Professional Fees, Billing & Coding HI-1011- Chapter 19

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| By Dhardma1

Dhardma1

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Quizzes Created: 12 | Total Attempts: 27,920

Questions: 10 | Attempts: 332 | Updated: Mar 22, 2023

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This quiz, titled 'Professional Fees, Billing & Coding HI-1011- Chapter 19', assesses knowledge on medical billing processes, insurance claims, and patient finance management. It covers topics such as Terms of Service payments, allowable amounts by insurance, and compliance with the True and Lending Act.

Questions and Answers

1.

TOS payments should be encouraged
- A.
  
  True
- B.
  
  False
Correct Answer
A. True

Explanation
Encouraging TOS (Terms of Service) payments is beneficial because it ensures that users comply with the terms and conditions set by a company or platform. By making these payments, users acknowledge and agree to abide by the rules, which helps maintain a fair and secure environment for all users. TOS payments also provide a source of revenue for the company, enabling them to continue offering their services and improving the platform for users.

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2.

The full amount paid by the insurance company for a procedure is referred to as
- A.
  
  Set amount
- B.
  
  Adjusted amount
- C.
  
  Allowable amount
- D.
  
  Determined amount
Correct Answer
C. Allowable amount

Explanation
The term "allowable amount" refers to the total sum that an insurance company is willing to pay for a specific medical procedure. This amount is predetermined and agreed upon between the insurance company and the healthcare provider. It represents the maximum reimbursement that the insurance company will cover, and any additional costs beyond this amount would typically be the responsibility of the patient.

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3.

Only one collection letter should be sent to a patient prior to sending them to a collection agency service
- A.
  
  True
- B.
  
  False
Correct Answer
B. False

Explanation
Multiple collection letters should be sent to a patient prior to sending them to a collection agency service. This is because sending multiple letters gives the patient ample opportunity to settle their outstanding debts before resorting to involving a collection agency. It also ensures that the patient is aware of their financial obligations and provides them with a fair chance to address the issue before further actions are taken.

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4.

You should not continue to see patients that have filed bankruptcy
- A.
  
  True
- B.
  
  False
Correct Answer
B. False

Explanation
Continuing to see patients who have filed bankruptcy is not prohibited or unethical. Bankruptcy is a legal process that allows individuals or businesses to reorganize or eliminate their debts. It does not affect a patient's ability to receive medical care or the healthcare provider's ability to treat them. Therefore, it is not necessary to stop seeing patients who have filed bankruptcy.

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5.

True and Lending Act needs to be followed with patients that credit has been extended to and the office is applying finance charges to the account
- A.
  
  True
- B.
  
  False
Correct Answer
A. True

Explanation
The True answer is correct because the Truth in Lending Act requires that lenders provide clear and accurate information about the terms and costs of credit to borrowers. This includes disclosing any finance charges that will be applied to the account. By following this act, lenders ensure transparency and protect the rights of borrowers.

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6.

Insurance companies should have claims sent to them daily
- A.
  
  True
- B.
  
  False
Correct Answer
A. True

Explanation
True. Insurance companies should send claims daily to the insurance company to continue the financial flow within the office for services rendered.

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7.

Face to face collection efforts are not very effective
- A.
  
  True
- B.
  
  False
Correct Answer
B. False

Explanation
The statement suggests that face to face collection efforts are not effective, but the correct answer is False. This means that face to face collection efforts are actually effective.

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8.

You can collect the payment for a patient that has had their account turned over to a collection agency
- A.
  
  True
- B.
  
  False
Correct Answer
A. True

Explanation
True. Any payment received needs to be turned over to the collection agency.

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9.

You can bill a minor if you don't have the parent's information
- A.
  
  True
- B.
  
  False
Correct Answer
B. False

Explanation
The statement is false because in most cases, you cannot bill a minor without the parent's information. Minors are typically not legally responsible for their own medical bills, and healthcare providers require the parent's information to ensure proper billing and payment. Without the parent's information, it would be difficult to collect payment or communicate with the responsible party for the minor's healthcare expenses.

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10.

The insurance contract exists between the insurance company and the
- A.
  
  Doctor
- B.
  
  Guarantor
- C.
  
  Insured
- D.
  
  Minor
Correct Answer
C. Insured

Explanation
The insurance contract exists between the insurance company and the insured. The insured refers to the person or entity that is covered by the insurance policy. They are the ones who purchase the insurance and are protected against potential financial losses or damages. The insurance company, on the other hand, is the provider of the insurance coverage and agrees to compensate the insured in case of covered events or risks. The insured pays premiums to the insurance company in exchange for this coverage.

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Current Version
Mar 22, 2023

Quiz Edited by
ProProfs Editorial Team
Apr 05, 2012

Quiz Created by
Dhardma1

Professional Fees, Billing & Coding Hi-1011- Chapter 19

TOS payments should be encouraged

The full amount paid by the insurance company for a procedure is referred to as

Only one collection letter should be sent to a patient prior to sending them to a collection agency service

You should not continue to see patients that have filed bankruptcy

True and Lending Act needs to be followed with patients that credit has been extended to and the office is applying finance charges to the account

Insurance companies should have claims sent to them daily

Face to face collection efforts are not very effective

You can collect the payment for a patient that has had their account turned over to a collection agency

You can bill a minor if you don't have the parent's information

The insurance contract exists between the insurance company and the