Hospital And Clinic Billing! CPAT Trivia Quiz

46 Questions | Total Attempts: 1035

SettingsSettingsSettings
Hospital And Clinic Billing! CPAT Trivia Quiz

Can you pass this hospital and billing trivia quiz? This particular quiz is for someone studying to become a Certified Patient Account Technician. This quiz will tell you what NCCI identifies, at what time the NCCI reviews claims, and why it was introduced. This quiz breaks down these questions to give you an idea of what you have to look forward to in this field of study.


Questions and Answers
  • 1. 
    The components of an E/M code include all of the following except:
    • A. 

      Examination

    • B. 

      Medical Decision Making

    • C. 

      Time

    • D. 

      History

  • 2. 
    How many components are used in defining the level of an E/M service:
    • A. 

      4

    • B. 

      5

    • C. 

      6

    • D. 

      7

  • 3. 
    These defining components include all of the following except:
    • A. 

      Time

    • B. 

      Cost

    • C. 

      Coordination of Care

    • D. 

      History

  • 4. 
    NCCI is the acronym for:
    • A. 

      National Correct Coding Initiative

    • B. 

      National Corrected Coding Issues

    • C. 

      National Correct Coding Issues

    • D. 

      National Corrected Coding Initiative

  • 5. 
    NCCI reviews claims at what time:
    • A. 

      Before they are submitted

    • B. 

      After they are approved for payment

    • C. 

      Before they are paid

    • D. 

      All of the above

  • 6. 
    NCCI identifies:
    • A. 

      Codes that should not be billed together

    • B. 

      Unbundled codes

    • C. 

      Mutually exclusive codes

    • D. 

      Both A and C

  • 7. 
    NCCI was introduced to do all of the following except:
    • A. 

      Increase reimbursement

    • B. 

      Identify codes that may be a potential for fraud and abuse

    • C. 

      Establish standards of medical billing

    • D. 

      Identify codes that are components of another code and should not be billed together.

  • 8. 
    MUE's were designed to:
    • A. 

      Reduce clerical errors

    • B. 

      Increase reimburesment

    • C. 

      Reduce incorrect coding based on anatomic consideration

    • D. 

      Both A and C

  • 9. 
    A hospital cannot bill a beneficiary for units of service in excess of MUE limitseven if they have an ABN on file:
    • A. 

      True

    • B. 

      False

  • 10. 
    • A. 

      Inpatient Hospitals

    • B. 

      Outpatient

    • C. 

      Ambulatory Care Facilities

    • D. 

      Both A and D

    • E. 

      All of the above

  • 11. 
    APC is the acronym for:
    • A. 

      Automatic Payment Classification

    • B. 

      Ambulatory Patient Classification

    • C. 

      Automatic Payment Classification

    • D. 

      Ambulatory Payment Classification

  • 12. 
    Elements required to assign an APC include all of the following:
    • A. 

      CPT codes

    • B. 

      ICD-9 codes

    • C. 

      Site of service

    • D. 

      Condition codes

  • 13. 
    Per Medicare timely filing regulations, a claim for date of service October 1, 2010 must be submitted by:
    • A. 

      December 31, 2010

    • B. 

      December 31, 2011

    • C. 

      December 31, 2012

    • D. 

      18 months

  • 14. 
    Per Medicare timely filing regulations, a claim for date of service June 23, 2009 must be submitted by:
    • A. 

      Dec 31, 2010

    • B. 

      Dec 31, 2011

    • C. 

      Dec 31, 2012

    • D. 

      18 months

  • 15. 
    Ancillary services include all of the following except:
    • A. 

      Radiology

    • B. 

      Operating Room

    • C. 

      Laboratory

    • D. 

      Blood Administration

  • 16. 
    Medicare Part A pays for outpatient services provided in a hospital setting exclusive of physician/ technical charges.
    • A. 

      True

    • B. 

      False

  • 17. 
    For Medicare to consider an item or service as medically necessary it must meet the following guidelines except:
    • A. 

      Consistent with the symptoms or diagnosis

    • B. 

      Not furnished primarily for the convenience of the patient

    • C. 

      Ordered by the physician

    • D. 

      Medically necessary

  • 18. 
    Examples of Never Events are:
    • A. 

      Conducting a wrong surgery on a patient

    • B. 

      Performing surgery on a wrong body part

    • C. 

      Administering incorrect medication

    • D. 

      Both A and B

    • E. 

      All of the above

  • 19. 
    The following provisions must be confirmed to determine whether the waiver of liability provision is applicable:
    • A. 

      The service or item must be covered

    • B. 

      The service must be determined to be unreasonable or unnecessary for the diagnosis

    • C. 

      A physician can only render the treatment and the carrier has not previously denied coverage

    • D. 

      Both A and B

    • E. 

      All of the above

  • 20. 
    Hospital outpatient services that are provided to a patient classified as DOA are covered by Medicare Part B if the patient has been pronounced dead prior to arrival.
    • A. 

      True

    • B. 

      False

  • 21. 
    A method of payment for health services by which a healthcare provider is paid a fixed per capita amount for each person service, regardless of the actual number or nature of services provided:
    • A. 

      Fee schedule

    • B. 

      Capitation

    • C. 

      Per diem

    • D. 

      Fee for service

  • 22. 
    A method of payment for health services based on straight charges:
    • A. 

      Fee schedule

    • B. 

      Capitation

    • C. 

      Per diem

    • D. 

      Fee for service

  • 23. 
    A comprehensive list of fees that are paid for specific services that are rendered:
    • A. 

      Fee schedule

    • B. 

      Capitation

    • C. 

      Per diem

    • D. 

      Fee for service

  • 24. 
    Reimbursement based on a set rate per day in the hospital regardless of any actual charges or cost incurred:
    • A. 

      Fee schedule

    • B. 

      Capitation

    • C. 

      Per diem

    • D. 

      Fee for service

  • 25. 
    For Medicare beneficiary, the outpatient observation limit is:
    • A. 

      24 hours

    • B. 

      48 hours

    • C. 

      72 hours

    • D. 

      96 hours

  • 26. 
    CLIA is the acronym for:
    • A. 

      Clinical laboratory Improvement Act

    • B. 

      Clinical Laboratory Improvement Assessment

    • C. 

      Clinical Laboratory Improvement Amendment

    • D. 

      Clerical Laboratory Improvement Act

  • 27. 
    CLIA numbers have how many digits:
    • A. 

      5

    • B. 

      8

    • C. 

      10

    • D. 

      12

  • 28. 
    Medicare is a health insurance program for which of the following:
    • A. 

      People age 65 or older

    • B. 

      Some people with disabilities

    • C. 

      People with End- Stage Renal Disease

    • D. 

      All of the above

  • 29. 
    Medicare has how many parts:
    • A. 

      2

    • B. 

      3

    • C. 

      4

    • D. 

      5

  • 30. 
    If the HICN starts with a number, how many positions must be numeric?
    • A. 

      6

    • B. 

      7

    • C. 

      9

    • D. 

      11

  • 31. 
    If the HICN starts with a letter, how many positions must be numberic:
    • A. 

      6

    • B. 

      7

    • C. 

      9

    • D. 

      11

  • 32. 
    If the HICN ends with an A, this would indicate the cardholder is the:
    • A. 

      Husband

    • B. 

      Wage earner

    • C. 

      Wife

    • D. 

      Child

  • 33. 
    If the HICN ends with a C, this would indicate the cardholder is:
    • A. 

      Husband

    • B. 

      Non-wage earner

    • C. 

      Wife

    • D. 

      Child

  • 34. 
    If the HICN ends with a B, this would indicate the cardholder:
    • A. 

      Husband

    • B. 

      Non-wage earner

    • C. 

      Wife

    • D. 

      Child

  • 35. 
    For each benefit period the patient is responsible for what amount for a hospital stay of 1 to 60 days?
    • A. 

      $110

    • B. 

      $500

    • C. 

      $1132

    • D. 

      $1295

  • 36. 
    For each benefit period the patient is responsible for what amount for care recieved in a skilled nursing facility for the first 20 days:
    • A. 

      $137.50

    • B. 

      $1100

    • C. 

      $110

    • D. 

      Nothing

  • 37. 
    For each benefit period the patient is responsible for what amount for care recieved in skilled nursing facility for days 21-100:
    • A. 

      $147.50

    • B. 

      $1100

    • C. 

      $110

    • D. 

      Nothing

  • 38. 
    The Medicare Part B deductible is:
    • A. 

      $100

    • B. 

      $110

    • C. 

      $162

    • D. 

      $250

  • 39. 
    Medicare Part B covers all of the following except:
    • A. 

      Eye Exam

    • B. 

      Mammograms

    • C. 

      Glaucoma Screening

    • D. 

      Pneumonia Vaccinations

  • 40. 
    The following is not covered by Medicare Parts A and B except:
    • A. 

      Bone Mass Measurements

    • B. 

      Hearing Aids

    • C. 

      Cosmetic Surgery

    • D. 

      Dental Care

  • 41. 
    A health insurance policy sold by private insurance companies to cover Medicare deductibles and coinsurance is called:
    • A. 

      Medicaid

    • B. 

      Medigap

    • C. 

      Secondary

    • D. 

      Tricare

  • 42. 
    In order to obtain Medigap coverage the beneficiary must have:
    • A. 

      Part A only

    • B. 

      Part B only

    • C. 

      Parts A and B

    • D. 

      Medicare/ Medicaid

  • 43. 
    To qualify for Medicaid, a patient must have all of the following except:
    • A. 

      A monthly income below certain limits

    • B. 

      Part A and B

    • C. 

      Parts A only

    • D. 

      Assets not more than $4000

  • 44. 
    QMB coverage will pay for:
    • A. 

      Medicare Part B premiums

    • B. 

      Small part of your Part B premiums

    • C. 

      Premiums, deductibles, and coinsurance

    • D. 

      Medigap

  • 45. 
    SLMB coverage will pay for:
    • A. 

      Medicare Part B premiums

    • B. 

      Small part of your Part B premiums

    • C. 

      Premiums, deductibles, and coinsurance

    • D. 

      Medigap

  • 46. 
    QI1 coverage will pay for:
    • A. 

      Medicare Part B premiums

    • B. 

      Small part of your Part B premiums

    • C. 

      Premiums, deductibles, and coinsurance

    • D. 

      Medigap