The 'Module 113 Final Review' quiz assesses understanding of insurance claims processing, including dispute resolution, claim tracking, and compliance with financial standards. It is crucial for professionals managing insurance claims and ensures adherence to legal and procedural guidelines.
There is no copayment with a managed care plan
Bill the plan for the copayment
Bill the patient for the copayment
Collect the copayment when the patient arrives for the office visit
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Two
Three
Five
Six
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Federal insurance commissioner
State insurance commissioner
State insurance federation
Department of public service
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State health insurance program
Federal health insurance program
Regional health insurance program
Local health insurance program
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Send a patient information brochure
Send a confirmation letter
Discuss fees and policies at the time of the initial contact
All of the above
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Patient's financial accounting record
Practice's day sheet
Copy of the CMS-1500 form
Patients's insurance contract
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Not be affected
Be denied
Be less
Be more
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Chapter 7
Chapter 11
Chapter 12
Chapter 13
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The local social security administration office
A regional fiscal intermediary
The center for medicare and medicaid services
The national blue cross association
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Once a year
Every other year
Once every 3 years
Once every 5 years
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Laboratory and x-ray services
Vaccines and ambulance services
Mammograms and pap smears
Eyeglasses and prescription drugs
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Statement of service
Centralized billing
Outsourcing
Cycle billing
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Advise the physician to write off the amount as a bad debt
Pay the physician within 2 to 3 weeks and honor the assignment even before the company recovers their money from the patient
Pay the physician witin 2 to 3 weeks after recovering the money from the patient
Notify the physician of the error and indicate in a letter that it will never happen again
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$100 or more
$300 or more
$500 or more
$1000 or more
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Before any services are provided
Right after services are provided
At the time of the first statement
In a follow-up telephone call
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Ask if there is a backlog of claims at the insurance office
Submit a copy of the original claim
Verify the correct mailing address
All of the above
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Paid
Rejected
Suspended
Denied
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Say, "all right" and bill the patient
State the office policy and ask for the full fee
Indicate that because it is such a small sum, it can be paid later
Ask that the payment be mailed to the office
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Do not try and be friendly; just get to the point
Use a friendly tone and ask why payment has not been made
Do not suggest that the patient has overlooked a previous statement
Do not imply that the patient has good intentions to pay
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Tickler file
Clinical file
Data file
Patient file
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One
Two
Three
Five
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Number of statements sent
Number of claims processed
Accounts payable
Accounts receivable
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Private-label card
Credit card
Debit card
Verifone card
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Equal Credit Opportunity Act
Fair Credit Billing Act
Truth in Lending Act
Fair Debt Collection Practices Act
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1 year
2 years
3 years
5 years
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Certified mail with return receipt requested
Certified mail
Standard mail
Overnight mail
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After 9 AM and before 9 PM
After 8 AM and before 9 PM
After 8 AM and before 8 PM
After 9 AM and before 8 PM
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People's court
Justice court
Small claims court
All of the above
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Presented at the time of service
Mailed right after the date of service
Mailed 2 weeks after the date of service
Mailed 30 days after the date of service
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Cigna plan
Kaiser permanente plan
Health maintenance act of 1973
Omnibus budget reconciliation act
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Applying a discount (percentage) to the entire fee
Applying a discount after the insurance company has paid its portion
Writing off the balance of an account after the insurance company has paid its portion
Making no charge to anyone, patient or insurance company, for medical care
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1,4,6, and 8 weeks
30,60,90, and 120 days
1,2,3, and 6 months
30,60,90,120, and 180
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Increased cash flow
Decreased cash flow
Decreased accounts receivable
Decreased copayments
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Equal Credit Opportunity Act
Fair Credit Reporting Act
Fair Credit Billing Act
Truth in Lending Act
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Secured debt
Nonsecured debt
Nonexempt assets
Exempt assets
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Fee for service
Capitation
Usual charges
Customary fees
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Paid
Rejected
Suspended
Denied
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2 weeks
30 days
60 days
90 days
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The amount of money available in the cash drawer
The amount of money taken into the office in a given period of time
The ongoing availability of cash in the medical practice
The amount of money in accounts receivable
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Flex time
Floating time
Job share
Salary
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Health maintenance organization (HMO)
Managed care organization (MCO)
Preferred provider organization (PPO)
Exclusive provider organization (EPO)
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Diagnostic tests
Hospital rooms
Hospice care
Nursing facility care
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All physician and hospital deductibles
The deductible not covered under medicare
80% of the medicare allowed amount
75% of the medicare allowed amount
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$100
$250
$350
$500
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Organize the accounts alphabetically and start with the letter A
Organize the accounts by account number and start with number 1
Organize the accounts according to amounts owed and start with the largest amount
Determine what patient you think may be easier to collect from and start with that account
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Fee for service
Usual, customary, and reasonable charges
Allowable charges
Prepaid health plan
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Disabled adult
Disabled child
Wage earner
Widow
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Primary care
Secondary care
Concurrent care
Tertiary care
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