Patient Access Department - Registrar Competency Exam
A timed and scored examination that will measure a Patient Access Representative's ability to perform basic registration and insurance verification functions. This test is a mandatory examination that requires a passing score for continued employment.
Questions and Answers
- 1.
Per The Joint Commission standards, what is the minimum number of patient identifiers required to verify the identity of a patient? HINT: Patient Identifiers: Name, Social Security Number, Date of Birth, Medical Record Number, etc.
- A.
One
- B.
Two
- C.
Three
- D.
Four
- E.
None of these
Correct Answer
C. ThreeExplanation
The Joint Commission requires a minimum of three patient identifiers when confirming a patient's identity. Registrars should only select a patient record only when three identifiers have been confirmed by the patient and/or family.Rate this question:
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- 2.
An 8 year old patient is registering for a Radiology appointment. His mother and father each have separate insurance coverage through their employers. The child is covered by both policies. Mother: BCBS - Mother's DOB 04/10/1970. Employed by Pepsico, which has over 100 employees. Father : Oxford-. Father's DOB 01/17/1969. Works at local pharmacy, Alvin's Drugs, and has 9 employees. Which policy is primary?
Correct Answer
the father's
father's
father
OxfordExplanation
The father's insurance is primary. The Birthday Rule applies to this case, as the parent whose birthday month is earlies in the year dictates which insurance should be billed as primary.Rate this question:
- 3.
A patient arrives for an outpatient appointment. As you verify eligibility, you notice that the patient has Medicare part A only. His Medicare part B is inactive. How should this patient be registered?
- A.
Using Medicare Part B (015 and 017)
- B.
Using Medicare Part A (089 and 017)
- C.
Self-pay (031)
Correct Answer
C. Self-pay (031)Explanation
Since Medicare part A only covers inpatient services, this patient should be registered as Self-Pay.Rate this question:
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- 4.
True or FalseA nursing home patient is sent for inpatient admission at HNH. The patient has Medicare part B only. How should this patient be registered?
- A.
Self-Pay
- B.
Medicare Part A (089/017)
- C.
Medicare Part B (015/017)
Correct Answer
C. Medicare Part B (015/017)Explanation
Medicare Part B may be used for both inpatient and outpatient services when the patient has part B only.Rate this question:
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- 5.
A patient may be eligible to receive Medicare benefits due to:
- A.
Their age
- B.
A disability
- C.
A chronic Kidney/Renal condition that requires dialysis treatment
- D.
Both A and B
- E.
A, B and C
Correct Answer
E. A, B and CExplanation
Medicare beneficiaries are entitled to receive Medicare benefits because of their age, a disability, or ESRD (End Stage Renal Disease).Rate this question:
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- 6.
EMTALA (Emergency Medical Treatment and Active Labor Act) dictates:
- A.
A patient in the Emergency Department must be treated and stabilized regardless of their ability to pay.
- B.
A patient that is in active labor (anywhere in the hospital) must be treated and stabilized regardless of their ability to pay.
- C.
All Emergency Department and Labor patients must be treated quickly.
- D.
Both A and B
- E.
None of these
Correct Answer
D. Both A and BExplanation
EMTALA states that all Emergency Room patients and any patient in active labor must be treated and stabilized regardless of their ability to pay.Rate this question:
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- 7.
A 45 year old patient presents his Medicare card and his wife's Cigna policy. The patient states that he is currently disabled and receiving Social Security benefits as a result of a back injury. His wife works in a law firm that employs 21 people. Which insurance is primary for this patient?
- A.
Cigna
- B.
Medicare
- C.
Not enough information provided to answer question
Correct Answer
B. MedicareExplanation
The patient is 45 years old and disabled, receiving Social Security benefits as a result of a back injury. Medicare is a federal health insurance program for individuals who are 65 years or older, or individuals under 65 who have certain disabilities. Given that the patient is disabled and receiving Social Security benefits, it is likely that he qualifies for Medicare. The information provided does not indicate any specific eligibility for Cigna insurance, therefore Medicare is the primary insurance for this patient.Rate this question:
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- 8.
A Medicare patient is being registered at the MS center. He presents a Medicare card as well as an Aetna commercial policy, which he states is provided through his wife's job at Walmart. The patient states he is retired. Which insurance is primary?
- A.
Medicare
- B.
Aetna
- C.
Not enough information provided
Correct Answer
B. AetnaExplanation
The patient's Aetna commercial policy would be considered the primary insurance in this case. This is because the patient states that the Aetna policy is provided through his wife's job at Walmart, indicating that it is an employer-sponsored insurance plan. Employer-sponsored plans are typically considered primary over Medicare, which is a government-funded insurance program.Rate this question:
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- 9.
Mr. Yoo Ki Myung is here to be registered for the Clinic. You notice that English is not his primary language, as he is having some difficulty reading and understanding consent forms. What should you do?
- A.
Have an Environmental Services employee translate.
- B.
Call the Language Line and ask for an interpreter in the patient's language.
- C.
Register the patient and speak slowly so that he may understand you.
- D.
Ask the patient to bring in a family member that may translate for his next visit.
Correct Answer
B. Call the Language Line and ask for an interpreter in the patient's language.Explanation
If a patient demonstrates a language barrier or requests and interpreter, HNH is required to provide one. The Language Line may be accessed by dialing '0' and asking the HNH operator to connect you with an interpreter in the appropriate language. HNH employees may NOT use non-clinical staff for interpretation in a clinical setting.Rate this question:
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- 10.
After the interpreter is contacted, Mr. Myung hands you his Korean passport as his ID. The passport reads as follows: Last Name: MyungFirst Name: Yoo KiHow should this patient's name be registered?
- A.
First: Yoo Middle: K Last: Myung
- B.
First: Yoo Middle: NONE Last: Myung
- C.
First: YooKi Middle: NONE Last: Myung
Correct Answer
C. First: YooKi Middle: NONE Last: MyungExplanation
In the Korean culture, most first names are composed of 2 names- there are no middle names. Both first names, Yoo and Ki should be entered together as the first name. NOTE: If the patient's LEGAL ID separates the names, you must follow what the ID dictates.Rate this question:
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- 11.
A patient is seen in the ED and states their elbow injury is a result of a motor vehicle accident. The patient was the driver. The patient has Allstate car insurance and a BCBS policy through his work. How should this patient be registered?
- A.
BCBS Policy ONLY
- B.
Allstate policy ONLY.
- C.
BCBS policy as Primary; Allstate policy secondary
- D.
Allstate policy as Primary; BCBS policy secondary
Correct Answer
D. Allstate policy as Primary; BCBS policy secondaryExplanation
If a patient is involved in a motor vehicle accident and is covered under a MVA policy, the MVA must be billed. If the patient has medical insurance, that policy is billed as secondary.Rate this question:
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- 12.
Rachel Weinburgh is being registered for Lab work. Her demographics are as follows: Rachel WeinburghDOB: 11/13/1967SSN: 111-22-3333Address: 123 Up Way Balloonville, PA 14579Phone: 201-833-3000 What is the proper way to begin your search for Rachel in the database?
- A.
Search by her Last Name and her DOB first
- B.
Search by her Social Security number first
- C.
Search by her Phone Number first
- D.
None of the above
Correct Answer
B. Search by her Social Security number firstExplanation
Since a Social Security number is a unique identifier, it is best to begin a patient search with this number. If no matches are found, a name search should follow.Rate this question:
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- 13.
When searching for Rachel Weinburgh, you enter her Social Security number and find no match in the database. You decide to continue with a name and date of birth search (as you should).Per Patient Access rules, how should a patient name search be performed for Rachel Weinburgh? Rachel WeinburghDOB: 11/13/1967
- A.
Last: Weinb First: Rach DOB: 11/13/1967
- B.
Last: Weinburgh First: Rachel DOB: 11/13/1967
- C.
Last: Weinburgh First: R DOB: 11/13/1967
- D.
Last: Wei First: Rac DOB: 11/13/1967
Correct Answer
D. Last: Wei First: Rac DOB: 11/13/1967Explanation
Per Patient Access Rules, name searches should be performed by entering the first three letters of the first and last name only. The DOB should be entered as well to narrow the search and increase accuracy.Rate this question:
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- 14.
Mr. Bradley Pitt, an 87 year old retiree, is to here to be registered for Physical Therapy. He hands you a Medicare, a BCBS Medigap card and a NJ Medicaid card - all policies are active. In what order should the three payors be listed?
- A.
Medicare, Medicaid, BCBS
- B.
BCBS, Medicare, Medicaid
- C.
Medicaid, Medicare, BCBS
- D.
Medicare, BCBS, Medicaid
Correct Answer
D. Medicare, BCBS, MedicaidExplanation
When billing for healthcare services for a patient who has multiple types of insurance, the order in which insurers are billed is determined by coordination of benefits rules. For Mr. Bradley Pitt, who has Medicare, a BCBS (Blue Cross Blue Shield) Medigap policy, and NJ Medicaid, the correct order of payors would be:
Medicare as the primary insurance because it is the federal health insurance program for people who are 65 or older, among others. As Mr. Pitt is 87 years old, Medicare would be his primary coverage.
BCBS Medigap as the secondary insurance. Medigap is a Medicare Supplement Insurance that helps fill "gaps" in Original Medicare and is sold by private companies. Medigap policies can help pay some of the remaining health care costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles.
NJ Medicaid as the tertiary insurer. Medicaid would be the payer of last resort after Medicare and any other insurance (like Medigap) have paid. Medicaid programs can help pay for costs not covered by Medicare and Medigap.
Therefore, the correct order should be Medicare, BCBS, Medicaid.Rate this question:
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- 15.
A patient gives you their insurance card, a NJ Driver’s license, and a work ID. The names on the cards read: Insurance Card: John Smith III NJ Driver's License: John Anthony Smith III Work ID: Johnny Smith How should the patient be registered?
Correct Answer
John Anthony Smith III
Driver's License
NJ Driver's LicenseExplanation
The patient should be registered as John Anthony Smith III because this is the name that appears on the NJ Driver's License, which is the most official form of identification among the three cards provided. The work ID, which reads Johnny Smith, may not be the patient's legal name and should not be used for registration purposes. The insurance card, which reads John Smith III, may also not be the patient's full legal name as it does not include the middle name "Anthony" that is present on the driver's license. Therefore, the name on the driver's license should be used for registration.Rate this question:
- 16.
True or False: A Triage Tag number is the most important patient identifier during a disaster situation.
- A.
True
- B.
False
Correct Answer
A. TrueExplanation
True- During a declared disaster, the Triage Tag number (found repeating throughout the Triage Tag) should be used as the patient's main identifier.Rate this question:
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- 17.
You are registering Leia Skywalker and come across a possible duplicate screen. The screen displays: Current Patient: Skywalker, Leia DOB: 08/01/1990 MRN: 890777Possible Duplicate Patient: PrincessSkywalker, Leia DOB: 08/01/1990 MRN: 555522Skywalker, Leia DOB: 08/01/1990 MRN: 123456After interviewing the patient, you confirm all three are the same person. Which medical record number do you continue with?
- A.
890777
- B.
555522
- C.
123456
Correct Answer
C. 123456Explanation
Per Patient Access rules, if a patient has more than one CONFIRMED medical record, the lowest number must be chosen. All others should be flagged for duplicates.Rate this question:
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Current Version
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Apr 05, 2024Quiz Edited by
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Jan 15, 2010Quiz Created by
Mmatias
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