Medical Billing MCQ Questions Answers

1. Which is the code for anesthesia (type of service code)?

2. In which box are the CPT codes entered on the CMS-1500 Form?

3. Ideal practice management software should have good reporting and multi-tasking capabilities.

4. Which component of HIPAA have been put into effect?

5. HIPAA provides protections for both Group Health Plans and Individual Coverage.

6. Which is not a suitable marketing strategy for medical billing business?

7. What is the full form of AIDA?

8. _____is an agreement made between the insurance company and the insured to send payments directly to the physician.

9. Which is not a coding convention?

10. Who can also be a guarantor?

11. Why was HIPAA enacted into a law?

12. Which does not cover preventive care services?

13. Which body is responsible for implementing the Privacy Rules

14. What is the role of a clearing house while submitting claims electronically?

15. Which is not necessarily a function performed by a medical biller?

16. If the patient deductible is $700, and the deductible met is $685, the coverage is 80/20 and the physician's charge is $75, how much should the patient pay?

17. What things should you emphasize on while selecting an attorney when starting your own medical billing business?

18. Which is not a type of insurance coverage?

19. Which correctly defines the Encounter Document?

20. What is a write off?

21. What is the way to determine the primary and secondary policy if a child is covered under both parent's policies?

22. National Provider Identifier is a _____ digit number.

23. Which is a more efficient and less time consuming method to submit your claims?

24. What do the CPT codes refer to?

25. In which method will you bill your clients for giving your services as a medical biller?

26. The component 'National Identifier Standards' fall under which component of HIPAA?

27. Which is not one of the co-operating parties which maintains and upgrades ICD-9-CM codes?

28. Which are the disclosures exempted from minimum necessary?

29. What is needed to file Worker's Compensation and Auto Insurance Claims?

30. How is the patient identified in case of Champva?

31. Which does the acronym HIPAA stand for?

32. What is not one of the eligibility criteria for Medicare?

33. What is the need for insurance verification?

34. What is the length of the standard CPT codes?

35. Identify the order of events after a claim reaches the insurance carrier: 1.Application of leftover deductible 2.Examining the procedures performed and the 'medical necessity' on these procedures 3.Application of 'allowable payments options' for every procedure performed 4.Review of the claim for proper formatting and information

36. Which information is needed to complete the CMS 1500 form?

37. What does the bottom of the CMS 1500 Form report?

38. What is an accident rider?

39. Which is not a kind of third-party reimbursement?

40. Which is the first phase of the insurance claim life cycle?

41. Which date format is used on the CMS 1500 Form?

42. What is a covered entity?

43. What are the main benefits of electronic claims?

44. What is a deductible?

45. Why were security standards created in HIPAA?

46. Why was the accountability component added to HIPAA?

47. Which is not a feature of Managed Care Plans?

48. If the patient deductible is $600, and the deductible met is $400, the coverage is 60/40 and the physician's charge is $95, how much should the patient pay?

49. It is necessary to attach a document called _________ when submitting a secondary claim.

50. Which aspects does administrative safeguards focus on?

51. What is a benefit?

52. Which is not a part of Patient Condition Information?

53. Which is required to organize your office as a medical biller?

54. What is not a part of the diagnosis information?

55. What is contained in the release of information (ROI) form?

56. What does the UB-04 form include?

57. CPT Codes are updated ________.

58. The 'Group' in the 'Group Health Insurance Card' refers to the _________.

59. Electronic Medical Claims (EMC) help to ___________.

60. What are modifiers?

61. In DME claims which of the following is necessary: Referring physician or Ordering physician?

62. If a provider is non-par, any allowed claim amount that is ______ billed charges should be unacceptable.

63. A ________ limits the amount of out-of-pocket expenses a patient will have to pay for TRICARE-covered medical services.

64. This type of workers compensation would be described as: abnormal conditions or disorders caused by exposure to enviromental factors. Examples of these could be exposure to a chemical, inhalation, ingestion or direct exposure.

65. Which one of the following is the largest Blue Cross Blue Shield member?

66. Medicare Advantages Plans cover consultation codes?

67. According to the MBAA, up to _____ % of US medical bills contain errors.

68. True or false? An individual on an HMO plan would need a referral to get a yearly mammogram.

69. What is the abbrevation for SSI?

70. Your office has discovered a breach of a patient’s PHI. How long do you have to notify the patient?

71. You must notify the local media if a breach of PHI involves ___ or more patients.

72. The form which is specifically used to bill dental services is called?

73. The federal law that was originally created to safeguard an employees retirement benefits is abbreviated as:

74. True or False? Med pay is a form of no-fault insurance.

75. Will Medicare accept a UB-92 form?

76. The incident-to rule:

77. The difference between the summarized income rate and the summarized cost rate over a given valuation period is the:

78. A health benefit plan allowing the patient to choose to receive a service from a group of contracted providers is a:

79. What is a challenge of processing medical bills off site?

80. Submitting several CPT treatment codes when only one code is necessary is called:

81. After the claim is paid, the payer requests documentation to support coding. What type of audit is this?

82. Coding for a name-brand medication when a generic brand was used is called __________.

83. Medical care, other than those provided by the physician or hospital, which are related to a patient’s care, are called:

84. Tricare was formerly known as

85. A 3-digit number used on hospital bills to tell the insurer where the patient was when they received treatment, or what type of item a patient received, is the:

86. True or False: A Heralding Notice from a payer is a notice that your office has been targeted for an audit.

87. Which one of the following was known as Medicare + Choice?

88. HEAT is an effort of which federal agency(ies)?

89. The average amount Medicare will pay a provider or hospital for a procedure is the:

90. How many digits are in a National Provider Identifier?

91. Level II HCPCS codes are formatted as a single letter followed by _________.

92. True or false? The coder should NOT correct any errors in a bill.

93. What are modifiers used for?

94. The claim form for billing for facility fees which replaces the UB92 form is the _______ form.

95. In March 2013, Noridian (Medicare Part B contractor in jurisdictions E and F) issued what type of review in Arizona?

96. What could POS exactly stand for in Medical Billing?

97. What is the minimum number of patients affected by a breach of PHI that requires you to personally notify the patient(s) of a breach?

98. When is it acceptable for a physician to accept a gift from a patient?

99. True or False? The difference between the Medicare and Medicaid allowable is that Medicaid does NOT pay a percentage of the allowed amount.

100. Health insurance coverage which is contracted to supplement Medicare coverage is called: