1.
What action is expected from the patient at the time of their visit?
Correct Answer
C. Payment/co-pay
Explanation
The patient is expected to make a payment or co-pay at the time of their visit. This is a common practice in healthcare facilities where patients are required to pay a certain amount of money, either as a full payment or a partial payment, at the time of their appointment. This payment helps cover the cost of the visit and any additional services provided. It is important for patients to be prepared to make this payment in order to receive the necessary medical care.
2.
Making copies of insurance cards is part of what process?
Correct Answer
A. Check in process
Explanation
Making copies of insurance cards is part of the check-in process. This process typically occurs before a patient sees the doctor and involves providing necessary information and documentation, such as insurance cards, to the healthcare facility. It is important to have copies of insurance cards on file to ensure accurate billing and to verify coverage for the patient's visit.
3.
Why would a patient sign an assignment of benefits form?
Correct Answer
C. So the insurance will pay directly to the provider
Explanation
A patient would sign an assignment of benefits form so that the insurance company will pay the healthcare provider directly. By signing this form, the patient authorizes the insurance company to send the payment for the medical services directly to the provider, eliminating the need for the patient to pay out-of-pocket and then seek reimbursement. This ensures a smoother payment process and reduces the financial burden on the patient.
4.
What is the Workman's Comp an example of?
Correct Answer
A. Third Party Payer
Explanation
Workman's Comp is an example of a third-party payer. In this context, a third-party payer is an entity, such as an insurance company, that pays for the medical expenses and lost wages of an injured worker on behalf of the employer. The employer and the injured worker are the first and second parties, respectively, in this arrangement. Therefore, Workman's Comp acts as a third-party payer by assuming the financial responsibility for the worker's compensation.
5.
What does CEU stand for and why is it necessary?
Correct Answer
D. Continuing Education Units/Keep your certification active
Explanation
CEU stands for Continuing Education Units. It is necessary to keep your certification active. Continuing Education Units are a measure of the time spent in a structured learning environment to enhance professional knowledge and skills. By earning and maintaining CEUs, professionals can demonstrate their commitment to staying updated in their field and ensuring their skills are current. It also helps to maintain the credibility and validity of their certification.
6.
Which part of the Medicare covers prescription drug services?
Correct Answer
D. D
Explanation
Medicare Part D covers prescription drug services. This part of Medicare is a standalone prescription drug plan that helps individuals pay for their prescription medications. It is available to anyone who is eligible for Medicare, regardless of their income or health status. Medicare Part D provides coverage for both brand-name and generic prescription drugs, and the specific medications covered can vary depending on the plan chosen. Individuals can enroll in a Medicare Part D plan during their initial enrollment period or during the annual open enrollment period.
7.
What is necessary to document in the appt book and the medical record?
Correct Answer
B. Cancellations/Rescheduled appointments
Explanation
In order to maintain an accurate and organized appointment book and medical record, it is necessary to document any cancellations or rescheduled appointments. This information is important for tracking patient attendance and ensuring that appointments are properly managed. By documenting cancellations and rescheduled appointments, healthcare providers can effectively update their schedules and make necessary adjustments to accommodate other patients. Additionally, this information can also be used for billing and insurance purposes, as it provides a record of any changes made to the original appointment.
8.
How many provisions does HIPAA contain?
Correct Answer
B. Two
Explanation
HIPAA, the Health Insurance Portability and Accountability Act, contains two provisions. These provisions are designed to protect individuals' health information and ensure its confidentiality. The first provision is the Privacy Rule, which establishes standards for safeguarding protected health information. The second provision is the Security Rule, which sets forth requirements for the security of electronic health information. Together, these two provisions aim to protect patients' privacy and maintain the security of their health data.
9.
What require annotation?
Correct Answer
A. Sorting Mail
Explanation
Sorting mail requires annotation because it involves categorizing and organizing different types of mail based on their content, recipient, or priority. Annotation helps in identifying and labeling the mail correctly, ensuring that it reaches the intended recipient and is handled appropriately. It also helps in keeping track of important information or instructions associated with the mail, such as urgent or confidential items. Annotation is essential in maintaining an efficient and accurate mail sorting process.
10.
Who is the legal owner of the patients medical record?
Correct Answer
B. The pHysician or agency where services were provided
Explanation
The correct answer is the physician or agency where services were provided. The medical records are considered the property of the healthcare provider or facility that created them. The patient has the right to access and request copies of their medical records, but they do not own them. The physician or agency is responsible for maintaining and protecting the confidentiality of the medical records. The patient's insurance company does not own the medical records either.
11.
What would cause you to have a young child and their parent wait in a separate area?
Correct Answer
A. The child is ill with flu like symptoms. Prevent the spread of illness
Explanation
When a child is ill with flu-like symptoms, it is important to prevent the spread of illness to other patients and staff in the waiting area. By having the young child and their parent wait in a separate area, the risk of spreading the illness to others is minimized. This helps to maintain a safe and healthy environment for everyone present in the waiting area.
12.
Healthcare information is used to:
Correct Answer
D. All of the above
Explanation
Healthcare information is used to determine how many patients enter a facility with the same diagnosis, which helps in understanding the prevalence and severity of specific conditions. It is also used to decide what equipment is needed to meet the needs of the patients, ensuring that the facility is well-equipped to provide appropriate care. Additionally, healthcare information helps the facility plan for the needs of the next week and next year, allowing them to allocate resources, staff, and services accordingly. Therefore, all of the above options are correct.
13.
When is it necessary to shred or incinerate medical records?
Correct Answer
B. When the records have exceeded the maximum retention time
Explanation
Medical records contain sensitive and confidential information about patients, and it is crucial to protect their privacy. Shredding or incinerating medical records becomes necessary when they have exceeded the maximum retention time. This ensures that the records are properly disposed of and cannot be accessed or misused by unauthorized individuals. By following the proper retention guidelines, healthcare organizations can maintain compliance with legal and regulatory requirements while safeguarding patient confidentiality.
14.
Which of the following identifying markers should the medical assistant attempt to remember about suspicious individuals?
Correct Answer
D. All of the above
Explanation
The medical assistant should attempt to remember all of the above identifying markers about suspicious individuals. Height, hair color and length, and clothing worn can all be important details that can help in identifying and describing suspicious individuals accurately. By remembering all of these markers, the medical assistant can provide detailed and accurate information to law enforcement or other relevant authorities if necessary.
15.
When do you need to observe the provider's initials/signature?
Correct Answer
A. Before filing lab or other diagnostic results
Explanation
Observing the provider's initials/signature before filing lab or other diagnostic results is necessary to ensure accuracy and accountability. This step helps in verifying the authenticity of the results and ensures that they are properly documented and filed. It also helps in tracking the provider responsible for the results and maintaining a clear record for future reference. This practice is essential for maintaining quality control and ensuring patient safety.
16.
The medical assistant should collect which of the following when a new patient comes to the office?
Correct Answer
D. All of the above
Explanation
When a new patient arrives at a medical office, it is essential to gather comprehensive information for accurate record-keeping, insurance billing, and patient identification. This includes a completed patient information sheet with personal and medical history, a copy of their insurance card (front and back) for verification and billing purposes, and a copy of their driver's license to confirm their identity.
17.
When is it necessary to verify preauthorization?
Correct Answer
B. Before outpatient surgery
Explanation
It is necessary to verify preauthorization before outpatient surgery to ensure that the insurance company has approved and will cover the cost of the procedure. Verifying preauthorization beforehand helps prevent any unexpected financial burden on the patient and ensures a smooth process during check-in and surgery.
18.
A type of insurance that protects workers from loss wages after an industrial accident that happened on the job is called?
Correct Answer
B. Worker's compensation
Explanation
Worker's compensation is the correct answer because it specifically refers to the type of insurance that provides coverage for workers who have experienced an industrial accident while on the job. This insurance helps protect workers by providing them with financial compensation for lost wages, medical expenses, and rehabilitation costs resulting from the accident. It is designed to ensure that workers are supported and can recover from their injuries without facing financial hardship.
19.
When is a good time to print out the encounter forms for the next day?
Correct Answer
D. The night before or morning of
Explanation
The night before or morning of is the best time to print out the encounter forms for the next day because it allows enough time to review and prepare for the upcoming appointments. Printing them a week before or a week after would be too early or too late, respectively. Similarly, printing them the day after would not be ideal as it would cause delays in documentation. Therefore, printing the encounter forms the night before or morning of ensures that they are ready and up-to-date for the day's appointments.
20.
The maximum amount of money that the third-party payors will pay for a specific procedure or service is called the:
Correct Answer
B. Allowable charge
Explanation
The term "allowable charge" refers to the maximum amount of money that third-party payors, such as insurance companies or government programs, are willing to pay for a specific medical procedure or service. This amount is predetermined and may be based on factors such as the provider's contract with the payor or the average cost of the procedure in a particular geographic area. The allowable charge represents the limit of what the payor will cover, and any amount above this limit would typically be the responsibility of the patient or provider.
21.
Where would you find the NPI number?
Correct Answer
A. CMS-1500
Explanation
The NPI number can be found on the CMS-1500 form. The CMS-1500 is a standard claim form used by healthcare professionals to bill Medicare and Medicaid for services rendered. The NPI number is a unique identifier assigned to healthcare providers by the National Plan and Provider Enumeration System (NPPES). It is used to track and identify providers for billing and administrative purposes. Therefore, the correct answer is CMS-1500.
22.
Which of the following statements best describes the concept of "professional courtesy"?
Correct Answer
B. Charging reduced or no fee for services rendered to other medical professionals
Explanation
Professional courtesy refers to the practice of charging reduced or no fee for services provided to other medical professionals. This is done as a gesture of respect and support within the medical community. It allows healthcare professionals to seek necessary medical care without financial burden, promoting collaboration and mutual assistance among colleagues. By providing this courtesy, medical professionals uphold ethical standards and foster a sense of camaraderie within their profession.
23.
What is a reason a patient would sue the provider?
Correct Answer
C. Abandonment/if he leaves on vacation and does not provide another MD to care for them during his leave
Explanation
If a patient's healthcare provider leaves on vacation without arranging for another doctor to care for them during their absence, it can be considered abandonment. This means that the provider has failed to fulfill their duty of care towards the patient, potentially putting their health and well-being at risk. In such a situation, the patient may have grounds to sue the provider for neglecting their medical needs and potentially causing harm by not ensuring proper care during their absence.
24.
How would you properly index the name "Amanda M. Stiles-Duncan" for filing?
Correct Answer
A. Stilesduncan, Amanda M.
Explanation
The correct answer is "Stilesduncan, Amanda M." This is the correct way to index the name "Amanda M. Stiles-Duncan" for filing because it follows the standard practice of listing the last name first, followed by a comma, and then the first name. The hyphenated last name "Stiles-Duncan" is treated as one unit and placed after the last name. The middle initial "M." is included after the first name.
25.
What can help you with ease of use and confidentiality?
Correct Answer
D. Computers
Explanation
Computers can help with ease of use and confidentiality because they provide user-friendly interfaces and allow for the encryption and password protection of files and data. They offer features like search functions, bookmarking, and easy navigation, making it convenient to access and manage information. Additionally, computers can store files securely, restrict access to authorized individuals, and provide encryption options to protect sensitive data from unauthorized access or theft.
26.
A claim that is printed and mailed to the carrier site is called a _______copy?
Correct Answer
C. Hard
Explanation
A claim that is printed and mailed to the carrier site is called a hard copy because it refers to a physical copy of the document that is printed on paper. Unlike soft copies, which are digital files that can be stored and accessed electronically, hard copies are tangible and can be physically handled and stored. Therefore, in this context, the correct term for the printed and mailed claim would be a hard copy.
27.
What term would best describe the result of releasing patient information without authorization?
Correct Answer
B. Malfeasance
Explanation
Malfeasance is the appropriate term to describe the result of releasing patient information without authorization. Malfeasance refers to the intentional wrongdoing or misconduct by a person in a professional position. Releasing patient information without authorization is a violation of privacy laws and ethical standards, and it constitutes a deliberate breach of trust and professional responsibility.
28.
What kind of calls does a Triage Nurse handle?
Correct Answer
D. Ear pain, sore throat, headaches
Explanation
A Triage Nurse handles calls related to ear pain, sore throat, and headaches. These symptoms are commonly seen in primary care settings and can be indicative of various conditions such as ear infections, strep throat, and migraines. Triage Nurses are trained to assess the severity of these symptoms and provide appropriate advice or refer the patient to a higher level of care if needed.
29.
If Mr.Jones insurance has a $500 deductible and a $50 surgery copay, how much will his insurance pay on his bill of $4359.00?
Correct Answer
A. $3809.00
Explanation
Mr. Jones' insurance will pay the bill amount minus the deductible and copay. The deductible is $500 and the copay is $50. Therefore, the insurance will pay $4359 - $500 - $50 = $3809.00.
30.
What are some examples of what is considered to be outside your scope of practice?
Correct Answer
D. All of the above
Explanation
Medical assistants have a defined scope of practice that outlines the tasks and responsibilities they are trained and legally allowed to perform. This scope varies by state but generally does not include performing surgery, providing medical advice independently, or administering medications without direct supervision. While medical assistants may be trained in EKG, assisting with procedures, and venipuncture, these tasks are often performed under the supervision of a licensed healthcare professional.
31.
The best method of patient identification is:
Correct Answer
B. A state-issued ID card or drivers license
Explanation
A state-issued ID card or driver's license is the best method of patient identification because it is an official document issued by the government that includes a photograph, name, and other identifying information. This type of identification is widely recognized and accepted in healthcare settings as a reliable way to verify a patient's identity. Birth certificates, student IDs, and social security cards may not always have a photograph or be as widely recognized, making them less reliable for patient identification purposes.
32.
What three regulations require you to make sure every patient receives a Privacy Practice Policy?
Correct Answer
C. State, Local, Federal
Explanation
The correct answer is State, Local, Federal. This means that there are three regulations at different levels (state, local, and federal) which require healthcare providers to ensure that every patient receives a Privacy Practice Policy. These policies are necessary to protect the privacy and confidentiality of patients' personal health information.
33.
A system of recording, classifying all employees in a facility?
Correct Answer
C. Blanket-position bonding
Explanation
Blanket-position bonding refers to a system of recording and classifying all employees in a facility based on their positions. This means that employees are grouped together based on their job roles or positions within the organization. This type of bonding allows for easier management and organization of employees, as well as the ability to track and monitor their performance and progress. It provides a comprehensive overview of the workforce and helps in making informed decisions regarding employee placement and resource allocation.
34.
What is required when making travel arrangements for providers?
Correct Answer
A. Verify all schedules
Explanation
When making travel arrangements for providers, it is necessary to verify all schedules. This ensures that the providers' schedules are accurate and up-to-date, which is crucial for effective travel planning. By verifying the schedules, any conflicts or overlapping appointments can be identified and addressed in advance. This helps to avoid any potential disruptions or delays in the providers' travel plans and ensures that they are able to fulfill their obligations without any scheduling conflicts. Therefore, verifying all schedules is an important step in making travel arrangements for providers.
35.
Which of the following items are parts of the physician's office budget?
Correct Answer
D. All of the above
Explanation
All of the items mentioned - medical equipment, rent or mortgage, and taxes - are parts of the physician's office budget. These are common expenses that a physician's office incurs in order to operate efficiently and provide medical services to patients. Medical equipment is necessary for diagnosis and treatment, rent or mortgage is the cost of the office space, and taxes are required by law. Therefore, all of these items are included in the physician's office budget.
36.
What must you consider when updating a Medicare Fee Schedule?
Correct Answer
B. Max fees allowed by Medicare
Explanation
When updating a Medicare Fee Schedule, it is important to consider the maximum fees allowed by Medicare. This means that when setting or adjusting fees, healthcare providers must ensure that the charges do not exceed the maximum amount that Medicare will reimburse. This is crucial in order to comply with Medicare regulations and to avoid potential billing issues or reimbursement denials.
37.
Which of the following is not one of the patients rights provided by HIPAA?
Correct Answer
C. Right to obtain the original medical record
Explanation
The correct answer is "Right to obtain the original medical record." This is not one of the patients' rights provided by HIPAA. HIPAA grants patients the right to notice of a facility's privacy practices, the right to receive notice of all disclosures of PHI, and the right to have access to, view, and obtain a copy of their PHI. However, it does not specifically grant the right to obtain the original medical record.
38.
When is it necessary for a patient to sign a Medicare Summary Notice?
Correct Answer
A. When they want to have a non-covered procedure
Explanation
Patients are required to sign a Medicare Summary Notice when they want to have a non-covered procedure. This is because a non-covered procedure means that Medicare will not pay for it, and the patient will be responsible for the full cost. By signing the Medicare Summary Notice, the patient acknowledges that they understand and agree to pay for the non-covered procedure out of their own pocket.
39.
Which of the following dates is written correctly for inclusion in the heading of a letter?
Correct Answer
C. May 1, 2007
Explanation
The correct answer is "May 1, 2007." This is the correct format for writing a date in the heading of a letter. It includes the month written out in full, followed by the day and year separated by commas. The use of the full year "2007" is also appropriate in this context.
40.
An instance when you would instruct the patient to call 911?
Correct Answer
D. C/O SOB and Chest Pain
Explanation
The correct answer is C/O SOB and Chest Pain. Instructing the patient to call 911 in this instance is necessary because shortness of breath (SOB) and chest pain can be symptoms of a serious medical condition, such as a heart attack or pulmonary embolism, which require immediate medical attention. Calling 911 ensures that the patient can receive prompt and appropriate medical care. Domestic violence and burglary, although serious issues, do not typically require emergency medical assistance.
41.
The process done before claims submission to examine for accuracy and completeness is to:
Correct Answer
B. Audit
Explanation
Before submitting claims, it is important to examine them for accuracy and completeness. This process is known as an audit. During an audit, claims are reviewed to ensure that all necessary information is included and that there are no errors or discrepancies. This helps to prevent any potential issues or delays in the claims submission process.
42.
Which letter style combines efficiency with an attractive page layout?
Correct Answer
A. Modified-block
Explanation
The modified-block letter style combines efficiency with an attractive page layout. In this style, the body of the letter is aligned to the left margin, but the date, closing, and signature block are centered or aligned to the right. This layout creates a professional appearance while still maintaining a streamlined format. The modified-block style is commonly used in business correspondence as it allows for clear organization and readability.
43.
Which standard size letterhead is appropriate for most business correspondence?
Correct Answer
C. 8 1/2 x 11 inches
Explanation
The standard size letterhead that is appropriate for most business correspondence is 8 1/2 x 11 inches. This size is commonly used in the business world as it provides enough space for the content of the letter while still being easy to handle and fit into standard envelopes. The other sizes mentioned are either too small or too large for regular business correspondence.
44.
Health insurance designed for military dependents and retired military personnel is:
Correct Answer
B. TRICARE
Explanation
TRICARE is the correct answer because it is a health insurance program specifically designed for military dependents and retired military personnel. It provides comprehensive coverage for medical services, including doctor visits, hospital stays, prescription medications, and preventive care. TRICARE offers different plans and options to cater to the specific needs of military families and veterans, ensuring that they have access to quality healthcare.
45.
The amount of money paid to keep an insurance policy in force is the:
Correct Answer
A. Premium
Explanation
The amount of money paid to keep an insurance policy in force is known as the premium. This is the regular payment made by the policyholder to the insurance company in exchange for coverage. It is typically paid on a monthly or yearly basis and is determined based on various factors such as the type of insurance, the coverage amount, the policyholder's risk factors, and the insurance company's underwriting guidelines. The premium is essential to maintain the policy and ensure that the policyholder continues to receive the benefits and protection provided by the insurance policy.
46.
The federal and state-sponsored health insurance program for the medically indignet is called:
Correct Answer
B. Medicaid
Explanation
Medicaid is the correct answer because it is a federal and state-sponsored health insurance program specifically designed to provide coverage for individuals and families with low income and limited resources. It aims to assist medically indigent individuals by offering them access to necessary healthcare services, including doctor visits, hospital stays, prescription drugs, and more. Unlike Medicare, which primarily covers individuals aged 65 and older, Medicaid is available to people of all ages who meet the eligibility criteria. Medigap, on the other hand, is a supplemental insurance policy that helps cover the gaps in Medicare coverage. MediCal is a separate program specific to the state of California.
47.
Which of the following would most likely be a sentinel event?
Correct Answer
A. Mistaken patients identities
Explanation
A sentinel event is an unexpected occurrence involving death or serious physical or psychological injury. Mistaken patient identities can lead to serious consequences such as wrong treatments, medications, or surgeries. While a baby born before the due date and a death after emergency surgery are also significant events, they may not necessarily be considered sentinel events unless they result in serious harm or death. Therefore, the most likely sentinel event among the given options is mistaken patient identities.
48.
Arrange these names in alphabetical order (scroll down to view names).select the sequence of the numbers that reflects the correct alphabetic order. (1) Woods-Jones, Stephanie (2) Ross, Kim (3) Mitchell, Pat (4) Jones, Sandra
Correct Answer
D. (4), (3), (2), (1)
Explanation
The correct alphabetical order of the names is Jones, Sandra; Mitchell, Pat; Ross, Kim; Woods-Jones, Stephanie. Therefore, the correct sequence of numbers that reflects this order is (4), (3), (2), (1).
49.
Cardinal rules for bookkeeping include:
Correct Answer
D. All of the above
Explanation
The cardinal rules for bookkeeping include good penmanship, legible records, and straight columns of figures. These rules are essential for maintaining accurate and organized financial records. Good penmanship ensures that the entries are clear and easy to read, reducing the chances of errors or misinterpretation. Legible records enable easy referencing and auditing, ensuring transparency and accountability. Straight columns of figures make it easier to calculate and analyze financial data. Therefore, all of the above options are correct as they are fundamental principles that contribute to effective bookkeeping.
50.
Acting in anticipation of future problems is:
Correct Answer
B. Being proactive
Explanation
Being proactive means taking action in advance to prevent or address future problems. It involves being proactive rather than reactive, and actively seeking solutions or taking preventive measures. This approach helps individuals or organizations to anticipate potential issues, plan ahead, and take necessary steps to mitigate risks or avoid problems altogether. It is a proactive mindset that focuses on being prepared and taking initiative, rather than waiting for problems to arise and then reacting to them.