NHA CMAA Module 6 Billing and Revenue Cycle

Front

A medical administrative assistant is reviewing remittance advice to determine how claims have been paid and to see if any errors have occurred by the third-party payer. This action occurs in which phase of the revenue cycle? Options: A. Receiving and posting reimbursement, B. Payer adjudication, C. Appeals and claims collections, D. Health care encounter and documentation

Back

Receiving and posting reimbursement

Front

What stage is the revenue cycle considered to be completed? A. Registration and scheduling, B. Payer adjudication, C. Health care encounter and documentation, D. Posting the payment

Back

Posting the payment

Front

A medical administrative assistant is checking with a patient’s insurance payer to determine if a referral or preauthorization is needed prior to performing an MRI. This action occurs in which phase of the revenue cycle?

Back

Utilization management review

Front

A medical administrative assistant is contacting the insurance payer to determine benefits coverage for a procedure and is requesting approval. Which step of the revenue cycle is being followed?

Back

Eligibility and insurance preauthorization

Front

Which of the following items is required in the encounter note? A. Provider signature, B. Copay amount, C. Provider’s phone number, D. Patient address

Back

Provider signature

Front

How often should a medical administrative assistant perform charge reconciliation?

Back

Daily

Front

A medical administrative assistant notices a difference between the billed and allowed amount. Which type of transaction must be posted in the patient account? Options: A. Hardship write-off, B. Contractual adjustment, C. Payment posting, D. Charge entry

Back

Contractual adjustment

Front

An electronic health record (EHR) system assists health care organizations with which of the following tasks? A. Provider documentation, B. Interviewing and hiring new staff, C. Ordering of supplies, D. Attracting new patients

Back

Provider documentation

Front

Which of the following payers is designed for military members and their family? A. TRICARE, B. Medicare, C. Medicaid, D. Workers' compensation

Back

TRICARE

Front

A provider agrees to accept the payer's allowed amount. What is the provider's status?

Back

Participating provider