Deck 1: Introduction to Professional Billing and Coding Careers

Question 1

Most hospitals today are owned by a:

A) single, private owner.
B) nonprofit organization.
C) university.
D) corporation.

Answer 1

corporation.

Question 2

Managed care is a system in which physicians contract to participate in a health insurance network and healthcare delivery is:

A) at the discretion of the physician.
B) provided only by in-network physicians.
C) based on the patient's ability to pay.
D) monitored to control costs.

Answer 2

monitored to control costs.

Question 3

Which department is a part of patient financial services(PFS)?

A) billing.
B) collections.
C) revenue integrity.
D) all of the above.

Answer 3

all of the above.

Question 4

It is common for small-group practices to outsource:

A) billing and accounts receivable.
B) insurance coverage verifications.
C) appointment scheduling and patient reminders.
D) medical records management.

Question 5

The increased demand for medical billers, medical office assistants, and medical coders can be attributed to:

A) the growth of managed care.
B) physician practices' having more responsibility for filing claims.
C) the need for additional staff to file claims and work to obtain timely payment.
D) all of the above.

Question 6

Prior to the enactment of the Health Maintenance Organization Act of 1973, a solo practice included all of the following staff members EXCEPT:

A) physician.
B) nurse.
C) certified medical biller.
D) receptionist.

Question 7

A medical office assistant may handle all of the following duties in a medical office EXCEPT:

A) scheduling appointments.
B) compiling and recording medical records.
C) interpreting laboratory test results.
D) answering telephones.

Question 8

A large-group practice is a specialized practice that is likely to:

A) employ more nurses than doctors.
B) include a physical therapist as part of the medical team.
C) employ in-house staff to handle claims and accounts receivable.
D) contract with an outside firm to handle claims and accounts receivable.

Question 9

A practice with three physicians would generally be categorized as a:

A) solo practice.
B) private practice.
C) small-group practice.
D) large-group practice.

Question 10

A group of physicians with different specialties may practice together at one outpatient facility known as a:

A) free clinic.
B) small-group practice.
C) multispecialty clinic.
D) private hospital.

Question 11

The percentage of all healthcare providers who are allied health professionals is:

A) 25%.
B) 40%.
C) 50%.
D) 60%.

Question 12

A possible job title for a medical coder position would be:

A) admitting clerk.
B) administrative medical assistant.
C) medical receptionist.
D) health information technician.

Question 13

Prior to the enactment of the Health Maintenance Organization Act of 1973, the growth of a physician's practice would be based on:

A) advertising and referrals.
B) managed care contracts.
C) consultations.
D) hospital affiliations.

Question 14

The responsibilities of a medical biller may include all of the following EXCEPT:

A) contacting patients to collect money.
B) submitting insurance claims.
C) entering patient charge information.
D) contacting insurance carriers about outstanding claims.

Question 15

A practice with 10 or more physicians would generally be categorized as a:

A) solo practice.
B) private practice.
C) small-group practice.
D) large-group practice.

Question 16

A centralized billing office (CBO) typically contracts with a physician's office to perform which of the following functions?

A) scheduling patient appointments
B) handling claims and/or accounts receivable
C) verifying insurance coverage
D) compiling and recording medical charts, reports, and correspondence

Question 17

Which facility would most likely employ a refund specialist?

A) solo practice.
B) hospital.
C) large-group practice.
D) multi-specialty clinic.

Question 18

A payment poster would most likely work in which facility?

A) a private practice.
B) a small-group practice.
C) a large-group practice.
D) all of the above.

Question 19

The healthcare professional who researches data in medical records in order to accurately document diagnoses and procedures and obtain maximum reimbursement for physicians is the:

A) medical office assistant.
B) medical collector.
C) medical coder.
D) payment poster.

Question 20

The percentage of all healthcare providers who are physicians and nurses is:

A) 25%.
B) 40%.
C) 50%.
D) 60%.

Question 21

The duties and responsibilities of a medical biller may include all of the following EXCEPT:

A) submitting insurance claims.
B) analyzing patient charge information.
C) contacting insurance carriers on incorrectly paid claims.
D) explaining HIPAA regulations.

Question 22

Medical coding certifications include all of the following EXCEPT:

A) Certified Medical Billing Specialist (CMBS).
B) Certified Coding Associate (CCA).
C) Certified Professional Coder (CPC).
D) Certified Coding Specialist (CCS).

Question 23

Important skills required of a payment poster include all of the following EXCEPT:

A) data entry skills.
B) math skills.
C) phlebotomy skills.
D) working knowledge of insurance contracts.

Question 24

Benefits of professional memberships include all of the following EXCEPT:

A) networking with professionals.
B) receiving multiple job offers.
C) learning the latest developments.
D) taking professional courses.

Question 25

In order to receive the Certified Professional Coder (CPC) certification, you must:

A) have a college degree plus 1 year of experience.
B) have 2 years of work experience and pass the certification exam.
C) pass the certification exam within 12 months of obtaining your first job.
D) have 3 years of work experience and pass the certification exam.

Question 26

To achieve certification as a National Certified Medical Office Assistant (NCMOA), you must have all of the following qualifications EXCEPT:

A) high-school diploma or equivalent.
B) graduation from an approved program of study or 1 year of experience.
C) evaluations of billing performance.
D) a passing grade on the NCMOA exam.

Question 27

The healthcare professional who is responsible for answering questions and explaining topics such as HIPAA privacy regulations, living wills, and do-not-resuscitate orders (DNRs) to patients and their family members is the:

A) medical collector.
B) insurance verification representative.
C) admitting clerk.
D) privacy compliance officer.

Question 28

The healthcare professional who contacts patients or insurance carriers to collect fees owed to the medical facility is the:

A) medical office assistant.
B) medical coder.
C) payment poster.
D) medical collector.

Question 29

The duties and responsibilities of a medical coder may include all of the following EXCEPT:

A) greeting visitors and directing them to appropriate staff.
B) researching and reference checking of medical records.
C) accurately coding primary and secondary diagnoses.
D) using ICD-10-CM and CPT^® coding books.

Question 30

The Certified Medical Billing Specialist (CMBS) certification is awarded through the:

A) American Health Information Management Association.
B) Medical Association of Billers.
C) National Center for Competency Testing.
D) National Healthcareer Association.

Question 31

The Certified Professional Coder (CPC) certification is designed to evaluate a medical coder's knowledge of all of the following EXCEPT:

A) medical terminology.
B) math concepts.
C) coding concepts.
D) human anatomy.

Question 32

What are the duties and responsibilities of an admitting clerk?

A) registering and greeting patients.
B) having patients complete paperwork.
C) dealing with patients who may be upset or irritable.
D) all of the above.

Question 33

The Certified Coding Specialist (CCS) certification is awarded through the:

A) American Health Information Management Association.
B) American Academy of Professional Coders.
C) National Center for Competency Testing.
D) National Healthcareer Association.

Question 34

Coders without much job experience can receive the following certification:

A) National Certified Medical Office Assistant (NCMOA).
B) Certified Medical Administrative Assistant (CMAA).
C) Certified Coding Associate (CCA).
D) Certified Professional Coder (CPC).

Question 35

The duties and responsibilities of a medical collector may include:

A) sending patient billing statements.
B) compiling medical charts, reports, and correspondence.
C) reviewing medical records for compliance with regulations.
D) accurately coding diagnoses and procedures.

Question 36

The duties and responsibilities of a payment poster generally include:

A) greeting visitors and directing them to appropriate staff.
B) reading Explanation of Benefits documents issued by insurance carriers.
C) submitting claims to insurance carriers.
D) scheduling and confirming patients' appointments.

Question 37

A registered health information technician (RHIT) may also be referred to as a(n):

A) payment poster.
B) medical records analyst.
C) medical collector.
D) insurance verification representative.

Question 38

The healthcare professional who contacts insurance carriers to verify benefit information for patients is the:

A) insurance verification representative.
B) admitting clerk.
C) payment poster.
D) medical collector.

Question 39

The duties and responsibilities of a privacy compliance officer may include all of the following EXCEPT:

A) posting payments or making adjustments to patient accounts.
B) answering questions about privacy regulations.
C) explaining DNR orders to patients and their family members.
D) data entry of patient demographics.

Question 40

How many courses are required to achieve a medical billing certification?

A) three
B) six
C) eight
D) ten

Question 41

The National Center for Competency Testing awards the:

A) National Certified Medical Office Assistant (NCMOA) certificate.
B) Certified Medical Administrative Assistant (CMAA) certificate.
C) Certified Medical Billing Specialist (CMBS) certificate.
D) Certified Coding Associate (CCA) certificate.

Question 42

Allied health employees make up 40% of all healthcare professionals.

Question 43

What is required to become a medical and health services manager?

A) high school diploma
B) associates degree
C) bachelor's degree in health administration
D) master's degree in health administration

Question 44

The certification offered by the American Medical Billing Association (AMBA) to those who pass its exam is:

A) Certified Medical Billing Specialist.
B) Certified Coding Specialist.
C) Registered Health Information Technician.
D) Certified Medical Reimbursement Specialist.

Question 45

The Registered Health Information Technician (RHIT) certification proves proficiency in all of the following EXCEPT:

A) patient record maintenance and management.
B) ICD-10-CM and CPT^® coding.
C) Proficiency in electronic health records
D) familiarity with regulations regarding patient health information.

Question 46

The Certified Professional Coder (CPC) certification is awarded through the:

A) American Academy of Professional Coders.
B) American Health Information Management Association.
C) National Center for Competency Testing.
D) National Healthcareer Association.

Question 47

A registered health information technician (RHIT) ensures the quality of medical records by verifying that all records are:

A) complete.
B) accurate.
C) compliant with healthcare regulations.
D) all of the above.

Question 48

The Certified Coding Specialist-Physician (CCS-P) demonstrates expertise in all of the following areas EXCEPT:

A) group practices.
B) inpatient hospitals.
C) specialty clinics.
D) solo practice offices.

Question 49

A small-group practice will frequently contract out its billing and accounts receivable.

Question 50

The Healthcare Financial Management Association (HFMA) defines revenue cycle as "all administrative and clinical functions that contribute to the capture, management, and collection of patient service revenue."

Question 51

The American Health Information Management Association awards the:

A) National Certified Medical Office Assistant (NCMOA) certificate.
B) Certified Medical Administrative Assistant (CMAA) certificate.
C) Certified Medical Billing Specialist (CMBS) certificate.
D) Certified Coding Associate (CCA) certificate.

Question 52

After 1 year of experience, a medical office assistant can take an exam through the National Center for Competency Testing and be certified as a(n):

A) Certified Coding Associate (CCA).
B) National Certified Medical Office Assistant (NCMOA).
C) Certified Coding Specialist (CCS).
D) Certified Medical Administrative Assistant (CMAA).

Question 53

It is rare to find a privately owned hospital today.

Question 54

If you work in a doctor's office, a clinic, or a similar setting, what should you consider obtaining to demonstrate your ability?

A) Certified Professional Coder-Hospital (CPC-H) certification
B) Certified Coding Specialist-Physician (CCS-P) certification
C) Certified Coding Associate (CCA) certification
D) Certified Medical Administrative Assistant (CMAA) certification

Question 55

The processing of hospital claims often takes place off site.

Question 56

A physician who chooses not to handle billing and insurance claims within his or her facility may contract with a(n):

A) patient account services (PAS) facility.
B) centralized billing office (CBO).
C) small group practice.
D) third party administrator (TPA).

Question 57

Applicants who are successful in passing the Certified Professional Coder-Hospital (CPC-H) examination, but have not met the required coding work experience, will be awarded:

A) Certified Professional Coder-Hospital (CPC-H) certification.
B) Certified Professional Coder-Physician (CPC-P) certification.
C) Certified Coding Specialist (CCS) certification.
D) Certified Professional Coder-Hospital-Apprentice (CPC-H-A) certificate.

Question 58

A large-group practice will frequently contract out its billing and accounts receivable.

Question 59

A candidate for Certified Medical Billing Specialist (CMBS) certification aims to:

A) improve his or her medical billing knowledge.
B) assist providers in obtaining maximum reimbursement for services.
C) develop new coding and documentation skills.
D) all of the above.

Question 60

How long does it take to become a certified HIPAA professional?

A) 2 days
B) 2 weeks
C) 2 months
D) 2 years

Question 61

To become a registered health informational technician you must pass a written examination overseen by the American Health Information Management Association (AHIMA).

Question 62

A(n) ________ practice usually consists of three to nine physicians of the same specialty.

Question 63

A Certified Coding Associate (CCA) does not need much job experience.

Question 64

To become a Certified Medical Administrative Assistant (CMAA), you must be a graduate of a healthcare training program or have 1 or more years of full-time job experience.

Question 65

A medical receptionist is considered back office staff in a physician's office.

Question 66

Providers never have a financial interest in common with a centralized billing office (CBO).

Question 67

The individual who contacts insurance carriers to verify benefits is referred to as a(n) ________.

Question 68

A(n) ________ contacts patients or insurance carriers to collect money owed to the facility or practice.

Question 69

The Certified Professional Coder (CPC) certification requires 2 years of work experience.

Question 70

A medical collector can perform most of her job on the phone.

Question 71

Professional memberships can help you keep current with developments in your field.

Question 72

The position of refund specialist requires research and analytical skills.

Question 73

The development of ________ required physicians to become responsible for filing health insurance claims.

Question 74

The front office staff member who primarily handles administrative duties is referred to as a(n) ________.

Question 75

All facilities will have the same specific job description for a medical biller.

Question 76

According to federal law a medical billing professional must become certified as a reimbursement specialist.

Question 77

________ personnel make up 60% of all healthcare professionals.

Question 78

A registered health information technician (RHIT) is not responsible for the quality of medical records.

Question 79

The privacy compliance officer is responsible for answering questions about the Health Insurance Portability and Accountability Act (HIPAA).

Question 80

To achieve certification as a Certified Medical Billing Specialist (CMBS), an individual must have 5 or more years of job experience.