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Questions to help prepare for certification

Questions and Answers

1.

The key patient demographic information we gather at intake to identify if the Patient has previously been at the hospital includes:
- A.
  
  Social security number, date of birth, gender, and address.
- B.
  
  Name, date of birth, driver's license, and gender.
- C.
  
  Date of birth, name, social security number, and gender.
- D.
  
  Name, address, date of birth, and gender.
Correct Answer
C. Date of birth, name, social security number, and gender.
2.

If during the MPI search the Patient's name is not located, a temporary medical record number should be assigned.
- A.
  
  True
- B.
  
  False
Correct Answer
B. False
3.

To obtain payer information during the intake process, you should utilize:
- A.
  
  Analytical skills to assess and review payer information and documents.
- B.
  
  Available verification tools to confirm the payer information.
- C.
  
  Interview skills to request payer information and documents.
- D.
  
  All of the above.
Correct Answer
D. All of the above.
4.

It is through the verification process we confirm the accuracy and completeness of key:
- A.
  
  Demographic, encounter, and family information.
- B.
  
  Encounter, payer, and demographic information.
- C.
  
  Payer, encounter, and geographic information.
- D.
  
  Demographic, insurance, and physician information.
Correct Answer
C. Payer, encounter, and geographic information.
5.

____________ is to attest as meeting a standard of care prior to service.
- A.
  
  Pre-certification.
- B.
  
  Benefit level.
- C.
  
  Eligibility period.
- D.
  
  Referral
- E.
  
  Authorization.
Correct Answer
A. Pre-certification.
6.

_____________ is defined as the period in time when a person is qualified for healthcare services covered by the insurance plan or entity (third party payer).
- A.
  
  Pre-certification.
- B.
  
  Benefit level.
- C.
  
  Eligibility period.
- D.
  
  Referral.
- E.
  
  Authorization.
Correct Answer
C. Eligibility period.
7.

_____________ is to give official approval or permission for the service.
- A.
  
  Pre-certification.
- B.
  
  Benefit level.
- C.
  
  Eligibility period.
- D.
  
  Referral.
- E.
  
  Authorization. Authorization.
Correct Answer
E. Authorization. Authorization.
8.

A _____________ is to send or direct for treatment, aid, information, or decision. Some third party payers utilize this process to monitor and manage patient care.
- A.
  
  Pre-certification.
- B.
  
  Benefit level.
- C.
  
  Eligibility period.
- D.
  
  Referral.
- E.
  
  Authorization.
Correct Answer
D. Referral.
9.

_____________ is defined as the service the third party payer will pay, based on the Patient's coverage plan.
- A.
  
  Pre-certification.
- B.
  
  Benefit level.
- C.
  
  Eligibility period.
- D.
  
  Referral.
- E.
  
  Authorization.
Correct Answer
B. Benefit level.
10.

Factors influencing the hospital's decision on what and when payer information is verified include:
- A.
  
  The quantity of visits requiring manual eligibility and benefit verification
- B.
  
  The average charge and net reimbursement for the service.
- C.
  
  Net reimbursement compared to costs to complete the verification steps.
- D.
  
  Access to online payer verification tools.
- E.
  
  All of the above.
Correct Answer
E. All of the above.
11.

How many days of an extended inpatient post-acute care service does Medicare Cover per benefit period?

Correct Answer
100
12.

What must a hospital do before it can charge a patient for a Medicare non-covered service?

Correct Answer
present patient with an ABN
13.

What percent of the Medicare fee or payment rate for an outpatient service is the patient responsible for after the deductibles are met?

Correct Answer
20%
14.

Which Part of Medicare pays for an outpatient services?

Correct Answer
B
15.

Modifiers are attached to which types of codes?

Correct Answer
CPT/HCPCS

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Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.

Current Version
Dec 31, 2012

Quiz Edited by
ProProfs Editorial Team
Apr 26, 2009

Quiz Created by
Keader

CPAT Prep Access

The key patient demographic information we gather at intake to identify if the Patient has previously been at the hospital includes:

If during the MPI search the Patient's name is not located, a temporary medical record number should be assigned.

To obtain payer information during the intake process, you should utilize:

It is through the verification process we confirm the accuracy and completeness of key:

____________ is to attest as meeting a standard of care prior to service.

_____________ is defined as the period in time when a person is qualified for healthcare services covered by the insurance plan or entity (third party payer).

_____________ is to give official approval or permission for the service.

A _____________ is to send or direct for treatment, aid, information, or decision. Some third party payers utilize this process to monitor and manage patient care.

_____________ is defined as the service the third party payer will pay, based on the Patient's coverage plan.

Factors influencing the hospital's decision on what and when payer information is verified include:

How many days of an extended inpatient post-acute care service does Medicare Cover per benefit period?

What must a hospital do before it can charge a patient for a Medicare non-covered service?

What percent of the Medicare fee or payment rate for an outpatient service is the patient responsible for after the deductibles are met?

Which Part of Medicare pays for an outpatient services?

Modifiers are attached to which types of codes?