Medical Insurance
https://www.stuvia.com/user/aaaplus
and Billing 16th Edition, 16E, Linda
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M. Smith, Complete guide A+.pdfhttps://www.stuvia.com/user/aaaplus_)W()*E(*&R(&*&R*&()*()*_)*(*&$*(*&%*&(@%)%
TEST BANK Fordney's Medical Insurance and Billing 16/E Linda Smith
Chapter 01: Role of an Insurance Billing Specialist
Smith: Fordney’s Medical Insurance and Billing, 16th Edition
MULTIPLE CHOICE
1. The primary goal of an insurance billing specialist is:
a. to manage the health care organization’s billing office
b. to ensure the cash flow of a health care organization through revenue cycle
management
c. to send bills to patients for services they receive
d. to post payments received from patients and insurance carriers
ANS: B DIF: Moderate OBJ: 2
2. Facility billing includes charging for medical services provided by:
a. physicians
b. laboratory services
c. ambulance services
d. ambulatory surgical centers
ANS: D DIF: Easy OBJ: 2
3. A claims assistance professional
a. works for the consumer.
b. works for the health care organization.
c. works for an insurance company.
d. works for the federal government.
ANS: A DIF: Easy OBJ: 2
4. What is “cash flow” in a medical practice?
a. The actual money available to a medical practice
b. The amount of money received by a medical practice in 1 day
c. The amount of money received by a medical practice in 1 month
d. The amount of outstanding money on the accounts receivable
ANS: A DIF: Moderate OBJ: 2
5. Which level of education is generally required for one who seeks employment as an insurance
coder?
a. College diploma
b. High school diploma
c. Completion of an accredited program for coding certification
d. No specific level of education is required
ANS: C DIF: Easy OBJ: 4
6. The amount of money an insurance billing specialist earns is dependent on which of the
following factors?
a. Knowledge
b. Experience
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,Medical Insurance
https://www.stuvia.com/user/aaaplus
and Billing 16th Edition, 16E, Linda
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c. Size of employing institution
d. All are correct
ANS: D DIF: Moderate OBJ: 5
7. A self-employed medical insurance biller who does independent contracting is responsible for
a. advertising.
b. billing.
c. accounting.
d. All are correct.
ANS: D DIF: Hard OBJ: 2
8. Medical etiquette refers to
a. consideration for others.
b. moral principles or practices.
c. laws.
d. the Oath of Hippocrates.
ANS: A DIF: Moderate OBJ: 9
9. The process of shortening words and using abbreviations that do not follow standard
grammar, spelling and punctuation when writing electronic mail communications is referred
to as:
a. emoticons
b. abbreviations
c. text speak
d. short text
ANS: C DIF: Easy OBJ: 9
10. Professional ethics include
a. state laws.
b. federal laws.
c. standards of conduct.
d. civil torts.
ANS: C DIF: Moderate OBJ: 9
11. The earliest written code of ethical principles for the medical profession is the
a. Oath of Hippocrates.
b. Socratic oath.
c. Code of Hammurabi.
d. Medicolegal oath.
ANS: C DIF: Easy OBJ: 9
12. What is the name of the modern code of ethics that the American Medical Association (AMA)
adopted in 1980?
a. The Modern Standards of Conduct Code
b. The Principles of Medical Ethics
c. The Oath of Hippocrates
d. The American Medical Association Code of Ethics
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,Medical Insurance
https://www.stuvia.com/user/aaaplus
and Billing 16th Edition, 16E, Linda
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ANS: B DIF: Easy OBJ: 9
13. Reporting incorrect information to government-funded programs is
a. unethical.
b. illegal.
c. abuse.
d. fraud.
ANS: B DIF: Moderate OBJ: 9
14. The doctrine stating that physicians are legally responsible for both their own conduct and that
of their employees is known as
a. respondeat superior.
b. let the master answer.
c. vicarious liability.
d. All are correct.
ANS: D DIF: Hard OBJ: 10
15. What is the independent contractor’s liability if they operate their own medical insurance
billing company?
a. None. The professional liability insurance of the company they contract with will
cover them.
b. The independent contractor is liable and should purchase errors and omissions
insurance.
ANS: B DIF: Moderate OBJ: 10
COMPLETION
1. _____________________ is the total income produced by a health care organization.
ANS: Revenue
DIF: Moderate OBJ: 1
2. An individual health care provider’s patient charts which includes notes and information
collected by them is referred to as the: ___________________
ANS: Medical record
DIF: Moderate OBJ: 3
3. Information collected from clinicians in all health care organizations who are involved in a
patient’s care which is made available to all authorized clinicians to access when providing
patient care is the: _____
ANS: Health record
DIF: Moderate OBJ: 3
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https://www.stuvia.com/user/aaaplus https://www.stuvia.com/user/aaaplus
,Medical Insurance
https://www.stuvia.com/user/aaaplus
and Billing 16th Edition, 16E, Linda
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4. Charging for services done in hospitals, acute care hospitals, skilled nursing or long-term care
facilities, rehabilitation centers, or ambulatory surgical centers is known as _____ billing.
ANS: facility
DIF: Moderate OBJ: 2
5. Charging for services performed by physicians, nurse practitioners, licensed clinical social
workers and physical therapists is known as ________________ billing.
ANS: professional
DIF: Moderate OBJ: 2
6. Individuals who are employed by an insurance carrier and whose role is to analyze and
process incoming claims, checking them for validity and determining if the services were
reasonable and necessary are referred to as ____________.
ANS: claims examiners
DIF: Moderate OBJ: 3
7. Individuals who work for consumers and help patients organize, file and negotiate health
insurance claims. ________________
ANS: Claims assistance professionals
DIF: Easy OBJ: 3
8. Patients who do not have any medical insurance and are liable for the entire bill are referred to
as _____________ patients.
ANS: self-pay
DIF: Easy OBJ: 3
9. Transmitting, receiving, storing, and forwarding of text, voice messages, attachments, or
images by computer from one person to another is referred to as ______ mail.
ANS: electronic
DIF: Moderate OBJ: 3
10. Standards of conduct by which an insurance billing specialist determines the propriety of his
or her behavior in a relationship are known as medical ____________________.
ANS: ethics
DIF: Moderate OBJ: 9
11. The Greek physician known as the Father of Medicine devised the ____________________.
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https://www.stuvia.com/user/aaaplus
and Billing 16th Edition, 16E, Linda
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M. Smith, Complete guide A+.pdfhttps://www.stuvia.com/user/aaaplus_)W()*E(*&R(&*&R*&()*()*_)*(*&$*(*&%*&(@%)%
TEST BANK Fordney's Medical Insurance and Billing 16/E Linda Smith
Chapter 01: Role of an Insurance Billing Specialist
Smith: Fordney’s Medical Insurance and Billing, 16th Edition
MULTIPLE CHOICE
1. The primary goal of an insurance billing specialist is:
a. to manage the health care organization’s billing office
b. to ensure the cash flow of a health care organization through revenue cycle
management
c. to send bills to patients for services they receive
d. to post payments received from patients and insurance carriers
ANS: B DIF: Moderate OBJ: 2
2. Facility billing includes charging for medical services provided by:
a. physicians
b. laboratory services
c. ambulance services
d. ambulatory surgical centers
ANS: D DIF: Easy OBJ: 2
3. A claims assistance professional
a. works for the consumer.
b. works for the health care organization.
c. works for an insurance company.
d. works for the federal government.
ANS: A DIF: Easy OBJ: 2
4. What is “cash flow” in a medical practice?
a. The actual money available to a medical practice
b. The amount of money received by a medical practice in 1 day
c. The amount of money received by a medical practice in 1 month
d. The amount of outstanding money on the accounts receivable
ANS: A DIF: Moderate OBJ: 2
5. Which level of education is generally required for one who seeks employment as an insurance
coder?
a. College diploma
b. High school diploma
c. Completion of an accredited program for coding certification
d. No specific level of education is required
ANS: C DIF: Easy OBJ: 4
6. The amount of money an insurance billing specialist earns is dependent on which of the
following factors?
a. Knowledge
b. Experience
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https://www.stuvia.com/user/aaaplus https://www.stuvia.com/user/aaaplus
,Medical Insurance
https://www.stuvia.com/user/aaaplus
and Billing 16th Edition, 16E, Linda
https://www.stuvia.com/user/aaaplus_)W()*E(*&R(&*&R*&()*()*_)*(*&$*(*&%*&(@%)%&*(@&(*@%*&@(%@%&*(
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c. Size of employing institution
d. All are correct
ANS: D DIF: Moderate OBJ: 5
7. A self-employed medical insurance biller who does independent contracting is responsible for
a. advertising.
b. billing.
c. accounting.
d. All are correct.
ANS: D DIF: Hard OBJ: 2
8. Medical etiquette refers to
a. consideration for others.
b. moral principles or practices.
c. laws.
d. the Oath of Hippocrates.
ANS: A DIF: Moderate OBJ: 9
9. The process of shortening words and using abbreviations that do not follow standard
grammar, spelling and punctuation when writing electronic mail communications is referred
to as:
a. emoticons
b. abbreviations
c. text speak
d. short text
ANS: C DIF: Easy OBJ: 9
10. Professional ethics include
a. state laws.
b. federal laws.
c. standards of conduct.
d. civil torts.
ANS: C DIF: Moderate OBJ: 9
11. The earliest written code of ethical principles for the medical profession is the
a. Oath of Hippocrates.
b. Socratic oath.
c. Code of Hammurabi.
d. Medicolegal oath.
ANS: C DIF: Easy OBJ: 9
12. What is the name of the modern code of ethics that the American Medical Association (AMA)
adopted in 1980?
a. The Modern Standards of Conduct Code
b. The Principles of Medical Ethics
c. The Oath of Hippocrates
d. The American Medical Association Code of Ethics
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https://www.stuvia.com/user/aaaplus https://www.stuvia.com/user/aaaplus
,Medical Insurance
https://www.stuvia.com/user/aaaplus
and Billing 16th Edition, 16E, Linda
https://www.stuvia.com/user/aaaplus_)W()*E(*&R(&*&R*&()*()*_)*(*&$*(*&%*&(@%)%&*(@&(*@%*&@(%@%&*(
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ANS: B DIF: Easy OBJ: 9
13. Reporting incorrect information to government-funded programs is
a. unethical.
b. illegal.
c. abuse.
d. fraud.
ANS: B DIF: Moderate OBJ: 9
14. The doctrine stating that physicians are legally responsible for both their own conduct and that
of their employees is known as
a. respondeat superior.
b. let the master answer.
c. vicarious liability.
d. All are correct.
ANS: D DIF: Hard OBJ: 10
15. What is the independent contractor’s liability if they operate their own medical insurance
billing company?
a. None. The professional liability insurance of the company they contract with will
cover them.
b. The independent contractor is liable and should purchase errors and omissions
insurance.
ANS: B DIF: Moderate OBJ: 10
COMPLETION
1. _____________________ is the total income produced by a health care organization.
ANS: Revenue
DIF: Moderate OBJ: 1
2. An individual health care provider’s patient charts which includes notes and information
collected by them is referred to as the: ___________________
ANS: Medical record
DIF: Moderate OBJ: 3
3. Information collected from clinicians in all health care organizations who are involved in a
patient’s care which is made available to all authorized clinicians to access when providing
patient care is the: _____
ANS: Health record
DIF: Moderate OBJ: 3
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https://www.stuvia.com/user/aaaplus https://www.stuvia.com/user/aaaplus
,Medical Insurance
https://www.stuvia.com/user/aaaplus
and Billing 16th Edition, 16E, Linda
https://www.stuvia.com/user/aaaplus_)W()*E(*&R(&*&R*&()*()*_)*(*&$*(*&%*&(@%)%&*(@&(*@%*&@(%@%&*(
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4. Charging for services done in hospitals, acute care hospitals, skilled nursing or long-term care
facilities, rehabilitation centers, or ambulatory surgical centers is known as _____ billing.
ANS: facility
DIF: Moderate OBJ: 2
5. Charging for services performed by physicians, nurse practitioners, licensed clinical social
workers and physical therapists is known as ________________ billing.
ANS: professional
DIF: Moderate OBJ: 2
6. Individuals who are employed by an insurance carrier and whose role is to analyze and
process incoming claims, checking them for validity and determining if the services were
reasonable and necessary are referred to as ____________.
ANS: claims examiners
DIF: Moderate OBJ: 3
7. Individuals who work for consumers and help patients organize, file and negotiate health
insurance claims. ________________
ANS: Claims assistance professionals
DIF: Easy OBJ: 3
8. Patients who do not have any medical insurance and are liable for the entire bill are referred to
as _____________ patients.
ANS: self-pay
DIF: Easy OBJ: 3
9. Transmitting, receiving, storing, and forwarding of text, voice messages, attachments, or
images by computer from one person to another is referred to as ______ mail.
ANS: electronic
DIF: Moderate OBJ: 3
10. Standards of conduct by which an insurance billing specialist determines the propriety of his
or her behavior in a relationship are known as medical ____________________.
ANS: ethics
DIF: Moderate OBJ: 9
11. The Greek physician known as the Father of Medicine devised the ____________________.
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