Update 2025-2026 Actual Exam 120 Questions
with 100% Verified Correct Answers Guaranteed
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"Quid Pro Quo" - CORRECT ANSWER: cases in which the employee is threatened or
suffers job detriment or retaliation for refusing to concede to sexual demands.
Abuse - CORRECT ANSWER: describes practices that either directly or indirectly result
in unnecessary costs to the Medicare Program. Acts committed knowingly, willfully and
intentionally.
ex. Charging in excess for services or supplies
Providing medical unnecessary services
Accounts payable A/P - CORRECT ANSWER: bills that the practice owes to vendors
Accounts receivables A/R - CORRECT ANSWER: are the amounts owed to you by your
patients
Actual Status - CORRECT ANSWER: report indicating financial operations of the last
reporting period that can be for a period of one, three, six or twelve months and can
also be obtained from past reports.
Administrative Simplification - CORRECT ANSWER: Provisions of HIPPA mandate that
the federal government adopt national standards for the electronic exchange, storage
and handling of health care data between health care payers, plans and providers.
Anti-Discrimination Rules for the American Workplace - CORRECT ANSWER: law
requires employer to provide reasonbile accommodation to employee or job applicant
with a disability.
,Authorization - CORRECT ANSWER: approval for services, including diagnostic
services and inpatient or outpatient treatment.
Automated Reviews RAC Audit - CORRECT ANSWER: when there is certainty that an
overpayment or underpayment exists, but there is no written policy, article or guideline.
For example, duplicate claims or pricing mistakes.
Average Active Listener - CORRECT ANSWER: retainer only about 50% of a
conversation
Average Billing per Patient - CORRECT ANSWER: Total Billing per month or
year/Number of patients by month or year
Average Cost per Patient - CORRECT ANSWER: Total variable expenses per month or
year/Total patients by month or year
Average Net Charges per Patient - CORRECT ANSWER: Total net collection per month
or year/Total number of patients by month or year
Breach - CORRECT ANSWER: unauthorized acquisition access, use or disclosure of
protected health information, ex. ALGH issue on breach where health info was spread
with no consents from patients.
Budget - CORRECT ANSWER: assists the practice in measuring projected financial
goals with the actual financial performance
Budget information should be shared... - CORRECT ANSWER: with the staff so they
can participate in effective cost controls.
, Budget Planning - CORRECT ANSWER: for optimum results evaluate the past 3 years
of income and expense in order to prepare your projected budget. Hint*A good manager
will plan a budget a year in advance.
Business Associates - CORRECT ANSWER: can be held directly accountable by
federal or state authority for failure to comply with HIPAA statutory or regulations. ex. IT
techs, Janitors, Cleaning Services, Vendors, Collection agencies, Consultants and
Billing Services.
Capitation - CORRECT ANSWER: known as per member per month. form of
reimbursement used most commonly by HMOs to compensate primary care physicians
for their services.
Charge off - CORRECT ANSWER: accounts receivable that will likely remain
uncollectable and will be written off as collection or bad debt. (Appears as an expense
to the practice income statement, thus reducing net income.
Claim filing questions to ask... - CORRECT ANSWER: -What are the time limits for
claim submissions?
-Can you track your charges and payments?
-How long does it take to pay a "clean claim"
Collecting co-pay for divorced cases - CORRECT ANSWER: the adult seeking
treatment is responsible for the bill. The person bringing the child is still responsible to
you for payment, the patient can bill their estranged, but not responsibility of the
practice.
Common employee barriers to ICD-10 - CORRECT ANSWER: 1. Resistant to change
2. Comfortable with old system
3. Opt for retirement
4. Need to spend money for learning new coding system