CMAS Financial Management & Accounting Flashcards

What is a superbill in medical office billing?

Answer: A document listing services rendered during a patient visit used to generate a claim

A superbill (encounter form) captures diagnosis codes, procedure codes, and services provided during a visit to support claim submission.

Which federal law requires employers to withhold Social Security and Medicare taxes from employee wages?

Answer: FICA

The Federal Insurance Contributions Act (FICA) mandates withholding of Social Security (6.2%) and Medicare (1.45%) taxes from employee paychecks.

A medical practice receives an Explanation of Benefits (EOB) showing a claim was denied due to 'no authorization on file.' What should the billing staff do first?

Answer: Verify whether a prior authorization was obtained and appeal with supporting documentation if applicable

Staff should first verify if an authorization exists and, if so, appeal the denial with documentation; if not, determine if retroactive authorization is possible.

What is the purpose of a fee schedule in a medical practice?

Answer: To list the prices a practice charges for its services before contractual adjustments

A fee schedule lists the standard charges a practice assigns to each service, which are then adjusted based on payer contracts and allowed amounts.

Which accounting method records revenue when it is earned and expenses when they are incurred, regardless of cash flow?

Answer: Accrual basis accounting

Accrual accounting recognizes transactions when they occur, providing a more accurate picture of financial performance than cash basis.

What is the main purpose of a collections policy in a medical office?

Answer: To establish consistent procedures for collecting patient balances and managing delinquent accounts

A collections policy standardizes how staff pursue overdue balances, protecting revenue while maintaining patient relationships and legal compliance.