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Medical Billing 101 Chapter 1
Concepts and Vocabulary for Medical Billing 101 Chapter 1
39
Medical
Professional
09/24/2010

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Term
True
Definition
T or F: You should use Caps Lock because CMS-1500 form only accepts capital letters
Term
d
Definition

Which looks like how a payment should be entered on a CMS-1500 form?

a) $25.00

b) 25.00

c) $25 00

d) 25 00

Term
b
Definition

Which is the correct way to enter a diagnosis code on a CMS-1500 form?

a) 250.00

b) 250 00

c) 25000 (an ICD-9 code)

Term
c
Definition

How should you enter a telephone number on a CMS-1500 form?

a) (123) 456-7890

b) 123-456-7890

c) 123 456 7890

d) (123) 456 7890

e) 1234567890

Term
GOODPATIENT, WILLIAM, F
Definition

The patient's full name: William F. Goodpatient IV

It appears on his card:  William F. Goodpatient

How would you type the name?

Term
GOODPATIENT IV, WILLIAM, F
Definition
The name on the patient's ID card is William F. Goodpatient IV.  How do you write the name on a CMS-1500 form?
Term
True
Definition
T or F:  You don't use titles or other designations (Sr., III) unless they appear that way on the patient's ID card.
Term
TRICARE
Definition
_________ claims require entry of active duty sponsor rank/grade after the name.
Term

False

 

You enter both without hyphens or spaces

Definition
T or F: On CMS-1500 forms, you enter Social Security and employee identification numbers with spaces rather than hyphens
Term
medical biller
Definition
the person responsible for submitting a provider's charges to the appropriate party
Term
accounts receivable
Definition
monies owed to a physician for his or her services
Term
physician-based
Definition
pertaining only to a physician
Term
outsource
Definition
send work offsite
Term
medical billing company
Definition
an offsite company hired to process medical bills for the physician
Term
certification
Definition
a professional status or level earned by successful completion of an examination
Term
Certified Medical Reimbursement Specialist
Definition
What does CMRS stand for?
Term
a
Definition

The CMRS is offered by:

a) American Medical Billing Association

b) National Electronic Billers Alliance

c) National Healthcare Association

d) AHIMA

e) ACAP

Term
Certified Healthcare Reimbursement Specialist
Definition
What does CHRS stand for?
Term
b
Definition

CHRS is offered by:

a) American Medical Billing Association

b) National Electronic Billers Alliance

c) National Healthcare Association

d) AHIMA

e) ACAP

Term
National Electronic Billers Alliance
Definition
What does NEBA stand for?
Term
Certified Billing and Coding Specialist
Definition
What does CBCS stand for?
Term
National Helathcareer Association
Definition
What does NHA stand for?
Term
American Health Information Management Association
Definition
What does AHIMA stand for?
Term
NHA
Definition
Who offers CBCS certification?
Term
NEBA
Definition
Who offers CHRS certification?
Term
Certified in Healthcare Privacy
Definition
What does CHP stand for?
Term
AHIMA
Definition
Who offers CHP certification?
Term
Claims Assistance Professional
Definition
What does CAP stand for?
Term
Alliance of Claims Assistance Professionals
Definition
What does ACAP stand for?
Term
b
Definition

CAP means you are a member of :

a) AHIMA

b) ACAP

c) NEBA

d) NHA

Term
CEU
Definition
a level of measurement of noncredited education
Term
continuing education unit
Definition
What does CEU stand for?
Term
Health Insurance Portability and Accountability Act
Definition
What does HIPAA stand for?
Term
1996
Definition
What year was HIPAA put into regulations?
Term
submitting a provider's charges to the appropriate party
Definition
What is the primary duty of a medical biller?
Term

False

 

A medical biller may also have this job function

Definition
T or F:  While a medical biller submits claims, an accountant is always responsible for maintaining the physician's accounts receivable
Term
c
Definition

Physician-based billing refers to:

a) durable medical equipment billing

b) hospital room charges

c) charges for a physician's services

d) all of the above

e) a and c

Term
g
Definition

If a medical biller does not file accurate claims, it could result in:

a) physician not getting paid

b) physician will not be able to meet office expenses

c) physician may not be able to afford malpractice insurance

d) other employees of physician may not get paid

e) a physician could get audited

f) a physican could suffer legal consequences

g) all of the above

Term
e
Definition

Certification:

a) demonstrates dedication, skill, and achievement

b) makes a biller a step above those not certified

c) designates a biller as a professional

d) can be a deciding factor in getting a job

e) all of the above

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