Medical Records Management
Pre-Test Questions
Course Introduction
Medical Records Management is a course designed to provide students with comprehensive knowledge and practical skills related to the systematic organization, maintenance, and protection of healthcare documentation. Topics covered include the principles of health information management, legal and ethical considerations in handling patient records, the transition from paper to electronic health records (EHRs), and standards for maintaining data accuracy, confidentiality, and security. Students will also explore record retention policies, coding systems, documentation requirements, and the role of medical records in supporting patient care, research, billing, and regulatory compliance within a healthcare setting.
Recommended Textbook
Insurance Handbook for the Medical Office 14th Edition by Marilyn Fordney
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18 Chapters
1231 Verified Questions
1231 Flashcards
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Chapter 1: Role of an Insurance Billing Specialist
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Sample Questions
Q1) AHIMA publishes
A) diagnostic and procedure coding competencies for outpatient services.
B) diagnostic coding and reporting requirements.
C) diagnostic medical terminology.
D) both a and b
Answer: D
Q2) Cost pressures on health care providers are forcing employers to reduce personnel costs by hiring
A) specialized health care practitioners.
B) health care workers with college degrees.
C) multiskilled health care practitioners.
D) untrained health care practitioners.
Answer: C
Q3) A claims assistance professional
A) works for the consumer.
B) helps patients file insurance claims.
C) neither a nor
D) venipunctures.
Answer: D
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Page 3
Chapter 2: Compliance, Privacy, Fraud, and Abuse in Insurance Billing
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Sample Questions
Q1) Charging excessively for services and supplies.
A)Abuse
B)Fraud
Answer: A
Q2) Unbundling or exploding charges.
A)Abuse
B)Fraud
Answer: B
Q3) Stealing money that has been entrusted to one's care is known as ___________________.
Answer: embezzlement
Q4) To bill Medicare beneficiaries at a higher rate than other patients is considered A) negligence.
B) abuse.
C) fraud.
D) illegal.
Answer: B
Page 4
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Chapter 3: Basics of Health Insurance
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Sample Questions
Q1) If the premium of an insurance policy is not paid, a ____________________ from 10 to 30 days is usually given before insurance coverage is canceled.
Answer: grace period
Q2) An insurance policy is a legally enforceable agreement called a/an ____________________.
Answer: contract
Q3) A two- or three-part form that incorporates a combination bill, insurance form, and routing document used in both computer- and paper-based systems is called an encounter form.
A)True
B)False
Answer: True
Q4) When does the physician/patient contract begin?
A) After the physician has examined the patient for the first time
B) When the patient steps into the examination room to be treated
C) When the physician accepts the patient and agrees to treat the patient
D) When the patient verbally agrees to accept the advice of the physician
Answer: C
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Chapter 4: Medical Documentation and the Electronic Health Record
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Sample Questions
Q1) The key to substantiating procedure and diagnostic code selections for proper reimbursement is
A) the information on the daysheet.
B) supporting documentation in the electronic health record.
C) the data on the patient's information sheet.
D) the data checked off on the patient's encounter form.
Q2) Providing similar services to the same patient by more than one physician on the same day.
A)Concurrent care
B)Consultation
C)Continuity of care
D)Counseling
E)Critical care
F)Emergency
G)Referral
Q3) Written information documenting facts and events that were rendered as patient care is referred to as a _____________________.
Q4) An age-appropriate review of past and current activities of the patient (e.g., smoking or use of alcohol) is known as a/an ____________________. To view all questions and flashcards with answers, click on the resource link above.
Chapter 5: Diagnostic Coding
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Sample Questions
Q1) List the ICD-10-CM code(s) for a patient with glaucoma with recurrent iridocyclitis.
Q2) In the computer-assisted coding technology known as ___, the physician uses pull-down menus.
Q3) What is the table that contains a classification of substances for identifying poisoning states and external causes of adverse effects?
A) Table of Drugs and Chemicals
B) Table of Neoplasms
C) Table of Hypertension
D) Table of Morphology
Q4) The presence of essential modifiers or their absence does not affect the code assigned.
A)True
B)False
Q5) All diagnoses that affect the current status of the patient and are documented can be assigned a code.
A)True
B)False
Q6) Provide the appropriate ICD-10-CM code for eczematous dermatitis.
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Chapter 6: Procedural Coding
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40 Flashcards
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Sample Questions
Q1) When counseling and coordination of care dominate ____________________% of face-to-face physician/patient encounters, then time is considered the key to qualify for a particular level of E/M service.
Q2) Mrs. Burke is a 54-year-old patient seen by her physician for an annual routine physical examination. She has no complaints or symptoms. A nonautomated urinalysis with microscopy and bilateral screening mammography were done. Code for the office visit, urinalysis, and mammography.
Q3) A medical practice can have more than one fee schedule unless specific state laws restrict this practice.
A)True
B)False
Q4) Included in a global surgery policy and a surgical package is/are
A) postoperative visits in and out of the hospital.
B) digital block or topical anesthesia.
C) preoperative visit and complications after surgery.
D) both a and b
Q5) A listing of accepted charges or established allowances for specific medical procedures is called a/an ____________________.
Q6) The E/M code 99203 is considered a level ____________________ code.
Page 8
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Chapter 7: The Paper Claim: Cms-1500 02-12
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78 Verified Questions
78 Flashcards
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Sample Questions
Q1) OCR is the acronym for A) open code resource.
B) optical character recognition.
C) optical code recognition.
D) online claim recall.
Q2) Which of the following is a lifetime 10-digit number issued to physicians that replaces all other numbers assigned by various health plans?
A) TIN
B) PIN
C) UPIN
D) NPI
Q3) Effective ___________, the revised paper claim form (02-12) is required for use by all providers.
Q4) In 2012, the CMS-1500 claim form was revised to version 02-12 to accommodate A) the change in the name of the Health Care Financing Administration.
B) reporting of NPI numbers.
C) ICD-10 diagnosis codes.
D) Optical scanning.
Q5) What is the treating physician's NPI number?
Q6) What is the date that the symptoms first presented for the condition treated?
Page 9
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Chapter 8: The Electronic Claim
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Sample Questions
Q1) ___ allows third-party payers to deposit funds into the physician's bank account automatically and eliminates the need for personal handling of checks.
Q2) Data that is made unintelligible to unauthorized parties is referred to as
A) coded.
B) decoded.
C) encoded.
D) encrypted.
Q3) Once a clearinghouse receives an electronic claims transmission, the first step is for claims to go through an editing process in which the claim is ___ for missing or incorrect information.
Q4) Research unpaid claims.
A)Daily
B)Weekly
C)End of month
D)Daily or weekly
Q5) Medical data which are compiled and produced in the specific format used throughout the health care industry and sent in electronic files are HIPAA ___ transactions.
Q6) A screen prompt is a __.
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Chapter 9: Receiving Payments and Insurance Problem
Solving
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Sample Questions
Q1) The status of electronic insurance claims may be accessed quickly through online health insurance physician web portals.
A)True
B)False
Q2) If a payment problem develops with an insurance company and the company ignores claims and exceeds time limits to pay a claim, it is prudent to contact the
A) federal insurance commissioner.
B) state insurance commissioner.
C) state insurance federation.
D) department of public service.
Q3) All of the following are responsibilities of the insurance payment poster EXCEPT:
A) posting insurance reimbursements for every code submitted in the insurance claim.
B) adjusting the amount charged to match the allowable charge.
C) filing the appeal for denial.
D) sending statements for patient deductibles and coinsurance balances.
Q4) All requests of the insurance commissioner must be submitted in writing and include the ____________________ signature.
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Chapter 10: Office and Insurance Collection Strategies
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Sample Questions
Q1) Accounts receivable are usually aged in time periods of
A) 1, 4, 6, and 8 weeks.
B) 30, 60, 90, and 120 days.
C) 1, 2, 3, and 6 months.
D) 30, 60, 90, 120, and 180 days.
Q2) The patient information sheet is also known as the ______________________________.
Q3) Which group of accounts would a collector target when he or she begins making telephone calls?
A) 30- to 60-day accounts
B) 60- to 90-day accounts
C) 90- to 120-day accounts
D) Accounts older than 120 days
Q4) In filing a claim in small claims court, the physician's office is referred to as the ____________________.
Q5) A personal check is a guarantee of payment.
A)True
B)False
Q6) The collection abbreviation TTA means ____________________.
Q7) The collection abbreviation OOT means ____________________.
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Chapter 11: The Blue Plans, Private Insurance, and Managed Care Plans
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Sample Questions
Q1) When a capitated patient's services go over a certain amount and the physician can begin asking the patient to pay (fee-for-service), this arrangement is provided in a ___________________ section of the managed care contract or agreement.
Q2) The abbreviation MCO stands for ______________________________.
Q3) Beginning in ______________, the passing of federal legislation in 2010 requires almost everyone to be insured or they will pay a fine.
Q4) Medicare-eligible patients are not involved with HMOs or prepaid health plans. A)True B)False
Q5) Referral of a patient recommended by one specialist to another specialist is known as
A) primary care.
B) secondary care.
C) concurrent care.
D) tertiary care.
Q6) UR is the abbreviation for ____________________, which is necessary to control costs in the health care setting.
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Chapter 12: Medicare
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Sample Questions
Q1) An NPI number issued to a provider by CMS is the acronym for _________________________.
Q2) Medicare outpatient coverage is referred to as Part ____________________.
Q3) Employee and employer contributions help pay for Medicare Part A health services. A)True
B)False
Q4) The Civil Monetary Penalties Law carries a sanction for a penalty of ____________________ for a physician who fails to electronically transmit or manually submit a Medicare claim.
Q5) A nonparticipating physician who is not accepting assignment may bill any fee he or she wants.
A)True
B)False
Q6) It is possible for an alien to be eligible for Medicare Part A and Part B. A)True B)False
Q7) What is the courtesy adjustment?
Q8) Medicare provides insurance for people ____________________ years of age or older who are retired on Social Security.
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Chapter 13: Medicaid and Other State Programs
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Sample Questions
Q1) The Medicaid patient may be responsible for a copayment.
A)True
B)False
Q2) The group of Medicaid recipients referred to as ____________________ includes all cash recipients of the Aid to Families with Dependent Children, certain other AFDC-related groups, most cash recipients of the Supplemental Security Income program, and other SSI-related groups.
Q3) The medically needy aged
A) require help in meeting costs of medical care.
B) qualify for cash assistance.
C) are classified as those with extremely low income. D) qualify for housing assistance.
Q4) The federal government determines the payment for medical services in the Medicaid program.
A)True
B)False
Q5) The federal government designs the Medicaid program for each state on the basis of the needs of the state.
A)True
B)False
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Chapter 14: Tricare and Veterans Health Care
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Sample Questions
Q1) A person retired from a career in the armed forces is eligible for TRICARE until 65 years of age.
A)True
B)False
Q2) TRICARE is considered primary to Medicare for people younger than age 65 who have Medicare Part A as a result of a disability and who have enrolled in Medicare Part B.
A)True
B)False
Q3) The Veterans Health Care Expansion Act of 1973 authorized the
A) CHAMPUS program.
B) CHAMPVA program.
C) TRICARE program.
D) VA program.
Q4) What is the system called that TRICARE claims processors use to verify beneficiary eligibility?
A) CHAMPUS
B) Eligibility report
C) TRI-CHECK
D) DEERS
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Chapter 15: Workers Compensation
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Sample Questions
Q1) If a worker has a work-related injury or illness and is unable to perform the duties of his or her occupation for 2 months and then returns to modified work for 1 month before returning to full work, the claim is referred to as a
A) nondisability claim.
B) temporary disability claim.
C) permanent disability claim.
D) permanent and stationary claim.
Q2) Beginning in the 1990s, increases in fraudulent workers' compensation claims have been noted throughout many large metropolitan cities.
A)True
B)False
Q3) In an industrial case, the physician's office may collect all amounts not covered by the workers' compensation fee schedule.
A)True
B)False
Q4) Chiropractic care is a medical benefit offered with state workers' compensation. A)True
B)False
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Chapter 16: Disability Income Insurance and Disability Benefit Programs
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Sample Questions
Q1) Coverage that provides a specific monthly or weekly income when a person is unable to work because of an illness or injury is known as
A) guaranteed income insurance.
B) disability income insurance.
C) supplemental insurance.
D) extended income insurance.
Q2) A reason for denial of disability income benefits is insufficient medical information.
A)True
B)False
Q3) Benefits for medical expenses are provided through disability income insurance.
A)True
B)False
Q4) Residual benefits pay a
A) partial benefit when the insured is not totally disabled.
B) partial benefit when the insured is totally disabled.
C) total sum based on the type of illness.
D) total payment based on the type of past employment.
Q5) Who are the eight types of workers not covered by state disability?
Q6) What are six major government disability programs?
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Chapter 17: Hospital Billing
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Sample Questions
Q1) An outpatient classification system developed by Health Systems International is ambulatory payment classifications (APCs).
A)Ambulatory payment
B)Bed leasing
C)Capitation or percentage of revenue
D)Case rate
E)Diagnosis-related groups (DRGs)
F)Differential by day in hospital
G)Differential by service type
H)Fee schedule
I)Flat rate
J)Per diem
K)Periodic interim payments (PIPs) and cash advances
L)Withhold
M)Reinsurance stop-loss
N)Charges
O)Discounts in the form of sliding scale
P)Sliding scales for discounts and per diems
Q2) PAT is an abbreviation for ____________________.
Q3) Medicare provides stop-loss called _____________________ in its regulations.
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Chapter 18: Seeking a Job and Attaining Professional Advancement
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Sample Questions
Q1) A résumé may be posted in an online job information site or bulletin board on the Internet.
A)True
B)False
Q2) In completing an application for employment, abbreviations are not used unless space is extremely limited.
A)True
B)False
Q3) An alien employee must have on file with his or her employer an Employment Eligibility Verification Form.
A)True
B)False
Q4) Research has proved that the most likely person to get hired has been A) interviewed first. B) interviewed last.
C) a walk-in interview. D) none of the above.
Q5) ____________________ the résumé carefully for spelling, punctuation, grammatical, and typographic errors.
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