AMCA Administrative Skills 3 — Questions and Answers
Question 1: Which of the following best describes a 'matrix' in appointment scheduling?
- A color-coded patient priority system
- Blocked time periods when the provider is unavailable (Correct answer)
- A list of patient diagnoses
- A spreadsheet tracking insurance payments
Correct answer: Blocked time periods when the provider is unavailable
A scheduling matrix blocks off times when the provider is out, in surgery, or otherwise unavailable for appointments.
Question 2: When a patient's account is sent to a collection agency, which step must occur first according to standard billing practice?
- File a complaint with the state medical board
- Send the patient a final notice and allow a response period (Correct answer)
- Immediately report the patient to credit bureaus
- Transfer the balance to the provider's personal account
Correct answer: Send the patient a final notice and allow a response period
Patients must receive adequate notice and opportunity to respond before their account is escalated to collections.
Question 3: What is the main purpose of a charge capture process in medical billing?
- To collect co-pays at the front desk
- To ensure all billable services are documented and coded (Correct answer)
- To authorize laboratory orders
- To schedule follow-up appointments
Correct answer: To ensure all billable services are documented and coded
Charge capture ensures every service provided is recorded with the appropriate code so it can be billed to the payer.
Question 4: Under HIPAA, which of the following is NOT considered protected health information (PHI)?
- Patient's date of birth linked to a diagnosis
- Patient's name linked to a treatment record
- A patient's de-identified statistical health data (Correct answer)
- Patient's address linked to a prescription
Correct answer: A patient's de-identified statistical health data
Fully de-identified data that cannot be linked to a specific individual is not considered PHI under HIPAA.
Question 5: A patient requests a copy of their medical records. Under HIPAA, within how many days must the practice respond?
- 10 days
- 30 days (Correct answer)
- 60 days
- 90 days
Correct answer: 30 days
HIPAA requires covered entities to provide access to records within 30 days of the request, with one possible 30-day extension.
Question 6: Which ICD-10-CM guideline requires coding to the highest level of specificity?
- Code first underlying condition
- Use the most specific code available (Correct answer)
- Always code the first-listed diagnosis only
- Assign unspecified codes when available
Correct answer: Use the most specific code available
ICD-10-CM guidelines direct coders to use the most specific code that accurately reflects the documented diagnosis.
Question 7: What does 'prior authorization' mean in the context of medical office administration?
- Approval from the patient before scheduling
- Insurance approval required before certain services are rendered (Correct answer)
- Physician sign-off on the superbill
- Verification that a patient has met their deductible
Correct answer: Insurance approval required before certain services are rendered
Prior authorization is insurer approval obtained before providing specific services or prescribing certain medications to ensure coverage.
AMCA Administrative Skills 3
Which of the following best describes a 'matrix' in appointment scheduling?