TEST BANK Fordney's Medical Insurance and Billing 16/E Linda Smith
a a a a a a a a a
Chapter 01: Role of an Insurance Billing Specialist
a a a a a a a
Smith: Fordney’s Medical Insurance and Billing, 16th Edition
a a a a a a a
MULTIPLEaCHOICE
1. Theaprimaryagoalaofaanainsuranceabillingaspecialistais:
a. toamanageatheahealthacareaorganization’sabillingaoffice
b. toaensureatheacashaflowaofaaahealthacareaorganizationathrougharevenueacycleam
anagement
c. toasendabillsatoapatientsaforaservicesatheyareceive
d. toapostapaymentsareceivedafromapatientsaandainsuranceacarriers
ANS:a B DIF: Moderate OBJ:a 2
2. Facilityabillingaincludesachargingaforamedicalaservicesaprovidedaby:
a. physicians
b. laboratoryaservices
c. ambulanceaservices
d. ambulatoryasurgicalacenters
ANS:a D DIF: Easy OBJ:a 2
3. Aaclaimsaassistanceaprofessional
a. worksaforatheaconsumer.
b. worksaforatheahealthacareaorganization.
c. worksaforaanainsuranceacompany.
d. worksaforatheafederalagovernment.
ANS:a A DIF: Easy OBJ:a 2
4. Whataisa“cashaflow”ainaaamedicalapractice?
a. Theaactualamoneyaavailableatoaaamedicalapractice
b. Theaamountaofamoneyareceivedabyaaamedicalapracticeaina1aday
c. Theaamountaofamoneyareceivedabyaaamedicalapracticeaina1amonth
d. Theaamountaofaoutstandingamoneyaonatheaaccountsareceivable
ANS:a A DIF: Moderate OBJ:a 2
5. Whichalevelaofaeducationaisagenerallyarequiredaforaoneawhoaseeksaemploymentaasaanainsuranceaco
der?
a. Collegeadiploma
b. Highaschooladiploma
c. Completionaofaanaaccreditedaprogramaforacodingacertification
d. Noaspecificalevelaofaeducationaisarequired
ANS:a C DIF: Easy OBJ:a 4
6. Theaamountaofamoneyaanainsuranceabillingaspecialistaearnsaisadependentaonawhichaofatheafo
llowingafactors?
a. Knowledge
b. Experience
, c. Sizeaofaemployingainstitution
d. Allaareacorrect
ANS:a D DIF: Moderate OBJ:a 5
7. Aaself-employedamedicalainsuranceabillerawhoadoesaindependentacontractingaisaresponsibleafor
a. advertising.
b. billing.
c. accounting.
d. Allaareacorrect.
ANS:a D DIF: Hard OBJ:a 2
8. Medicalaetiquettearefersato
a. considerationaforaothers.
b. moralaprinciplesaorapractices.
c. laws.
d. theaOathaofaHippocrates.
ANS:a A DIF: Moderate OBJ:a 9
9. Theaprocessaofashorteningawordsaandausingaabbreviationsathatadoanotafollowastandardagrammar
,aspellingaandapunctuationawhenawritingaelectronicamailacommunicationsaisareferredatoaas:
a. emoticons
b. abbreviations
c. textaspeak
d. shortatext
ANS:a C DIF: Easy OBJ:a 9
10. Professionalaethicsainclude
a. statealaws.
b. federalalaws.
c. standardsaofaconduct.
d. civilatorts.
ANS:a C DIF: Moderate OBJ:a 9
11. Theaearliestawrittenacodeaofaethicalaprinciplesaforatheamedicalaprofessionaisathe
a. OathaofaHippocrates.
b. Socraticaoath.
c. CodeaofaHammurabi.
d. Medicolegalaoath.
ANS:a C DIF: Easy OBJ:a 9
12. WhataisatheanameaofatheamodernacodeaofaethicsathatatheaAmericanaMedicalaAssociationa(AMA)aad
optedaina1980?
a. TheaModernaStandardsaofaConductaCode
b. TheaPrinciplesaofaMedicalaEthics
c. TheaOathaofaHippocrates
d. TheaAmericanaMedicalaAssociationaCodeaofaEthics
, ANS:a B DIF: Easy OBJ:a 9
13. Reportingaincorrectainformationatoagovernment-fundedaprogramsais
a. unethical.
b. illegal.
c. abuse.
d. fraud.
ANS:a B DIF: Moderate OBJ:a 9
14. Theadoctrineastatingathataphysiciansaarealegallyaresponsibleaforabothatheiraownaconductaandathataof
a theiraemployeesaisaknownaas
a. respondeatasuperior.
b. letatheamasteraanswer.
c. vicariousaliability.
d. Allaareacorrect.
ANS:a D DIF: Hard OBJ:a 10
15. Whataisatheaindependentacontractor’saliabilityaifatheyaoperateatheiraownamedicalainsuranceabi
llingacompany?
a. None.aTheaprofessionalaliabilityainsuranceaofatheacompanyatheyacontractawithawillac
overathem.
b. Theaindependentacontractoraisaliableaandashouldapurchaseaerrorsaandaomissionsai
nsurance.
ANS:a B DIF: Moderate OBJ:a 10
COMPLETION
1. a isatheatotalaincomeaproducedabyaaahealthacareaorganization.
ANS:a Revenue
DIF: Moderate OBJ:a 1
2. Anaindividualahealthacareaprovider’sapatientachartsawhichaincludesanotesaandainformationac
ollectedabyathemaisareferredatoaasathe:aa
ANS:a Medicalarecord
DIF: Moderate OBJ:a 3
3. Informationacollectedafromacliniciansainaallahealthacareaorganizationsawhoaareainvolvedainaaapa
tient’sacareawhichaisamadeaavailableatoaallaauthorizedacliniciansatoaaccessawhenaprovidingapati
entacareaisathe:aaaaaaaaaaaa
ANS:a Healtharecord
DIF: Moderate OBJ:a 3
, 4. Chargingaforaservicesadoneainahospitals,aacuteacareahospitals,askilledanursingaoralong-
termacareafacilities,arehabilitationacenters,aoraambulatoryasurgicalacentersaisaknownaas
billing.
ANS:a facility
DIF: Moderate OBJ:a 2
5. Chargingaforaservicesaperformedabyaphysicians,anurseapractitioners,alicensedaclinicalasociala
workersaandaphysicalatherapistsaisaknownaas billing.
ANS:a professional
DIF: Moderate OBJ:a 2
6. Individualsawhoaareaemployedabyaanainsuranceacarrieraandawhosearoleaisatoaanalyzeaandapro
cessaincomingaclaims,acheckingathemaforavalidityaandadeterminingaifatheaservicesawereareaso
nableaandanecessaryaareareferredatoaas .
ANS:a claimsaexaminers
DIF: Moderate OBJ:a 3
7. Individualsawhoaworkaforaconsumersaandahelpapatientsaorganize,afileaandanegotiateahealthain
suranceaclaims.aa
ANS:a Claimsaassistanceaprofessionals
DIF: Easy OBJ:aaa 3
8. Patientsawhoadoanotahaveaanyamedicalainsuranceaandaarealiableaforatheaentireabillaareareferredatoaas
patients.
ANS:a self-pay
DIF: Easy OBJ:a 3
9. Transmitting,areceiving,astoring,aandaforwardingaofatext,avoiceamessages,aattachments,aorai
magesabyacomputerafromaoneapersonatoaanotheraisareferredatoaas mail.
ANS:a electronic
DIF: Moderate OBJ:a 3
10. Standardsaofaconductabyawhichaanainsuranceabillingaspecialistadeterminesatheaproprietyaofahisaor
a herabehaviorainaaarelationshipaareaknownaasamedical .
ANS:a ethics
DIF: Moderate OBJ:a 9
11. TheaGreekaphysicianaknownaasatheaFatheraofaMedicineadevisedathe .
a a a a a a a a a
Chapter 01: Role of an Insurance Billing Specialist
a a a a a a a
Smith: Fordney’s Medical Insurance and Billing, 16th Edition
a a a a a a a
MULTIPLEaCHOICE
1. Theaprimaryagoalaofaanainsuranceabillingaspecialistais:
a. toamanageatheahealthacareaorganization’sabillingaoffice
b. toaensureatheacashaflowaofaaahealthacareaorganizationathrougharevenueacycleam
anagement
c. toasendabillsatoapatientsaforaservicesatheyareceive
d. toapostapaymentsareceivedafromapatientsaandainsuranceacarriers
ANS:a B DIF: Moderate OBJ:a 2
2. Facilityabillingaincludesachargingaforamedicalaservicesaprovidedaby:
a. physicians
b. laboratoryaservices
c. ambulanceaservices
d. ambulatoryasurgicalacenters
ANS:a D DIF: Easy OBJ:a 2
3. Aaclaimsaassistanceaprofessional
a. worksaforatheaconsumer.
b. worksaforatheahealthacareaorganization.
c. worksaforaanainsuranceacompany.
d. worksaforatheafederalagovernment.
ANS:a A DIF: Easy OBJ:a 2
4. Whataisa“cashaflow”ainaaamedicalapractice?
a. Theaactualamoneyaavailableatoaaamedicalapractice
b. Theaamountaofamoneyareceivedabyaaamedicalapracticeaina1aday
c. Theaamountaofamoneyareceivedabyaaamedicalapracticeaina1amonth
d. Theaamountaofaoutstandingamoneyaonatheaaccountsareceivable
ANS:a A DIF: Moderate OBJ:a 2
5. Whichalevelaofaeducationaisagenerallyarequiredaforaoneawhoaseeksaemploymentaasaanainsuranceaco
der?
a. Collegeadiploma
b. Highaschooladiploma
c. Completionaofaanaaccreditedaprogramaforacodingacertification
d. Noaspecificalevelaofaeducationaisarequired
ANS:a C DIF: Easy OBJ:a 4
6. Theaamountaofamoneyaanainsuranceabillingaspecialistaearnsaisadependentaonawhichaofatheafo
llowingafactors?
a. Knowledge
b. Experience
, c. Sizeaofaemployingainstitution
d. Allaareacorrect
ANS:a D DIF: Moderate OBJ:a 5
7. Aaself-employedamedicalainsuranceabillerawhoadoesaindependentacontractingaisaresponsibleafor
a. advertising.
b. billing.
c. accounting.
d. Allaareacorrect.
ANS:a D DIF: Hard OBJ:a 2
8. Medicalaetiquettearefersato
a. considerationaforaothers.
b. moralaprinciplesaorapractices.
c. laws.
d. theaOathaofaHippocrates.
ANS:a A DIF: Moderate OBJ:a 9
9. Theaprocessaofashorteningawordsaandausingaabbreviationsathatadoanotafollowastandardagrammar
,aspellingaandapunctuationawhenawritingaelectronicamailacommunicationsaisareferredatoaas:
a. emoticons
b. abbreviations
c. textaspeak
d. shortatext
ANS:a C DIF: Easy OBJ:a 9
10. Professionalaethicsainclude
a. statealaws.
b. federalalaws.
c. standardsaofaconduct.
d. civilatorts.
ANS:a C DIF: Moderate OBJ:a 9
11. Theaearliestawrittenacodeaofaethicalaprinciplesaforatheamedicalaprofessionaisathe
a. OathaofaHippocrates.
b. Socraticaoath.
c. CodeaofaHammurabi.
d. Medicolegalaoath.
ANS:a C DIF: Easy OBJ:a 9
12. WhataisatheanameaofatheamodernacodeaofaethicsathatatheaAmericanaMedicalaAssociationa(AMA)aad
optedaina1980?
a. TheaModernaStandardsaofaConductaCode
b. TheaPrinciplesaofaMedicalaEthics
c. TheaOathaofaHippocrates
d. TheaAmericanaMedicalaAssociationaCodeaofaEthics
, ANS:a B DIF: Easy OBJ:a 9
13. Reportingaincorrectainformationatoagovernment-fundedaprogramsais
a. unethical.
b. illegal.
c. abuse.
d. fraud.
ANS:a B DIF: Moderate OBJ:a 9
14. Theadoctrineastatingathataphysiciansaarealegallyaresponsibleaforabothatheiraownaconductaandathataof
a theiraemployeesaisaknownaas
a. respondeatasuperior.
b. letatheamasteraanswer.
c. vicariousaliability.
d. Allaareacorrect.
ANS:a D DIF: Hard OBJ:a 10
15. Whataisatheaindependentacontractor’saliabilityaifatheyaoperateatheiraownamedicalainsuranceabi
llingacompany?
a. None.aTheaprofessionalaliabilityainsuranceaofatheacompanyatheyacontractawithawillac
overathem.
b. Theaindependentacontractoraisaliableaandashouldapurchaseaerrorsaandaomissionsai
nsurance.
ANS:a B DIF: Moderate OBJ:a 10
COMPLETION
1. a isatheatotalaincomeaproducedabyaaahealthacareaorganization.
ANS:a Revenue
DIF: Moderate OBJ:a 1
2. Anaindividualahealthacareaprovider’sapatientachartsawhichaincludesanotesaandainformationac
ollectedabyathemaisareferredatoaasathe:aa
ANS:a Medicalarecord
DIF: Moderate OBJ:a 3
3. Informationacollectedafromacliniciansainaallahealthacareaorganizationsawhoaareainvolvedainaaapa
tient’sacareawhichaisamadeaavailableatoaallaauthorizedacliniciansatoaaccessawhenaprovidingapati
entacareaisathe:aaaaaaaaaaaa
ANS:a Healtharecord
DIF: Moderate OBJ:a 3
, 4. Chargingaforaservicesadoneainahospitals,aacuteacareahospitals,askilledanursingaoralong-
termacareafacilities,arehabilitationacenters,aoraambulatoryasurgicalacentersaisaknownaas
billing.
ANS:a facility
DIF: Moderate OBJ:a 2
5. Chargingaforaservicesaperformedabyaphysicians,anurseapractitioners,alicensedaclinicalasociala
workersaandaphysicalatherapistsaisaknownaas billing.
ANS:a professional
DIF: Moderate OBJ:a 2
6. Individualsawhoaareaemployedabyaanainsuranceacarrieraandawhosearoleaisatoaanalyzeaandapro
cessaincomingaclaims,acheckingathemaforavalidityaandadeterminingaifatheaservicesawereareaso
nableaandanecessaryaareareferredatoaas .
ANS:a claimsaexaminers
DIF: Moderate OBJ:a 3
7. Individualsawhoaworkaforaconsumersaandahelpapatientsaorganize,afileaandanegotiateahealthain
suranceaclaims.aa
ANS:a Claimsaassistanceaprofessionals
DIF: Easy OBJ:aaa 3
8. Patientsawhoadoanotahaveaanyamedicalainsuranceaandaarealiableaforatheaentireabillaareareferredatoaas
patients.
ANS:a self-pay
DIF: Easy OBJ:a 3
9. Transmitting,areceiving,astoring,aandaforwardingaofatext,avoiceamessages,aattachments,aorai
magesabyacomputerafromaoneapersonatoaanotheraisareferredatoaas mail.
ANS:a electronic
DIF: Moderate OBJ:a 3
10. Standardsaofaconductabyawhichaanainsuranceabillingaspecialistadeterminesatheaproprietyaofahisaor
a herabehaviorainaaarelationshipaareaknownaasamedical .
ANS:a ethics
DIF: Moderate OBJ:a 9
11. TheaGreekaphysicianaknownaasatheaFatheraofaMedicineadevisedathe .