Patient Access Department - Registrar Competency Exam

1. 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?

Have an Environmental Services employee translate.

Call the Language Line and ask for an interpreter in the patient's language.

Register the patient and speak slowly so that he may understand you.

Ask the patient to bring in a family member that may translate for his next visit.

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.

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.

2. True or False:

A Triage Tag number is the most important patient identifier during a disaster situation.

True

False

True- During a declared disaster, the Triage Tag number (found repeating throughout the Triage Tag) should be used as the patient's main identifier.

Explanation

True- During a declared disaster, the Triage Tag number (found repeating throughout the Triage Tag) should be used as the patient's main identifier.

3. 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?

The primary insurance policy for the 8-year-old patient will be determined by the "birthday rule." The birthday rule states that the parent whose birthday (month and day) occurs earlier in the calendar year has the primary insurance coverage for the child.

In this case:

Mother's DOB: 04/10/1970

Father's DOB: 01/17/1969

Since January 17 (Father's birthday) comes before April 10 (Mother's birthday) in the calendar year, the father's insurance policy (Oxford) would be considered primary.

The number of employees at their respective workplaces does not affect the determination of the primary insurance in this context; it's the birthday rule that applies.

Explanation

The primary insurance policy for the 8-year-old patient will be determined by the "birthday rule." The birthday rule states that the parent whose birthday (month and day) occurs earlier in the calendar year has the primary insurance coverage for the child.

In this case:

Mother's DOB: 04/10/1970

Father's DOB: 01/17/1969

Since January 17 (Father's birthday) comes before April 10 (Mother's birthday) in the calendar year, the father's insurance policy (Oxford) would be considered primary.

The number of employees at their respective workplaces does not affect the determination of the primary insurance in this context; it's the birthday rule that applies.

Submit

4. A patient may be eligible to receive Medicare benefits due to:

Their age

A disability

A chronic Kidney/Renal condition that requires dialysis treatment

Both A and B

A, B and C

Medicare beneficiaries are entitled to receive Medicare benefits because of their age, a disability, or ESRD (End Stage Renal Disease).

Explanation

Medicare beneficiaries are entitled to receive Medicare benefits because of their age, a disability, or ESRD (End Stage Renal Disease).

5. After the interpreter is contacted, Mr. Myung hands you his Korean passport as his ID. The passport reads as follows:

Last Name: Myung
First Name: Yoo Ki

How should this patient's name be registered?

First: YooMiddle: KLast: Myung

First: YooMiddle: NONELast: Myung

First: YooKiMiddle: NONELast: Myung

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.

Explanation

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.

6. EMTALA (Emergency Medical Treatment and Active Labor Act) dictates:

A patient in the Emergency Department must be treated and stabilized regardless of their ability to pay.

All Emergency Department and Labor patients must be treated quickly.

Both A and B

None of these

EMTALA states that all Emergency Room patients and any patient in active labor must be treated and stabilized regardless of their ability to pay.

Explanation

EMTALA states that all Emergency Room patients and any patient in active labor must be treated and stabilized regardless of their ability to pay.

7. 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?

Using Medicare Part B (015 and 017)

Using Medicare Part A (089 and 017)

Self-pay (031)

Since Medicare part A only covers inpatient services, this patient should be registered as Self-Pay.

Explanation

Since Medicare part A only covers inpatient services, this patient should be registered as Self-Pay.

8. 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?

BCBS Policy ONLY

Allstate policy ONLY.

BCBS policy as Primary; Allstate policy secondary

Allstate policy as Primary; BCBS policy secondary

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.

Explanation

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.

9. 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.

One

Two

Three

Four

None of these

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.

Explanation

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.

10. 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?

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.

Explanation

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.

Submit

11. True or False

A nursing home patient is sent for inpatient admission at HNH. The patient has Medicare part B only.

How should this patient be registered?

Self-Pay

Medicare Part A (089/017)

Medicare Part B (015/017)

Medicare Part B may be used for both inpatient and outpatient services when the patient has part B only.

Explanation

Medicare Part B may be used for both inpatient and outpatient services when the patient has part B only.

12. You are registering Leia Skywalker and come across a possible duplicate screen. The screen displays:

Current Patient: Skywalker, Leia DOB: 08/01/1990 MRN: 890777

Possible Duplicate Patient:

PrincessSkywalker, Leia DOB: 08/01/1990 MRN: 555522

Skywalker, Leia DOB: 08/01/1990 MRN: 123456

After interviewing the patient, you confirm all three are the same person. Which medical record number do you continue with?

890777

555522

123456

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.

Explanation

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.

13. 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?

Medicare

Aetna

Not enough information provided

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.

Explanation

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.

14. Rachel Weinburgh is being registered for Lab work. Her demographics are as follows:

Rachel Weinburgh

DOB: 11/13/1967

SSN: 111-22-3333

Address:
123 Up Way
Balloonville, PA 14579
Phone: 201-833-3000

What is the proper way to begin your search for Rachel in the database?

Search by her Last Name and her DOB first

Search by her Social Security number first

Search by her Phone Number first

None of the above

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.

Explanation

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.

15. 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?

Cigna

Medicare

Not enough information provided to answer question

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.

Explanation

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.

16. 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 Weinburgh

DOB: 11/13/1967

Last: Weinb First: Rach DOB: 11/13/1967

Last: Weinburgh First: Rachel DOB: 11/13/1967

Last: Weinburgh First: R DOB: 11/13/1967

Last: Wei First: Rac DOB: 11/13/1967

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.

Explanation

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.

17. 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?

Medicare, Medicaid, BCBS

BCBS, Medicare, Medicaid

Medicaid, Medicare, BCBS

Medicare, BCBS, Medicaid

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.

Explanation

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.