Prepare for the Medical Administrative Assistant certification exam with these study guide questions and answers. This covers scheduling, medical records, billing, and office management.
Q: Computer Scheduling
Answer: Electronic appointment book
Q: Book Scheduling
Answer: Hard copy appointment book
Q: Wave Booking
Answer: Patients are scheduled at the same time each hour to create short-term flexibility each hour.
Q: Modified Wave Booking
Answer: Wave booking can be modified in a couple of different ways. One example of this approach is to schedule two patients to come at 9 a.m. and one patient at 9:30 a.m. This hourly cycle is repeated throughout the day.
Q: Double Booking
Answer: Two patients are scheduled to come at the same time to see the same physician.
Q: Stream/time-Specific Scheduling
Answer: Scheduling patients for specific times at regular intervals. The amount of time allotted depends on the reason for the visit.
Q: Open Booking (tidal wave scheduling)
Answer: Patients are not scheduled for a specific time, but told to come in at intermittent times. They are seen in the order in which the arrive.
Q: Cluster or Categorization Booking
Answer: Booking a number of patients who have specific needs together at the same time of day.
Q: Matrix
Answer: A grid with time slots blocked out when physicians are unavailable or the office is closed.
Q: Template
Answer: A document with a preset format that is used as a starting point so that it does not have e recreated each time.
Q: Screening System
Answer: Procedures to prioritize the urgency of a call to determine when the patient should be seen.
Q: Certified Mail
Answer: First-class mail that also gives the mail added protection by offering insurance, tracking, and return receipt options.
Q: Appointment Cards
Answer: Used to remind patients of scheduled appointments and to eliminate misunderstandings about dates and time.
Q: Health Insurance Portability and Accountability Act (HIPAA) of 1996
Answer: Legislation that includes Title II, the first parameters designed to protect the privacy and security of patient information.
Q: What are three advantages of computer scheduling?
Answer: Display available and scheduled times; length and type of appointment required and day or time preferences.
Q: When scheduling appointments, what factors need to be taken into account?
Answer: The needs of the patient, the habits and preferences of the provider, and the capacity of the facility.
Q: Electronic Medical Record (EMR)
Answer: An electronic record of health information that is created, added to, managed, and reviewed by authorized providers and staff within a single health care organization.
Q: Advance Directive Form
Answer: Document that spells out what kind of treatment a patient wants in the event that he can’t speak for himself. Also known as living will.
Q: Protected Health Information (PHI)
Answer: Information about health status or health care that can be linked to a specific individual.
Q: What are three types of demographics?
Answer: Name, address, and marital status.
Q: Health Insurance
Answer: Financial support for medical needs, hospitalization, medically necessary diagnostic tests and procedures, and may kinds of preventive services.
Q: Electronic Health Record (EHR)
Answer: An electronic health record of health-related information about a patient that conforms to nationally recognized interoperability standards that can be created, managed, and reviewed by authorized providers and staff from more than one health care organization.
Q: Co payment
Answer: Fees collected from patient at the time of services.
Q: Guarantor
Answer: Person or entity responsible for the remaining payment of services after insurance has paid.
Q: Birthday Rule
Answer: The health plan of the parent whose birthday comes first in the calendar year is designated as the primary plan.
Q: Healthcare Common Procedure Coding System (HCPCS)
Answer: A group of codes and descriptors used to represent health care procedures, supplies, products, and services.
Q: Reimbursement
Answer: Payment from insurance companies.
Q: International Classification of Diseases, ICD-9-CM and/or ICD-10-CM
Answer: Track a patient’s diagnosis and clinical history.
Q: Current Procedural Terminology (CPT) and Healthcare Common Procedure Coding System (HCPCS)
Answer: Are used to report provider services for the purpose of reimbursement.
Q: Medicare
Answer: Federally funded health insurance provided to people age 65 or older, people younger than 65 who have certain disabilities, and people of all ages with end-stage kidney disease.
Q: Modifiers
Answer: Added information or changed description of procedures and services, and are a part of valid CPT or HCPCS codes.
Q: Health History
Answer: Form that asks patients to list any illnesses or surgeries they have had, family history, medications taken, chronic health issues, allergies, and other physicians they consulted.
Q: Notice of Privacy Practices
Answer: Document informing a patient of when and how their PHI can be used.
Q: Consent
Answer: A patient’s permission
Q: Patient Financial Responsibility form
Answer: Form that confirms that the patient is responsible for payments to the provider.
Q: Assignment of benefits (AOB) form
Answer: Form that authorizes health insurance benefits to be sent directly to providers.
Q: Living Will
Answer: Document that spells out what kind of treatment a patient wants in the even that he can’t speak for himself. Also know as advance directive.
Q: DNR Form
Answer: Form that states that the patient does not want to be revived after experience a heart episode or other kind of life-threatening event.
Q: Encounter Form
Answer: A document used to collect data about elements of a patient visit that can become part of a patient record or be used for management purposes.
Q: Regular Referral
Answer: When a physician decides that a patient needs to see a specialist.
Q: Urgent Referral
Answer: When and urgent, but not life-threatening, situation occurs, requiring that the referral be taken care of quickly.
Q: STAT Referral
Answer: Needed in an emergency situation, and can be approved immediately over the telephone after the utilization review has approved the faxed document.
Q: Active Files
Answer: Section of medical charts for patients currently receiving treatment.
Q: Inactive Files
Answer: Section of medical charts for patients the provider has not seen for 6 months or longer.
Q: Closed Files
Answer: Section of medical charts for patients who have died, moved away, or terminated their relationship with the physician.
Q: Purging
Answer: The process of moving a file from active to inactive status
Q: Provisional Diagnosis
Answer: A temporary or working diagnosis.
Q: Differential Diagnosis
Answer: The process of weighing the probability that other diseases are the cause of the problem.
Q: Direct Filing System
Answer: System in which the only information needed for filing and retrieval is a patient’s name.
Q: Cross-reference
Answer: Reference to corresponding information in a separate location.
Q: Privacy Rule
Answer: A HIPAA rule that establishes protections for the privacy of individual’s health information.
Q: Individually Identifiable Health Information
Answer: Documents or bits of information that identify the person or provide enough information so that the person could be identified.
Q: Bookkeeping
Answer: Part of the office’s accounting functions, to include recording, classifying, and summarizing financial transactions.
Q: Copayment
Answer: A fixed fee for a service or medication, usually collected at the time of service or purchase.
Q: Deductible
Answer: The amount a patient must pay before insurance pays anything.
Q: Coinsurance
Answer: A form of cost sharing the kicks in after the deductible has been met.
Q: Statement
Answer: A request for payment.
Q: Explanation of Benefits (EOB)
Answer: A record of a patient’s fees.
Q: Accounts Receivable Ledger
Answer: Document that provides detailed information about charges, payments, and remaining amounts owed to a provider.
Q: Fee-for-service
Answer: Model in which providers set the fees for procedures and services.
Q: Allowable Amount
Answer: The limit that most insurance plans put on the amount that will be allowed for reimbursement for a service or procedure.
Q: Resource-based Relative Value Scale (RBRVS)
Answer: System that provides national uniform payments after adjustments across all practices throughout the country.
Q: Medicare Part B
Answer: Voluntary supplemental medical insurance to help pay for physicians’ and other medical professionals’ services, medical services, and medical-surgical supplies not covered by Medicare Part A.
Q: Petty Cash Fund
Answer: A small amount of cash available for expenses such as postage, parking fees, small contributions, emergency supplies, and miscellaneous small items.
Q: Disbursement
Answer: The record of the funds distributed to specific expense accounts.
Q: Daily Journal
Answer: A chronological record of bills received, bills paid, and payments and reimbursements received.
Q: Day Sheet
Answer: A daily record of financial transactions and services rendered.
Q: End-of-day Summary
Answer: Document consisting of proof of posting sections, month-to-date accounts receivable proof, and year-to-date accounts receivable proof.
Q: Single-entry System
Answer: A method of bookkeeping that relies on a one-sided accounting entry to maintain financial information.
Q: General Journal
Answer: Document where transactions are entered.
Q: Double-entry bookkeeping
Answer: A system in which every entry to an account requires an opposite entry to a different account.
Q: Subsidiary Journals
Answer: A document where transactions are summarized and later recorded in a general ledger.
Q: Invoice
Answer: A document that describes items purchased or services rendered and shows the amount due.
Q: Assets
Answer: The properties owned by a business.
Q: Equities
Answer: What is left of assets after creditors’ liabilities have been subtracted.
Q: Liabilities
Answer: The equity of those to whom money is owed (creditors).
Q: First-class Mail
Answer: Sealed or unsealed typed or handwritten material, including letters, postal cards, postcards, and business reply mail.
Q: Priority Mail
Answer: First-class mail weighing more than 13 ounces.
Q: Standard Mail
Answer: Mail that includes advertising, promotional, directory, or editorial material, or any combination of such material.
Q: Insured Mail
Answer: Mail that has insurance coverage against loss or damage.
Q: Registered Mail
Answer: Mail of all classes protected by registering and requesting evidence of its delivery.
Q: Packing Slip
Answer: A list of items in a package.
Q: Terminal Numbering System
Answer: Assigning consecutive numbers to patients while separating the digits in the number into groups of twos or threes.