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