MO136 Chapter 1 study Questions with Verified
Correct Answers
Administrative staff member help collect the maximum appropriate payment by
1. To understand patient's responsibilities to paying for medical services
2. To analyze charges and insurance coverage to prepare accurate, timely claims
3. To collect payment for medical services from health plan s and from patients
what is the major trend in the healthcare industry today?
A shift of payment responsibility from employers and insurance companies to patients
Why is it important to manage the business side of a physician practice?
To maintain profit
With how many health plans does the average practice work?
They are five of them:
1. Indemnity Plan
2. HMO
3. PPO
4. POS
5. CDHP
What does it mean to manage cash flow?
Making sure that sufficient monies to flow into the practice from patients and insurance
companies paying for medical services, to pay the practice's operating expenses.
Who commonly heads administrative staff?
Administrative staff may be headed by an office manager, practice manger , or practice
administrator to whom medical assistants, patient services representatives or receptionists, and
billing insurance, and collections specialists report
what skills do effective communicators possess?
A pleasant tone, a friendly attitude, and a helpful manner when gathering information increase
patient satisfaction.
, conversation must be brief and to the point, showing that the speaker values the provider's
value's time.
Good listening
Body language
Name three types of health information technology
1. Practice Management programs
2.Electronic Health Records
3. PM/EHRs
Computers are not more accurate than the Individual who entering the data
Medical insurance is an agreement between a policy holder-an individual - and a health plan
A medically necessary service is both reasonable and consistent with standards for the
diagnosis or treatment of injury or illness
Annual physical examinations, immunizations, and routine screening procedures are
preventive medical services
What is the difference between a covered service and a non-covered service?
covered services: medical procedures and treatments that are included as benefits in a health
plan
non covered services: medical procedures that are not included in a plan's benefits
List three difference typical noncovered services
dental services, eye exam, and employment related injuries
Which generally costs the policyholder less, a group or individual policy?
group
Disability insurance covers income lost because a person cannot
work
workers' compensation covers work related j-injuries
What are the two types of health care plan
1. HMO and PPO
what four conditions must be met before the insurance company makes a payment for an
indemnity claim?
Correct Answers
Administrative staff member help collect the maximum appropriate payment by
1. To understand patient's responsibilities to paying for medical services
2. To analyze charges and insurance coverage to prepare accurate, timely claims
3. To collect payment for medical services from health plan s and from patients
what is the major trend in the healthcare industry today?
A shift of payment responsibility from employers and insurance companies to patients
Why is it important to manage the business side of a physician practice?
To maintain profit
With how many health plans does the average practice work?
They are five of them:
1. Indemnity Plan
2. HMO
3. PPO
4. POS
5. CDHP
What does it mean to manage cash flow?
Making sure that sufficient monies to flow into the practice from patients and insurance
companies paying for medical services, to pay the practice's operating expenses.
Who commonly heads administrative staff?
Administrative staff may be headed by an office manager, practice manger , or practice
administrator to whom medical assistants, patient services representatives or receptionists, and
billing insurance, and collections specialists report
what skills do effective communicators possess?
A pleasant tone, a friendly attitude, and a helpful manner when gathering information increase
patient satisfaction.
, conversation must be brief and to the point, showing that the speaker values the provider's
value's time.
Good listening
Body language
Name three types of health information technology
1. Practice Management programs
2.Electronic Health Records
3. PM/EHRs
Computers are not more accurate than the Individual who entering the data
Medical insurance is an agreement between a policy holder-an individual - and a health plan
A medically necessary service is both reasonable and consistent with standards for the
diagnosis or treatment of injury or illness
Annual physical examinations, immunizations, and routine screening procedures are
preventive medical services
What is the difference between a covered service and a non-covered service?
covered services: medical procedures and treatments that are included as benefits in a health
plan
non covered services: medical procedures that are not included in a plan's benefits
List three difference typical noncovered services
dental services, eye exam, and employment related injuries
Which generally costs the policyholder less, a group or individual policy?
group
Disability insurance covers income lost because a person cannot
work
workers' compensation covers work related j-injuries
What are the two types of health care plan
1. HMO and PPO
what four conditions must be met before the insurance company makes a payment for an
indemnity claim?
