NHA CMAA Module 6 Billing and Revenue Cycle

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 of the following phases of the revenue cycle?

• A. Receiving and posting reimbursement

• B. Payer adjudication

• C. Appeals and claims collections

• D. Health care encounter and documentation

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

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?

• A. Payer adjudication

• B. Appeals and claims collection

• C. Charge capture and coding

• D. 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 followed?

• A. Appeal

• B. Payer adjudication

• C. Eligibility and insurance preauthorization

• D. Encounter documentation

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

How often should a medical administrative assistant perform charge reconciliation?

• A. Yearly

• B. Monthly

• C. Daily

• D. 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?

• A. Hardship write-off

• B. Contractual adjustment

• C. Payment posting

• D. Charge entry

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

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

• A. TRICARE

• B. Medicare

• C. Medicaid

• D. 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