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MT Customer Service

Total questions: 22

Worksheet time: 6hrs 30mins

Name
Class
Date
1.

If a person is calling to make a payment on the patient's account, what are the 4 forms of identification they can use to identify themselves to make that payment without a consent form?

a)

A. Full Name, DOB

b)

B. Employer Name, Emergency Contact

c)

C. Physical Address, Social Security Number

d)

D. Both A & C

e)

E. Both B & C

2.

Betty called and spoke to a Customer Service rep because her payment was not reflected on her statement. What is the next step the rep should take?

a)

CSR requests that payment is allocated to Patient Accounting and notify patient

b)

Verify the identity of person >research system for missing payment> refer item to resolution through payment posting

c)

CSR notifies supervisor to research payment

d)

None of the above

3.

Once a note has been entered on the patient’s account, the note can be corrected for errors.

a)

True

b)

False

4.

A fixed amount per contractual period that a patient pays before health insurance will begin to pay.

a)

Copayment

b)

Co-Insurance

c)

Out of Pocket

d)

Deductible

5.

What is the definition of EOB?

a)

A. Notice of explanation of reasons for payment, adjustment, denial or non-covered charges of a medical claim

b)

B. Explanation of an outstanding balance to the provider

c)

C. Bill sent out to patient explaining what portion was paid to the pharmacy

d)

D. Both A & C

6.

Name 3 Characteristics of a good, high quality CSR Rep?

a)

Defeated, Helpless, Bewildered

b)

Professionalism, Personal, Polite

c)

Unpleasant, Nervous, Obnoxious

d)

Uptight, Mysterious, Amoral

7.

Name the standard form use for charges from hospitals?

a)

A. CMS-1500 Form

b)

B. CMS-1300 Form

c)

C. UB-04 Form

d)

D. Both A & C

8.

What are 3 common call reasons within Customer Service?

a)

Denied claims which have passed to patient responsibility

b)

Disputes about charges billed or payments collected

c)

Patients who cannot make full payments on their accounts or calling to make payment arrangements

d)

All the above

9.

The explanation of benefits (EOB) is an itemized statement made by a payer in response to a claim. What is listed on an EOB?

a)

A. Actions the payer is taking on each item of claim

b)

B. Details of denied charges, payments made, and reductions in charges due to contracted agreement with providers

c)

C. Both A & B

d)

D. Prescriptions

10.

A customer service rep is responsible for answering billing questions or concerns from multiple sources including patients, family members, attorneys and payers.

a)

True

b)

False

11.

Jack contacted a customer service rep to request payment plan. What steps should the rep take?

a)

CSR transfer call to billing manager

b)

CSR connects the patient to the payment vendor

c)

CSR advise patient it’s not their responsibility

d)

None of the above

12.

What is the name of the application process for patients that indicate they are unable to pay and have no insurance?

a)

A. Charity Application

b)

B. Mobile Application

c)

C. Patient Healthcare Application

d)

D. Both A & C

13.

Protecting Patient Health Information is the responsibility of everyone at Steward?

a)

True

b)

False

14.

What is the definition of Patient Communication?

a)

Disregarding or invalidating patient feelings.

b)

Any time one party misunderstands the words or actions of another.

c)

Any form or inquiry or comment received from the patient or patient's rep via phone calls, face to face interactions, written correspondences electric mail.

d)

All the above

15.

Patient demographic and insurance information is obtained at which stage of the patient access process?

a)

Servicing

b)

Patient Scheduling & Pre-reg and registration where not already validated

c)

Billing

d)

Claims processing

16.

What is the Role of a customer service representative?

a)

Primary point of contact and representative of the organization to patients and guarantors who have issues with their bills

b)

Correspond with customers to resolve coding and posting issues

c)

Ensure payment for services by verifying benefits with insurance provider

d)

All the above

17.

Name 3 types of Patient Responsibilities?

a)

Co-payment

b)

Deductible

c)

Co-Insurance

d)

All the above

18.

What is a fixed percentage a patient pays for services?

a)

Co-Payment

b)

Co-Insurance

c)

Deductible

d)

None of the above

19.

What is a small fixed amount a patient directly pays a provider for specific services?

a)

Co-Insurance

b)

Deductible

c)

Co-Payment

d)

None of the above

20.

Which tab will allow you to view charges, non-charges or all transactions?

a)

Transactions

b)

Claims

c)

Coll Support

d)

None of the above

21.

Once you have added the new insurance, you can reorder that insurance by going to the Order by Eff Date Tab from the insurance tab.

a)

True

b)

False

22.

Jackie is reviewing Susan’s account and wants to see all notes listed on her account. Which tab will allow Jackie to view all notes?

a)

Insurance > All Notes

b)

Coll Support > All Notes

c)

Transactions > All Notes

d)

Fin Summary > All Notes