CMAA: Billing & Revenue Cycle

A medical administrative assistant is reviewing remittance advice to determine how claims have been paid and to see if any errors have been made by the third-party payer. This action occurs in which of the following phases of the revenue cycle?

• Receiving and posting reimbursement

• Payer adjudication

• Appeals and claims collections

• Health care encounter and documentation

What stage is the revenue cycle considered to be completed?

• Registration and scheduling

• Payer adjudication

• Health care encounter and documentation

• Posting the payment

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 of the following phases of the revenue cycle?

• Payer adjudication

• Appeals and claims collection

• Charge capture and coding

• Utilization management review

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

• Appeal

• Payer adjudication

• Eligibility and insurance preauthorization

• Encounter documentation

Which of the following items is required in the encounter note?

• Provider signature

• Copay amount

• Provider's phone number

• Patient address

How often should a medical administrative assistant perform charge reconciliation?

• Yearly

• Monthly

• Daily

• Weekly

A medical administrative assistant notices a difference between the billed and allowed amount. Which of the following type of transaction must be posted in the patient account?

• Hardship write-off

• Contractual adjustment

• Payment posting

• Charge entry

An electronic health record (EHR) system assists health care organizations with which of the following tasks?

• Provider documentation

• Interviewing and hiring new staff

• Ordering of supplies

• Attracting new patients

Which of the following payers is designed for military members and their family?

• TRICARE

• Medicare

• Medicaid

• Workers' compensation

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

• Non-participating provider

• Eligible

• Participating provider

• Value-based