Test Bank Fordney's Medical Insurance and Billing 17th Edition
By Linda Smith
All Chapters (1-20) Q&A Verified | Grade A+
ISBN 9780443110450
~1~
, TABLE OF CONTENTS
Chapter 01: Role of an Insurance Billing Specialist ...................................................................... 3
Chapter 02: Privacy, Security and HIPAA ..................................................................................... 14
Chapter 03: Compliance, Fraud and Abuse ................................................................................. 24
Chapter 04: Basics of Health Insurance ....................................................................................... 35
Chapter 05: The Blue Plans, Private Insurance, and Managed Care Plans .................................. 49
Chapter 06: Medicare ................................................................................................................... 62
Chapter 07: Medicaid and Other State Programs........................................................................ 79
Chapter 08: Tricare and Veterans Health Care ........................................................................... 94
Chapter 09: Workers’ Compensation ........................................................................................ 112
Chapter 10: Disability Income Insurance and Disability Benefit Insurance ............................ 131
Chapter 11: Medical Documentation and the Electronic Health Record ................................. 144
Chapter 12: Diagnostic Coding .................................................................................................. 162
Chapter 13: Procedural Coding .................................................................................................. 180
Chapter 14: The Paper Claim CMS-1500 ................................................................................... 192
Chapter 15: The Electronic Claim .............................................................................................. 205
Chapter 16: Receiving Payments and Insurance Problem Solving ........................................... 216
Chapter 17: Collection Strategies .............................................................................................. 232
Chapter 18: Outpatient Facility Billing ...................................................................................... 251
Chapter 19: Inpatient Facility Billing ........................................................................................ 266
Chapter 20: Seeking a Job and Attaining Professional Advancement ...................................... 278
~2~
,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
CORRECT ANSWER: 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
CORRECT ANSWER: 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.
~3~
, d. works for the federal government.
CORRECT ANSWER: 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
CORRECT ANSWER: A DIF: Moderate OBJ: 2
5. Which level of education is generally required for one who seeks employment as
an insurance coder?
a. College diploma
b. High school diploma
c. Completion of an accredited program for coding certification
d. No specific level of education is required
CORRECT ANSWER: C DIF: Easy OBJ: 4
6. The amount of money an insurance billing specialist earns is dependent on which
of the following factors?
a. Knowledge
b. Experience
c. Size of employing institution
~4~
By Linda Smith
All Chapters (1-20) Q&A Verified | Grade A+
ISBN 9780443110450
~1~
, TABLE OF CONTENTS
Chapter 01: Role of an Insurance Billing Specialist ...................................................................... 3
Chapter 02: Privacy, Security and HIPAA ..................................................................................... 14
Chapter 03: Compliance, Fraud and Abuse ................................................................................. 24
Chapter 04: Basics of Health Insurance ....................................................................................... 35
Chapter 05: The Blue Plans, Private Insurance, and Managed Care Plans .................................. 49
Chapter 06: Medicare ................................................................................................................... 62
Chapter 07: Medicaid and Other State Programs........................................................................ 79
Chapter 08: Tricare and Veterans Health Care ........................................................................... 94
Chapter 09: Workers’ Compensation ........................................................................................ 112
Chapter 10: Disability Income Insurance and Disability Benefit Insurance ............................ 131
Chapter 11: Medical Documentation and the Electronic Health Record ................................. 144
Chapter 12: Diagnostic Coding .................................................................................................. 162
Chapter 13: Procedural Coding .................................................................................................. 180
Chapter 14: The Paper Claim CMS-1500 ................................................................................... 192
Chapter 15: The Electronic Claim .............................................................................................. 205
Chapter 16: Receiving Payments and Insurance Problem Solving ........................................... 216
Chapter 17: Collection Strategies .............................................................................................. 232
Chapter 18: Outpatient Facility Billing ...................................................................................... 251
Chapter 19: Inpatient Facility Billing ........................................................................................ 266
Chapter 20: Seeking a Job and Attaining Professional Advancement ...................................... 278
~2~
,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
CORRECT ANSWER: 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
CORRECT ANSWER: 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.
~3~
, d. works for the federal government.
CORRECT ANSWER: 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
CORRECT ANSWER: A DIF: Moderate OBJ: 2
5. Which level of education is generally required for one who seeks employment as
an insurance coder?
a. College diploma
b. High school diploma
c. Completion of an accredited program for coding certification
d. No specific level of education is required
CORRECT ANSWER: C DIF: Easy OBJ: 4
6. The amount of money an insurance billing specialist earns is dependent on which
of the following factors?
a. Knowledge
b. Experience
c. Size of employing institution
~4~
