyholder that allows a health plan to pay benefits directly to a provider.
updated in
When established patients present for appointments, their patient and insurance information may need to be______ the practice management program if there have been changes.
Medicaid
__________ always pays last.
supplemental insurance
__________ covers parts of expenses, such as coinsurance, that patients must otherwise pay out-of-pocket under the primary plan.
birthday rule
The ________ is used to determine which of two parents' medical coverage is primary for their child.
has been in effect for the patient the longest
If a patient has coverage under two individual insurance plans, the primary plan is the one that
federal and state laws
Financial arrangements such as payment plans between patients and providers are governed by
payment
Financial policies should explain what is required of the patient and when _________ is/are due.
Patient tracking features
__________ are used during patient encounters to track where patients are during the different steps of the encounter.
patients' locations
Patient tracking features may be used during patient encounters to track ___________.
case
A __________ groups transactions for visits to a physician's office organized around a specific medical condition.
chart
The __________ number is a unique number that identifies a patient.
New Patient; Patient/Guarantor
In Medisoft Network Professional, information on a new patient is entered by clicking the ____________ button at the bottom of the Patient List dialog box to open the _________ dialog box.
Field
The entry in the __________ box controls how the list is sorted.
chart
The information required to complete the twelve tabs of the Case dialog box comes from documents found in a patient's
two
When the patient's two complaints are not related, how many cases should be used?
chief complaint and medical condition
Transactions are usually grouped into cases based on the ______________for which the patient seeks treatment.
chart
The __________ is a folder that contains all records pertaining to a patient.
Account
Assigned providers and case billing codes are entered on the ________ tab of the Case dialog box.
capitated
In a __________ plan prepayments are made to the physician from a managed care company to cover the physician's services to a plan member for a specified period of time, whether the member seeks medical care or not.
Medicaid and Tricare tab on the Case dialog box
Some patients have coverage under Medicaid or TRICARE. Where is additional information, beyond the basic data, entered in Medisoft Network Professional?
Condition
The __________ tab in Medisoft stores data about a patient's illness, accident, disability, and hospitalization.
Miscellaneous
The __________ tab records a variety of information about the patient and his or her treatment.
check-in
During which stage in the patient flow does a staff member confer with a patient to determine whether any information, such as a change in insurance or employment, needs to be updated in the patient record?
patient flow
The term ________________refers to the progression of patients from the time they enter the office for a visit until they exit the system by leaving the office after a physician visit.
education
When patients leave the exam room, they proceed to the checkout desk, where they receive additional information and patient _________ materials, and also make payments that are due.
past medical history
The_______________ includes any illness (past or present) for which the patient has received treatment.
General
The ____________ tab(s) of the Patient Lookup dialog box includes the most commonly used search options: patient name, patient ID, telephone number, and Social Security number.
blue rectangle
In Medisoft Clinical Patient Records, a folder that contains information has a _______ in the upper-right corner.
OK
When you are finished entering a note in Medisoft Clinical Patient Records, click the ____________ button to save the note.
typing
The information recorded in the history folders of the patient chart in Medisoft Clinical Patient Records can be completed by ___________ or with the aid of templates.
Refresh
If you have entered data in a history folder but it does not have a blue rectangle indicating that the data has posted, click the ______ button to update the screen.
allergies or intolerances to it noted in the folder
When a new medication is prescribed for a patient, MCPR checks whether the patient has any __________________.
reviewed
In addition to adding, editing, or deleting allergies and intolerances, Medisoft Clinical Patient Records also records the date that allergies were last _________ with the patient.
OK
Once the fields in the Allergy dialog box have been completed, clicking the _______ button saves the information and adds it to the list at the top of the Rx/Medications dialog box.
noted in
Medications that have been added, discontinued, or changed should be _________ the patient chart.
Prescription
Clicking the New button in the Current tab of the Rx/Medications dialog box activates the ________ dialog box.
25
To enter the size of a pill in the Rx/Medications folder, use up to ______ characters.
is open
In Medisoft Clinical Patient Records, progress notes can be created only when a patient chart
chief complaint
In most practices, the _____________ is entered as the title of the progress note for the patient's visit.
signature PIN
Medisoft Clinical Patient Records requires users to enter their__________to a progress note.
using the numeric keypad feature or typing them directly in the field
Numeric entries in the Vital Signs dialog box can be entered by
regular or irregular
On the Vital Signs dialog box, a drop-down menu next to the Pulse field is used to select whether the patient's pulse was_____________.
intra-office messages
Using Medisoft Clinical Patient Records, staff members can send
attachments and a link to the relevant portion of a patient's chart
A message can contain/include
yellow; Messages folders
When the Messages dialog box opens, the _____ column on the left lists all the _______.
templates
A ________________works well for consultation letters and letters excusing a patient from jury duty for medical reasons.
blue; red
On the Vital Signs dialog box, abdominal values are highlighted in ____ when they are low compared to the normal range, and in ______ when they are high
front-end voice recognition
In ____________, the physician dictates and edits notes directly in the EHR.
all of the above
Physicians can dictate anytime, anywhere, using a (computer, telephone, other recording devices)
Dictation
__________________ is the process of recording spoken words that will later be transcribed into written form.
templates
_________ are preformatted files that are starting points for documents.
objective
Which part of a SOAP note includes signs and symptoms that can be measured, seen, heard, touched, felt, or smelled, including such vital signs as temperature, pulse, respiration, skin color, and swelling, and the results of diagnostic tests?
assessment
Which part of a SOAP note contains the physician's diagnosis of the patient's condition?
e-prescribing
In an electronic health record, ordering medication for a patient is known as
all of the above
E-prescribing offers built-in safety checks, such as (drug allergies, interactions between drugs, potential conflicts based on the patient's medical history)
Rx; toolbar
In Medisoft Clinical Patient Records, new prescriptions are entered via the Rx/Medications folder or by clicking the ______ button on the _______.
pricing
The bottom of the Select Rx Template Dialog Box displays __________ information for the prescribed medication, if contained in the database.
more rapidly
EHRs allow doctors to order tests and process the results _____________than traditional paper forms.
details
The fields in the ____________section of the Order dialog box, located at the top of the screen, specify settings for orders.
instructions; operator (the processor)
In Medisoft Clinical Patient Records Order dialog box, the ___________section is used to prepare notes for the patient or the __________.
Forms
To print an order for a patient from the Order Processing Select dialog box, click the ____________button and then click OK on the Standard Orders Printing Select dialog box.
Order Processing Select
In Medisoft Clinical Patient Records, when orders are being processed, the _________________dialog box displays the orders that meet the criteria selected.
HIPAA-mandated
Medical coding is the process of applying the ____________code sets to assign codes to diagnoses and procedures.
before
The process of medical coding occurs _____________claims are submitted to the payer.
seventeen
The Tabular List of the ICD-9-CM is made up of _________chapters of disease descriptions and codes, with two supplementary classifications.
all of the above
CPT category III codes are temporary codes for emerging (technology, procedures, services)
report the medical, surgical, and diagnostic services of providers
Procedure codes are used to ________________ and to establish guidelines for the delivery of the best possible care for patients.
E/M
The CPT codes that represent the thought process that the physician follows to determine the best course of care are known as ______________codes.
computer-assisted coding
The process of coding with software is known as
Tasks
The command to click to view electronic encounter forms in Medisoft Clinical Patient Records is located on the ____________menu.
Edit
When an encounter is selected in the Electronic Encounter Select dialog box in Medisoft, clicking the __________button causes the Electronic Encounter dialog box to open.
point-of-service (POS) plan
What type of health plan allows members to choose from a primary HMO-like network or a secondary network?
all of the above
What type(s) of payments are required by indemnity plans? (premiums, deductibles, coinsurance)
preferred provider organization (PPO)
The most popular type of health plan is the ________________.
staff
In a _________health maintenance organization (HMO), physicians are employed by the organization.
health reimbursement account (HRA)
A __________ is a medical reimbursement plan set up and funded by an employer.
savings accounts
Consumer-driven (directed) health plans (CDHPs) combine a high-deductible health plan with one or more tax-preferred ________ that the patient directs.
an employer
A health reimbursement account (HRA) is a medical reimbursement plan set up and funded by _________________.
group health plans (GHPs)
Many employees have medical insurance coverage under __________ that their employers sponsor.
federal Employee Retirement Income Security Act of 1974 (ERISA)
Self-insured health plans are regulated by
open enrollment
During ___________periods, employees choose the plans they prefer for the coming benefit period.
low cost
The Blue Cross and Blue Shield Association (BCBS) was created to provide _________ medical insurance.
Medicare Part A
__________, which is also called Hospital Insurance (HI), pays for inpatient hospital care, skilled nursing facility care, home health care, and hospice care.
TRICARE
__________ is a regionally managed health care program that brings the resources of military hospitals together with a network of civilian facilities and providers to offer increased access to health care services.
people over age 65
Medicare covers
Medigap
___________________ is private insurance that Original Medicare Plan beneficiaries may purchase to fill in some of the unpaid amounts in Medicare coverage.
Civilian Health and Medical Program of the Department of Veterans Affairs
The acronym CHAMPVA represents what formal program title?
resource-based relative value scale (RBRVS)
The payment system used by Medicare is called the
skill and time
The values used in a relative value scale (RVS) reflect the amount of ___________ that the procedures require of physicians.
all of the above
Which of these methods do payers use in paying providers? (capitation, contracted fee schedules, allowed charges)
covered
A cap rate for a particular capitated plan includes a payment factor for all services that are __________under the plan.
EDI/Eligibility tab
The__________ on the Insurance Carrier dialog box contains information used for electronic claims.
New
To enter a new insurance carrier in Medisoft Network Professional, select Lists>Insurance>Carriers and click the _____ button on the Insurance Carrier List dialog box.
Edit
To view information on an insurance carrier already stored in Medisoft Network Professional, select Lists>Insurance>Carriers, select the appropriate carrier and click the _____ button on the Insurance Carrier List dialog box.
EDI/Eligibility tab
To process an online eligibility verification, access the__________ on the Insurance Carrier dialog box.
all of the above
What types of transactions are recorded in a PM/EHR? (charges, adjustments, payments)
review billing compliance
Which of the following is the third step in the charge capture process?
all of the above
The last step of the charge capture process, checking out the patient, involves what activities? (schedule follow-up appointments, provide receipts to patients for payments, provide referrals and education materials)
Payments
______________are monies received from patients and insurance carriers.
Allowed Amounts
The____________ tab of the Procedure/Payment/Adjustment List dialog box in Medisoft Network Professional lists the amount each insurance carrier pays for a particular code.
addenda
The National Center for Health Statistics and the Centers for Medicare and Medicaid Services (CMS) release ICD-9-CM updates called the ____________ twice a year.
Lists; Diagnosis List
View stored diagnosis codes by clicking the ______menu and selecting Diagnosis Codes to display the ____________dialog box.
medically unlikely edit (MUE)
A ____________value is related to a specific CPT/HCPCS code and is based on the maximum units of service that a single provider would report.
global period
Health plans set a ____________ —a certain length of time in which the expected services are to be provided—for each package.
package
A__________is a group of related procedures and/or services included under a single code.
all of the above
Modifiers are generally needed when: (Unusual difficulties occurred during the procedure, Only part of a procedure was done, A service or procedure has been increased or reduced)
made up of two letters or a letter and a number
CPT modifiers are numerical; HCPCS modifiers are _____.
POS code
A ____________ indicates where services were performed.
error relating to the coding process
Using a diagnosis code that is not as specific as possible is an example of an _________.
Charge Transactions
The ____________ section of Medisoft Network Professional's Transaction Entry dialog box section is where charge transactions are shown.
MultiLink codes
_____________are groups of procedure code entries that relate to a single activity the practice commonly performs , such as all the procedure codes involved for an influenza vaccine administration in a family practice.
on the drop-down list activated by clicking in the Payment/Adjustment Code box
Where on the Transaction Entry dialog box are patients' time-of-service payments categorized as to the type of payment?
Quick Receipt
The Print Receipt and the _______________buttons can be used to create a receipt for a patient
all of the above
A walkout receipt includes information on the ____________ for a patient's encounter. (diagnosis, payments, procedures)
Print/Quick
In the Transaction Entry dialog box in Medisoft Network Professional, a walkout receipt is created via the ___________Receipt button or _____ Receipt button.
menu and toolbar
The patient education feature in MCPR opens in its own window, with its own
built-in
The patient education feature has a(n) ____________ search feature.
attach a note to the handout
The purpose of the Notate button on the Patient Education window toolbar is to
English and usually Spanish
The articles in the MPCR patient education feature are available in:
all of the above
Claims communicate information about a patient's ____________ to a payer. (diagnosis, charges, procedures)
correct reimbursement from payers
The insurance claim is the most important document for ______.
HIPAA 837
Which claim format allows for more data to be sent?
smallest units
Data elements are the _____________of information in a transaction.
Edit
The ____________ button at the bottom of Medisoft Network Professional's Claim Management dialog box opens a claim for reviewing and revising.
Navigator
________________buttons simplify the task of moving from one entry to another.
makes the last claim in the list active
The Last Claim button in Medisoft Network Professional's Claim Management dialog box
all of the above
In Medisoft Network Professional, filters can be used to create claims (for specific patients, for transactions under a certain dollar amount, for specific payers)
all of the above
Medisoft Network Professional claims can be selected and viewed by (insurance carrier, batch number, chart number )
all of the above
In the Billing Method box of Medisoft Network Professional's List Only Claims That Match dialog box, the radio button for either ____________ is chosen. (All, Electronic, Paper)
List Only Claims That Match dialog box
The Claim Status filter is available in the
Transactions
The ____________ tab(s) in Medisoft Network Professional's Claim dialog box list(s) information about the diagnoses, procedures, and amount charged on a claim.
if the claim was sent twice
The Billing Date box in the Carrier 1 tab of Medisoft Network Professional's Claim dialog box lists the most recent date the bill was sent
all of the above
Among the most common method of transmitting claims is (direct data entry, transmission through a clearinghouse, direct transmission to the payer)
per-claim; flat fee
Some clearinghouses charge on a_______ basis; others charge a ______per month.
revenue management
The ____________ feature of Medisoft Network Professional is used to submit claims that have been created.
from Revenue Management, select Claims on the Process menu
The general process of transmitting electronic claims begins by
all of the above
What boxes are located in the EDI Report section in Medisoft Network Professional? (Report Type Code, Attachment Control Number, Report Transmission Code)
EDI Notes
Medisoft Network Professional's ______box can be used for entering extra information for procedures and diagnoses that might be required by the patient's insurance carriers to process the electronic claim.
all of the above
The payer's automated review checks for (valid code linkages, noncovered services, patient eligibility for benefits)
Determination
_____is the adjudication step during which the payment decision is made.
claim turnaround time
State prompt payment laws mandate a time period known as ____________ within which clean claims must be paid.
insurance aging report
The PM/EHR can create a(n) ____________ listing the claims transmitted on each day and how long they have been in process with a particular payer.
pending
____________status for a claim means that the payer is waiting for information.
groups of claims
Which of the following is/are covered by remittance advices?
paper format and electronic format
The RAs that are sent to practices are sent in
autoposting
Through the process of ____________, payments listed on an ERA are automatically applied to the appropriate account.
claim adjustment reason codes
In order to provide details about an adjustment, payers use _________.
deciding if follow up is necessary
Which action is part of the final step of checking remittance data?
provider
Through the process of an electronic funds transfer, payments are directly deposited into bank account of the
capitated plan
In what type of plan is a flat fee paid to the physician no matter how many times a patient receives treatment, up to the maximum number of treatments allowed per year?
New
Use the ____________ button in the Deposit List dialog box to display the Deposit dialog box.
Allowed
Which column in the middle section of the Apply Payment/Adjustments to Charges dialog box shows the amount the payer allows for a procedure?
Deposit List box
If you need to enter capitation payments in Medisoft Network Professional, what dialog box must you use?
postpayment audits
A payer's initial determination is sometimes changed as a result of
all of the above
Which of the following has the right to file an appeal? (claimant, appellant, patient)
state insurance commissions
Which of these entities has the authority to review appeals that payers reject?
provider
Billing errors for which the ____________ owes refunds are known as overpayments.
a reasonable
Under state laws, payers may be given ____________ time limit during which they can recoup overpayments.
the amount that the primary payer paid on the claim
In order to coordinate benefits, the secondary payer must know
appeal
If there is a situation in which a payer has denied a valid payment, the practice may file a(n)
complaint, appeal, grievance
A payer's escalating structure of appeals may contain such steps as a(n)
after an insurance claim has been filed, and a remittance advice has been received
When are patient statements created?
Chart Numbers
To determine the starting and ending chart numbers for which statements will be created, use the ____________ filter in the Create Statements dialog box.
Create
What button in the Create Statement dialog box instructs the program to generate statements?
Edit
To review accounts in the Statement Management dialog box, use the ____________ button.
Comment tab
What tab in the Statement dialog box should be used in order to include notes about a statement?
Transactions tab
What tab in the Statement dialog box lists the visit data placed on the statement?
all of the above
Transactions can be listed on a statement according to ____________ using the TXN Sort order filter in the Data Selection Questions dialog box. (Document Number, Date of Service (Date From), Entry Number)
there are not enough funds in a checking account to cover a check or a checking account is closed
Under what circumstances might a bank reject a check, and thereby force a practice to make an adjustment?
adjustment
What is made to a patient's account when a practice receives an NSF notice from a bank?
reports
Useful information about the day-to-day operations in a practice is available in
four triangle buttons
To change a report's display, use the ____________ in the Print Preview window.
Chart Number
The two ____________ boxes of the Search dialog box allow the user to search for patients based on the spelling of their last name.
drop-down list and button with three dots
What types of options do selection boxes offer for entering data?
by default
In Medisoft Network Professional, the Windows System Date is entered in both Date Created boxes__________.
patient day sheet
At the end of the day, practices often print a report summarizing patient activity on that day, known as a
provider
All payments received on a particular day are listed on a payment day sheet, organized by
month
At the end of each ____________, practices usually print insurance analysis reports.
all of the above
Which of the following types of reports is considered a production summary report? (Production Summary by Insurance, Production Summary by Procedure, Production Summary by Provider)
Search dialog box
Patient account ledgers are generated according to the data that is inputted in the
Patient by Diagnosis
Diagnosis codes, chart numbers, patient names, ages, attending providers, facilities, and the dates of last visit can all be found on the ____________ report.
Standard Patient Lists
To access the Patient by Diagnosis and the Patient by Insurance Carrier reports, use the ____________ submenu on the Reports menu.
Contents
Select ____________ on the Medisoft Reports Help menu to view descriptions of all the reports available in Medisoft Reports.
emailing a report
Which of the following features is NOT available on the File menu of Medisoft Reports?
he amount of time the money has been owed
The amount of money owed to the practice, organized by ____________, is listed on an aging report.
Aging Reports submenu
To access standard aging reports on the Reports menu, use the
Custom Report List
Access Medisoft Network Professional's built-in custom reports that were created using the Report Designer via the ____________ option on the Reports menu.
All radio button
Users can display all the available types of custom reports listed in the Open Report dialog box by clicking the
all of the above
The built-in custom reports in Medisoft Network Professional include (CMS-1500 and Medicare CMS-1500 forms, superbills, patient statements and walkout receipts)
Open Report
Display the ____________ dialog box by clicking Custom Report List on the Reports menu.
Auto Size button
In order to accommodate longer titles in the Report Designer, what should be checked on the Size panel of the Text Properties dialog box?
all of the above
Which of the following formatting styles is included in the Medisoft Report Designer? (statement, insurance, ledger)
more than half
How many commercial plans offer some type of pay-for-performance program?
patient registries
Databases that can be used to keep track of specific tests are called
practice
The policy of the ____________ dictates the practice's retention of their medical and financial records.
the patient and the provider
Retention schedules protect
critical
It is ____________ for practices to receive full payment for services to be financially successful.
all of the above
Which of the following is among the common reasons why patients do not pay their medical bills on time? (lack of financial resources, lack of understanding that payment is their responsibility, lack of insurance)
resolve problems and collect payments
What is the purpose of patient follow-ups?
sending statements to patients
How does the collection process begin?
financial matters
The way a practice handles ____________ is explained in its financial policy.
insurance payers' claim turnaround times
Which of the following components should NOT be explained on a financial policy? (collecting prepayment for services, insurance payers' claim turnaround times, collecting payments for services not covered by insurance, setting up financial arrangements for unpaid balances)
a clear financial policy and effective communications with patients about their financial responsibilities
How does the patient collection process begin?
organizing accounts for effective follow-up and identifying overdue accounts
Identify primary tasks associated with the collection process.
the date of the bill
On what date does the aging process begin?
ticklers and collection reminders
What are displayed as collection list items in Medisoft?
New
Create a new tickler item by pressing the ____________ button in the Collection List dialog box.
Activities
To access the Collection List feature in Medisoft Network Professional, which of the following menus should you use?
once
How many times may a patient be contacted daily under collection laws?
Fair Debt Collection Practices Act of 1977 (FDCPA) and Telephone Consumer Protection Act of 1991
The ____________ is/are enforced by the Federal Trade Commission.
a letter with a professional and courteous tone that is brief and to the point
Compare these styles of collection letters and determine which one is best.
OK
Click the ____________ button in Medisoft Network Professional's Open Report window to generate collection letters.
all of the above
Where in Medisoft Network Professional do account alerts appear after the printing of collection letters (assuming the patient has an open tickler in the collection list)? (Quick Ledger, Transaction Entry, Appointment Entry)
agreement between a patient and a practice in which the patient agrees to make regular monthly payments over a specified period of time
What is a payment plan?
all of the above
On which basis does the ECOA prohibit credit discrimination? (martial status, national origin, age)
all of the above
Which of the following details is generally covered in a payment plan? (the date the last payment is due, the amount of each payment, the time when each payment is due)
Equal Credit Opportunity Act (ECOA)
Which of the following laws prohibits discrimination because a person receives public assistance?
outside firms
Collection agencies are ____________ hired by practices to collect on delinquent accounts.
collection agencies
It is typical for practices to pay ____________ based on the amount of money they collect.
ended
The collection process is ____________ if the cost of continuing to pursue the debt is higher than the total amount owed.
Activities menu
The Small Balance Write-off feature on the ____________ may be used for multiple patients' write-offs.
patient refund
If a practice has overcharged a patient for a service, it should issue a
Patient Selection and Write off
Which of these panels appears in the Small Balance Write-off dialog box?
Write off
Click the ____________ button to write off selected balances in the Small Balance Write-off dialog box.