question

What does the abbreviation MSHP designate?

answer

Multiskilled health practitioner

question

Cost pressures on health care providers are forcing employers to reduce personnel costs by hiring

answer

multiskilled health care practitioners

question

administrative medical office responsibilities include

answer

claims submission

question

A claims assistance professional

answer

works for the consumer and helps patients file insurance claims

question

What is "cash flow" in a medical practice?

answer

The actual money available to a medical practice

question

Front office medical duties have become increasingly important because

answer

diagnostic and procedure coding must be reviewed for it correctness and completeness

question

Which level of education is generally required for one who seeks employment as an insurance coder?

answer

Completion of an accredited program for coding certification

question

Which organization published diagnostic and procedure coding competencies for outpatient services and diagnostic coding and reporting requirements for physician billing?

answer

American Health Information Management Association (AHIMA)

question

The amount of money an insurance billing specialist earns is dependent on which of the following factors?

answer

Knowledge, Experience, and size of employing institution

question

A billing specialist is entrusted with?

answer

holding patients' medical information in confidence, collecting money, and being a reliable resource for co-workers

question

medical etiquette

answer

consideration for others

question

medical ethics include

answer

standards of conducts

question

The earliest written code of ethical principles for the medical profession is the

answer

code of hammurabi

question

What is the name of the modern code of ethics that the American Medical Association (AMA) adopted in 1980?

answer

The Principles of Medical Ethics

question

What should you do if you discover that a patient of your physician employer is under the care of another physician for the same ailment?

answer

Notify your physician

question

Reporting incorrect information to private insurance carriers is considered

answer

unethical

question

The Internet Healthcare Coalition has developed the ________ Code of Ethics

answer

eHealth

question

Reporting incorrect information to government-funded programs is

answer

illegal

question

Insurance specialist certificate programs include

answer

anatomy, diagnostic coding, computer technology

question

The doctrine stating that physicians are legally responsible for both their own conduct and that of their employees is known as

answer

respondeat superior, let the master answer, and vicarious liability

question

The AHIMA Code of Ethics is appropriate for

answer

health information specialists, coders, and insurance billing specialists.

question

Why are multiskilled health practitioners (MSHPs) in demand?

answer

They are cross-trained to provide more than one function, often competent in more than one discipline offer more flexibility to their employer

question

Which code of ethics is most appropriate for an insurance billing specialist who handles medical records?

answer

The american Health Information Management Association (AHIMA) code of ethics

question

AHIMA publishes

answer

diagnostic and procedure coding competencies for outpatient services and diagnostic coding and reporting requirements

question

A self-employed medical insurance biller who does independent contracting is responsible for

answer

advertising, billing, accounting

question

Using code number to increase payment when case documentation does not warrant it

answer

both illegal and unethical

question

Reporting incorrect information to medicare

answer

illegal

question

coding services that were not performed for payment

answer

both illegal and unethical

question

reporting incorrect information to a private insurance carrier

answer

unethical

question

unbundling services when an available single code includes all services

answer

both illegal and unethical

question

assigning a code without documentation from the provider

answer

both illegal and unethical

question

health care provider

answer

individual who renders medical services, furnishes bills, or is paid for health care in the normal course of business

question

clearinghouse

answer

Third-party administrator who receives insurance claims from the physicians office performs edits, and redistributes the claims electronically to various insurance carriers

question

covered entity

answer

A health care coverage carrier clearinghouse or physician who transmits health information in electronic form in connection with a transaction covered by HIPAA

question

business associate

answer

individual who is hired by a medical practice to process claims to a third-party payer

question

privacy officer, privacy official

answer

Individual who is designated to help a provider remain in compliance by setting policies and procedures in place training staff regarding HIPAA Privacy guidelines and acting as the contact person for questions and complaints

question

The process of meeting regulations, recommendations, and expectations of federal and state agencies that pay for health care services and regulate the industry is known as eHealth information management

answer

False

question

Under HIPAA guidelines, an outside billing company that manages claims and accounts for a medical clinic is known as a covered entity

answer

False

question

to give, release, or transfer information to another entity is called consent

answer

false

question

A HIPAA compliance exception to the right of privacy and privileged communication is a patients records pertaining to his or her industrial accident case.

answer

true

question

Confidentiality between the physician and the patient is automatically waived when the patient is being treated in a workers compensation case

answer

true

question

Notes, papers, and memos regarding patient information should be disposed of using a shredding device

answer

True

question

A patient has the right to obtain a copy of his or her confidential health information

answer

true

question

The HITECH Act replaced the HIPAA privacy laws

answer

False

question

Disclosing PHI as authorized by the laws relating to workers' compensation does not require a signed authorization

answer

true

question

Confidential information includes everything that is _______ a patient.

answer

heard about, read about, seen regarding

question

What is the correct response when a relative calls asking about a patient?

answer

Have the physician return the phone call

question

Forgiving the deductible or copayment for a Medicare patient

answer

fraud

question

Filing insurance claims for services not medically necessary

answer

abuse

question

billing medicare beneficiaries at a higher rate than other patients

answer

abuse

question

changing the date of service

answer

fraud

medical insurance ch. 1 and 2

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