1|Page
, T ST BANK Fordn y's M dical Insuranc
E e e e
th
And Billing 16 dition Author:Linda
E
Smith All Chapt rs[1-20] With V rifi d And
e e e
Corr ct Qu stions And Answ rs 100%
e e e
Compl t A+ Guid Instant Download
e e e
Availabl In PDF e
WRITT N BY GRAD D XAME E E
2|Page
,TABLE OF CONTENTS
Unit One: Career Roles and Responsibilities
1. Role of an Insurance Billing Specialist
2. Privacy, Security and HIPAA
3. Compliance, Fraud and Abuse
Unit Two: Introduction to Health Insurance
4. Basics of Health Insurance
5. The Blue Plans, Private Insurance and Managed Care Plans
6. Medicare
7. Medicaid and Other State Programs
8. TRICARE and Veteran’s Health Care
9. Workers Compensation
10. Disability Income Insurance and Disability Benefit Insurance
Unit Three: Documentation and Coding for Professional Services
11. Medical Documentation and the Electronic Health Record
12. Diagnostic Coding
13. Procedural Coding
Unit Four: Claims Submission in the Medical Office
14. The Paper Claim CMS-1500
15. The Electronic Claim
Unit Five: The Claim Follow-Up and Payment Process
16. Receiving Payments and Insurance Problem Solving
17. Collection Strategies
Unit Six: Healthcare Facility Billing
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, 18. Ambulatory Surgery Center
19. Hospital Outpatient and Inpatient Billing
Unit Seven: Employment
20. Seeking a Job and Attaining Professional Advancement
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
4|Page
, T ST BANK Fordn y's M dical Insuranc
E e e e
th
And Billing 16 dition Author:Linda
E
Smith All Chapt rs[1-20] With V rifi d And
e e e
Corr ct Qu stions And Answ rs 100%
e e e
Compl t A+ Guid Instant Download
e e e
Availabl In PDF e
WRITT N BY GRAD D XAME E E
2|Page
,TABLE OF CONTENTS
Unit One: Career Roles and Responsibilities
1. Role of an Insurance Billing Specialist
2. Privacy, Security and HIPAA
3. Compliance, Fraud and Abuse
Unit Two: Introduction to Health Insurance
4. Basics of Health Insurance
5. The Blue Plans, Private Insurance and Managed Care Plans
6. Medicare
7. Medicaid and Other State Programs
8. TRICARE and Veteran’s Health Care
9. Workers Compensation
10. Disability Income Insurance and Disability Benefit Insurance
Unit Three: Documentation and Coding for Professional Services
11. Medical Documentation and the Electronic Health Record
12. Diagnostic Coding
13. Procedural Coding
Unit Four: Claims Submission in the Medical Office
14. The Paper Claim CMS-1500
15. The Electronic Claim
Unit Five: The Claim Follow-Up and Payment Process
16. Receiving Payments and Insurance Problem Solving
17. Collection Strategies
Unit Six: Healthcare Facility Billing
3|Page
, 18. Ambulatory Surgery Center
19. Hospital Outpatient and Inpatient Billing
Unit Seven: Employment
20. Seeking a Job and Attaining Professional Advancement
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
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