Question 1

A practice has agreed to a capitated plan with an insurance carrier under which it covers 20 patients and receives a $3,000-per-month reimbursement payment. What payment will the practice receive if it only treats 10 patients in a month?

Accepted Answer

Under a capitated plan, the practice receives a fixed amount per month regardless of how many patients are treated. Therefore, the practice will still receive $3,000 even if only 10 patients are treated.

Question 2

What dialog box appears when the New button is clicked in the Deposit List dialog box?

Accepted Answer

The New button in the Deposit List dialog box typically opens the Deposit dialog box, allowing users to enter new deposit information.

Question 3

You are entering payment details in the Deposit dialog box and need to enter some specific details about the payment. What box would be used to enter this information?

Accepted Answer

The Description/Bank No. box is typically used to enter specific details about a payment, such as a description of the payment or banking information, which helps in identifying or providing additional information about the payment.

Question 4

Where is the insurance carrier that is making the payment selected in the Deposit dialog box?

Accepted Answer

The insurance carrier making the payment is selected in the Insurance box within the Deposit dialog box. This is where users specify which insurance company is providing the payment, ensuring that the deposit is accurately recorded against the correct insurer's account.

Question 5

The appropriate codes for the ____________ are selected from the Payment Code, Adjustment Code, Withhold Code, Deductible Code, and Take Back Code boxes.

Accepted Answer

The appropriate codes are selected based on the insurance carrier's requirements for processing claims and payments.

Question 6

What happens after a deposit entry is saved in the Deposit dialog box?

Accepted Answer

After a deposit entry is saved in the Deposit dialog box, the Deposit List dialog box reappears with the new deposit listed. This allows the user to see the updated list of deposits, including the one just entered.

Question 7

What does the Export button in the Deposit List dialog box do?

Accepted Answer

The Export button in the Deposit List dialog box is designed to export the data in formats compatible with financial management software, specifically Quicken or QuickBooks, allowing for easier accounting and financial tracking.

Question 8

What happens when the Detail button is clicked in the Deposit List dialog box?

Accepted Answer

The Detail button in the Deposit List dialog box opens the Deposit Detail dialog box, providing more information about the selected deposit.

Question 9

What button in the Deposit List dialog box is used to apply payments to specific charge transactions?

Accepted Answer

The Apply button in the Deposit List dialog box is used to apply payments to specific charge transactions, allowing users to allocate received payments against outstanding charges.

Question 10

Information about ____________ is contained in the top section of the Apply Payment/Adjustments to Charges dialog box.

Accepted Answer

The top section of the Apply Payment/Adjustments to Charges dialog box contains information about the patient, the payer, and the amount of the payment that is unapplied, making all of these options correct.

Question 11

Information about all ____________ charges for a patient is contained in the Apply Payment to Charges dialog box.

Accepted Answer

The Apply Payment to Charges dialog box contains information about all unpaid charges for a patient, as it is used to apply payments or adjustments to those charges that have not yet been settled.

Question 12

In what section of the Apply Payments to Charges window are the payments entered and applied?

Accepted Answer

Payments are typically entered and applied in the middle section of the Apply Payments to Charges window, where the user can see and manage the details of the payments being applied to specific charges.

Question 13

What section of the Apply Payment/Adjustments to Charges window contains several options that affect claims and statements?

Accepted Answer

The lower third of the Apply Payment/Adjustments to Charges window contains several options that affect claims and statements, such as the "Apply to Claim" and "Apply to Statement" options.

Question 14

Claims for any secondary or tertiary payer associated with a claim are created when the current insurance payment is saved, if the ____________ box is checked in the Apply Payments/Adjustments to Charges window.

Accepted Answer

The correct answer is C) Bill Remaining Insurances Now. This option indicates that once the current insurance payment is saved, the system will automatically create claims for any secondary or tertiary payers associated with the claim, provided this box is checked in the Apply Payments/Adjustments to Charges window.

Question 15

In the Apply Payment/Adjustments to Charges dialog box, $320.00 is entered in the Charge field and $295.00 is entered in the Allowed field. What amount will automatically be entered in the Adjustment field?

Accepted Answer

The Adjustment field will automatically show the difference between the Charge amount ($320.00) and the Allowed amount ($295.00), which is $25.00. This represents the amount that is adjusted off the charge based on the allowed amount.

Question 16

In the Apply Payment/Adjustments to Charges dialog box, $160.00 is entered in the Charge field and $28.00 is entered in the Adjustment field. What amount must be displayed in the Allowed field?

Accepted Answer

The Allowed amount is calculated by subtracting the Adjustment from the Charge. Therefore, $160.00 (Charge) - $28.00 (Adjustment) = $132.00 (Allowed).

Question 17

Only ____________ amounts are contained in the Take Back field in the Apply Payment/Adjustments to Charges dialog box.

Accepted Answer

Only positive amounts are contained in the Take Back field in the Apply Payment/Adjustments to Charges dialog box.

Question 18

Take backs should be applied ____________ most of the time.

Accepted Answer

Take backs, or adjustments made to correct overpayments, should be applied to the same charge that had the overpayment to ensure accurate accounting and reconciliation of the patient's account.

Question 19

What may be entered in the Rejection field in the Apply Payment/Adjustments to Charges dialog box?

Accepted Answer

The Rejection field is typically used to enter a rejection message from the Remittance Advice (RA) to document why a claim or payment was rejected.

Question 20

What is the purpose of the Options . . . button in the Apply Payment/Adjustments to Charges dialog box?

Accepted Answer

The Options button in the Apply Payment/Adjustments to Charges dialog box is used to change the default settings for patient payment application codes.

Quiz 7: Posting Payments and Creating Patient Statements