MedCerts: MCBC Knowledge Review Assessment with
all Correct & 100% Verified Answers |Latest Version |
Already Graded A+
What regulation addresses outpatient billing for nonphysician providers? ✔Correct Answer-
Incident-to billing
What is entered in Block 1 on the CMS-1500 claim form? ✔Correct Answer-Type of insurance
What is the full title of the HCPCS manual? ✔Correct Answer-Healthcare Common Procedure
Coding System
ICD-10-CM coding compliance includes accurate transformation of __________ into numbers
✔Correct Answer-Diagnoses
Where might an insurance specialist find Medicare's rules and regulations published? ✔Correct
Answer-Federal Register
Which HIPAA provision requires access to healthcare portability and renewability? ✔Correct
Answer-Title I
Which is a medical decision making complexity level used in CPT coding? ✔Correct Answer-All of
the above - Low, Moderate, High
For privacy, what is the recommendation if there is a window in the reception area? ✔Correct
Answer-Keep it closed
A patient is diagnosed with pneumothorax, which is a(n) __________. ✔Correct Answer-Collapsed
lung
When a patient describes the development of an illness from its onset and symptoms when seen by
a physician, which is being documented? ✔Correct Answer-History of present illness (HPI)
Which methods are most commonly used first by a practice to attempt to get a patient's payment on
overdue accounts? ✔Correct Answer-Letters and calls
Which is a patient bill that includes dates of service, services provided, charges, and what the patient
owes to the practice? ✔Correct Answer-Statement
Medicare uses the Medicare Physician Fee Schedule (MPFS) based on which of the following?
✔Correct Answer-RBRVS
The Resource-Based Relative Value Scale (RBRVS) is a system used to determine reimbursement rates
for medical services in the United States. It considers factors such as physician work, practice
expenses, and malpractice expenses to assign a relative value to each service.
What does the suffix "-rrhea" mean? ✔Correct Answer-Flow
, Which are paper-based claim guidelines for outpatient billing? ✔Correct Answer-All of the above -
Use original red form, Use CMS-1500, Print in black ink
CPT codes are assigned to procedures provided to patients. What is a cholecystectomy procedure?
✔Correct Answer-Removal of gallbladder
Which reimbursement payment method is based on a group of physicians within a geographic area?
✔Correct Answer-(UCR): Usual, Customary, and Reasonable: represents the typical or average cost
for a particular service or product in a specific geographic area.
What type of letter is sent to a patient if the physician chooses to no longer care for the patient?
✔Correct Answer-Dismissal
What task is being performed by the insurance specialist using an insurance aging report for claims
more than 30 days old? ✔Correct Answer-Follow up
Which type of managed care plan has the least flexibility? ✔Correct Answer-HMO: Health
Maintenance Organization
-Require a PCP
-Need a referral to see a specialist
-No non-out-of-network benefits
-No non-out-of-network coverage
What may accompany a remittance advice? ✔Correct Answer-Payment
If a claim is rejected, which could be a reason? ✔Correct Answer-All of the above - Submitted after
time limit, Incorrect patient information, Incorrect code linkage
Which type of audit is conducted after receiving the remittance advice? ✔Correct Answer-
Retrospective
Which federal provision provides incentives for electronic health records utilization? ✔Correct
Answer-Meaningful use
If the physician-patient relationship is terminated due to nonpayment of an account, what must be
sent? ✔Correct Answer-Dismissal letter
Which criteria is required for Medicare eligibility? ✔Correct Answer-All of the above - Age 65 and
older, Disabled, End-stage kidney disease
What covers a Medicare patient for a physician's services? ✔Correct Answer-Part B
What code set includes T-codes, or temporary codes, used for new and emerging technology and
services? ✔Correct Answer-Category III
If a patient's encounter form indicated cystitis, what does this mean? ✔Correct Answer-
Inflammation of the bladder
If a patient with a mild systemic disease is administered anesthesia, which modifier is added to the
procedure code for the anesthesia service? ✔Correct Answer-P2
all Correct & 100% Verified Answers |Latest Version |
Already Graded A+
What regulation addresses outpatient billing for nonphysician providers? ✔Correct Answer-
Incident-to billing
What is entered in Block 1 on the CMS-1500 claim form? ✔Correct Answer-Type of insurance
What is the full title of the HCPCS manual? ✔Correct Answer-Healthcare Common Procedure
Coding System
ICD-10-CM coding compliance includes accurate transformation of __________ into numbers
✔Correct Answer-Diagnoses
Where might an insurance specialist find Medicare's rules and regulations published? ✔Correct
Answer-Federal Register
Which HIPAA provision requires access to healthcare portability and renewability? ✔Correct
Answer-Title I
Which is a medical decision making complexity level used in CPT coding? ✔Correct Answer-All of
the above - Low, Moderate, High
For privacy, what is the recommendation if there is a window in the reception area? ✔Correct
Answer-Keep it closed
A patient is diagnosed with pneumothorax, which is a(n) __________. ✔Correct Answer-Collapsed
lung
When a patient describes the development of an illness from its onset and symptoms when seen by
a physician, which is being documented? ✔Correct Answer-History of present illness (HPI)
Which methods are most commonly used first by a practice to attempt to get a patient's payment on
overdue accounts? ✔Correct Answer-Letters and calls
Which is a patient bill that includes dates of service, services provided, charges, and what the patient
owes to the practice? ✔Correct Answer-Statement
Medicare uses the Medicare Physician Fee Schedule (MPFS) based on which of the following?
✔Correct Answer-RBRVS
The Resource-Based Relative Value Scale (RBRVS) is a system used to determine reimbursement rates
for medical services in the United States. It considers factors such as physician work, practice
expenses, and malpractice expenses to assign a relative value to each service.
What does the suffix "-rrhea" mean? ✔Correct Answer-Flow
, Which are paper-based claim guidelines for outpatient billing? ✔Correct Answer-All of the above -
Use original red form, Use CMS-1500, Print in black ink
CPT codes are assigned to procedures provided to patients. What is a cholecystectomy procedure?
✔Correct Answer-Removal of gallbladder
Which reimbursement payment method is based on a group of physicians within a geographic area?
✔Correct Answer-(UCR): Usual, Customary, and Reasonable: represents the typical or average cost
for a particular service or product in a specific geographic area.
What type of letter is sent to a patient if the physician chooses to no longer care for the patient?
✔Correct Answer-Dismissal
What task is being performed by the insurance specialist using an insurance aging report for claims
more than 30 days old? ✔Correct Answer-Follow up
Which type of managed care plan has the least flexibility? ✔Correct Answer-HMO: Health
Maintenance Organization
-Require a PCP
-Need a referral to see a specialist
-No non-out-of-network benefits
-No non-out-of-network coverage
What may accompany a remittance advice? ✔Correct Answer-Payment
If a claim is rejected, which could be a reason? ✔Correct Answer-All of the above - Submitted after
time limit, Incorrect patient information, Incorrect code linkage
Which type of audit is conducted after receiving the remittance advice? ✔Correct Answer-
Retrospective
Which federal provision provides incentives for electronic health records utilization? ✔Correct
Answer-Meaningful use
If the physician-patient relationship is terminated due to nonpayment of an account, what must be
sent? ✔Correct Answer-Dismissal letter
Which criteria is required for Medicare eligibility? ✔Correct Answer-All of the above - Age 65 and
older, Disabled, End-stage kidney disease
What covers a Medicare patient for a physician's services? ✔Correct Answer-Part B
What code set includes T-codes, or temporary codes, used for new and emerging technology and
services? ✔Correct Answer-Category III
If a patient's encounter form indicated cystitis, what does this mean? ✔Correct Answer-
Inflammation of the bladder
If a patient with a mild systemic disease is administered anesthesia, which modifier is added to the
procedure code for the anesthesia service? ✔Correct Answer-P2
