Medical Office Assistant Certification Quiz!

When collecting for services rendered, it is common practice to collect the allowed amount rather than the total charge. The allowed amount refers to the amount that the insurance company has agreed to pay for the services, which is typically lower than the total charge. This is because insurance companies negotiate discounted rates with healthcare providers. Therefore, it is important to collect the allowed amount to ensure proper reimbursement and avoid overcharging patients.

To ensure accurate billing to the appropriate payer, it is necessary to obtain a front and back copy of the patient's insurance card. This allows healthcare providers to verify the patient's insurance coverage, policy details, and contact information. By having a copy of the insurance card, providers can submit claims and receive payment from the insurance company for the services rendered to the patient.

When a patient has commercial insurance as primary and Medicaid as secondary, we will not collect a co-pay. This is because Medicaid is a government program that provides healthcare coverage for low-income individuals, and it typically covers the cost of the co-pay. Therefore, the correct answer is False.

Medicare Part B is medical coverage for Medicare patients that covers physician services. It is a component of the Medicare program that helps pay for medical services such as doctor visits, outpatient care, preventive services, and medical supplies. Medicare Part B helps ensure that Medicare beneficiaries have access to necessary healthcare services provided by physicians, including office visits, consultations, and other outpatient services. This coverage is important for Medicare patients to receive the medical care they need from healthcare providers.

When billing a well and sick visit on the same date of service, it is necessary to use modifier 25 on the sick visit. Modifier 25 is used to indicate that a significant, separately identifiable evaluation and management service was provided on the same day as another service. This is important for proper coding and reimbursement purposes, as it helps to distinguish the sick visit from the well visit and ensures that both services are appropriately documented and billed.

Medicare Part A is medical coverage specifically designed for Medicare patients that provides coverage for in-patient hospital services only. It includes coverage for hospital stays, skilled nursing facility care, hospice care, and limited home health services. Medicare Part A is an essential component of the Medicare program and helps to ensure that Medicare beneficiaries have access to necessary hospital services without incurring excessive out-of-pocket costs.

A deductible is the amount of money that a patient is responsible for paying out of their own pocket before their insurance company will start covering the remaining cost of their medical expenses. It is a predetermined amount set by the insurance company and is usually an annual requirement. Once the deductible is met, the insurance company will then begin to cover a percentage or the full cost of the medical expenses, depending on the specific insurance plan.

The company policy states that we are required to collect payment at the time of service. This means that customers are expected to pay for the products or services they receive immediately, without any delay. This policy helps ensure that the company receives timely payment and avoids any issues with outstanding balances or delayed payments.

Co-pay plans require the insured to pay a specified dollar amount, usually $25 or less, for each medical service or prescription drug. This amount is paid directly to the healthcare provider at the time of service. Co-pays are common in health insurance plans and help to share the cost of healthcare between the insurer and the insured. The exact amount of the co-pay can vary among different insurers and plans.

Molina Health Plan requires prior-authorization for trigger point injections to be considered for payment. Prior-authorization is a process where healthcare providers must obtain approval from the insurance company before performing certain medical procedures or prescribing specific medications. This ensures that the treatment is medically necessary and meets the plan's guidelines. Without prior-authorization, the insurance company may not cover the cost of trigger point injections, making it important for healthcare providers to obtain this approval before administering the treatment.