CHAA Financial Processes 2

Question 1

A patient's insurance plan has a $2,000 deductible and they have met $1,500. What should the access associate communicate about a $800 procedure?

Accepted Answer

The patient may owe approximately $500 toward the deductible plus any applicable coinsurance

Answer

The patient owes nothing because they have insurance

Answer

The patient must pay the full $800 upfront

Answer

Financial discussions should wait until after the procedure

Question 2

What is the primary purpose of collecting point-of-service (POS) payments?

Accepted Answer

To reduce accounts receivable days and improve cash flow

Answer

To generate revenue before insurance processes the claim

Answer

To penalize patients for seeking medical care

Answer

To verify the patient's identity

Question 3

A patient qualifies for charity care but also has Medicaid. How should this be handled?

Accepted Answer

Bill Medicaid first as the primary payer, then apply charity care to remaining balance if applicable

Answer

Apply charity care first since it covers more

Answer

Let the patient choose which program to use

Answer

Deny charity care since they have Medicaid

Question 4

What does 'timely filing' refer to in the context of healthcare billing?

Accepted Answer

Submitting insurance claims within the payer's deadline to avoid denial

Answer

Filing patient charts within 24 hours of discharge

Answer

Completing patient registration before the appointment time

Answer

Filing tax documents for the healthcare organization

Question 5

Which document is required before providing a patient with a good faith estimate under the No Surprises Act?

Accepted Answer

A scheduled service or a patient request for an estimate

Answer

A signed consent to treat

Answer

A referral from the primary care physician

Answer

Pre-authorization from the insurance company

Question 6

What is a 'clean claim' in healthcare billing?

Accepted Answer

A claim submitted with all required data elements and no errors

Answer

A claim that has been sanitized of patient identifiers

Answer

A claim that was paid on first submission regardless of accuracy

Answer

A claim with no associated patient balance