WorksheetsCBCS Quiz 1
Total questions: 15
Worksheet time: 8mins
Which of the following steps of the revenue cycle does effective communication begin?
Utilization management review
Healthcare encounter and documentation
Billing
Registration and scheduling
A billing and coding specialist is processing claims. Which of the following should the specialist identify as an example of fraud?
Billing non-covered services
Charging excessively for services in error
Mistakenly reporting duplicate charges
Upcoding
Which of the following actions by a billing and coding specialist represents a breach of confidentiality?
Protecting passwords and keeping them in a secured location
Never leaving the computer screen unattended
Discussing patient information to family members with the patient’s consent
Communicating patient information to family members with the patient’s consent following confidentiality standards
Which of the following terms describes a patient’s right to have their protected health information safeguarded and not disclosed to others without their permission?
(a)
A billing and coding specialist should identify that which of the following documents assists providers in determining whether there are any billing errors?
Charge description master
Aging report
Credit report
Preauthorization
Which of the following describes the practice of routinely submitting claims that have the same coding or modifier errors?
Upcoding
Overpayment
Abuse pattern
Claims not rendered
A billing and coding specialist should identify that a Medicare Recovery Auditor Contractor (RAC) can review medical records for which of the following?
To investigate if a patient was denied Medicare coverage
To investigate whether a provider is self-referring for ancillary services
To investigate billing and coding errors
Which of the following is an effective tool for collecting a patient’s payment for health care services?
Eligibility verification
Communication
Precertification
Cost share
Which of the following refers to the act of controlling access to records, protecting patient health information from destruction or loss, and safeguarding data?
Security
Confidentiality
Privacy
Integrity
Which of the following is a claim that is possible to adjudicate and includes all required data elements?
Pending claim
Clean claim
Delinquent claim
Which of the following requires a patient's authorization prior to disclosure?
Protected health information (PHI)
Workers' compensation claim
Release of information log
Third-party payer (TPP) and health care operations
A billing and coding specialist notices that a provider is reporting the same code for all new patient visits to get higher reimbursement. The specialist should identify this as which of the following?
Fraud
Abuse
Audit
My Answer
A billing and coding specialist is speaking with a patient on the telephone about their plan. Which of the following actions should the specialist take when communicating with the patient?
Use slang terminology
Explain financial responsibility
Demand payment
Use specific convention terms
A billing and coding specialist should identify that the Office Inspector General (OIG) has which of the following roles?
To investigate disclosure of protected health information
To evaluate workplace safety standards
To administer the Patient Protection and Affordable Care Act
To identify Medicare fraud and abuse
A billing and coding specialist is preparing to code an anesthesiologist's portion of a procedure. The specialist must be able to identify which of the following regulates this activity?
ICD-10-CM Official Guidelines
Federal Claims Collection Act (FCCA)
Stark Law
CPT guidelines
