CHAPTER 4: REVENUE CYCLE
MANAGEMENT REVIEW QUESTIONS
WITH CORRECT SOLUTIONS
Which means that the patient and/or insured has authorized the payer to reimburse the
provider directly? - ANSWER-assignment of benefits
Providers who do not accept assignment of Medicare benefits do not receive
information included on the _________, which is sent to the patient. - ANSWER-
Medicare Summary Notice
The transmission of claims data to payers or clearinghouses is called
claims____________. - ANSWER-submission
Which facilitates processing of nonstandard claims data elements into standard data
elements? - ANSWER-clearinghouse
A series of fixed-length records submitted to payers to bill for healthcare services is an
electronic_______________. - ANSWER-flat file format
Which is considered a covered entity? - ANSWER-private-sector payers that process
electronic claims
A claim that is rejected because of an error or omission is considered
a(n)____________. - ANSWER-open claim
An electronic claim is submitted using__________as its transmission media. -
ANSWER-magnetic tape
Which supporting documentation is associated with submission of an insurance claim? -
ANSWER-claims attachment
Which is a group health insurance policy provision that prevents multiple payers from
reimbursing benefits covered by other policies? - ANSWER-coordination of benefits
The sorting of claims upon submission to collect and verify information about the patient
and provider is called claims________________. - ANSWER-processing
Which of the following steps would occur first? - ANSWER-health insurance specialist
completes electronic or paper-based claim.
MANAGEMENT REVIEW QUESTIONS
WITH CORRECT SOLUTIONS
Which means that the patient and/or insured has authorized the payer to reimburse the
provider directly? - ANSWER-assignment of benefits
Providers who do not accept assignment of Medicare benefits do not receive
information included on the _________, which is sent to the patient. - ANSWER-
Medicare Summary Notice
The transmission of claims data to payers or clearinghouses is called
claims____________. - ANSWER-submission
Which facilitates processing of nonstandard claims data elements into standard data
elements? - ANSWER-clearinghouse
A series of fixed-length records submitted to payers to bill for healthcare services is an
electronic_______________. - ANSWER-flat file format
Which is considered a covered entity? - ANSWER-private-sector payers that process
electronic claims
A claim that is rejected because of an error or omission is considered
a(n)____________. - ANSWER-open claim
An electronic claim is submitted using__________as its transmission media. -
ANSWER-magnetic tape
Which supporting documentation is associated with submission of an insurance claim? -
ANSWER-claims attachment
Which is a group health insurance policy provision that prevents multiple payers from
reimbursing benefits covered by other policies? - ANSWER-coordination of benefits
The sorting of claims upon submission to collect and verify information about the patient
and provider is called claims________________. - ANSWER-processing
Which of the following steps would occur first? - ANSWER-health insurance specialist
completes electronic or paper-based claim.
