CMAS CMAS Financial Management & Accounting 2 — Questions and Answers
Question 1: What is a superbill in medical office billing?
- A large invoice sent to hospital systems
- A document listing services rendered during a patient visit used to generate a claim (Correct answer)
- An itemized bill mailed directly to the patient after insurance pays
- A government-issued billing manual for Medicare providers
Correct 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.
Question 2: Which federal law requires employers to withhold Social Security and Medicare taxes from employee wages?
- HIPAA
- FLSA
- FICA (Correct answer)
- ERISA
Correct answer: FICA
The Federal Insurance Contributions Act (FICA) mandates withholding of Social Security (6.2%) and Medicare (1.45%) taxes from employee paychecks.
Question 3: 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?
- Bill the patient for the full amount immediately
- Verify whether a prior authorization was obtained and appeal with supporting documentation if applicable (Correct answer)
- Write off the balance as a contractual adjustment
- Resubmit the claim without changes
Correct 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.
Question 4: What is the purpose of a fee schedule in a medical practice?
- To list the prices a practice charges for its services before contractual adjustments (Correct answer)
- To document patient financial assistance programs
- To set insurance company reimbursement rates
- To track employee overtime hours
Correct 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.
Question 5: Which accounting method records revenue when it is earned and expenses when they are incurred, regardless of cash flow?
- Cash basis accounting
- Accrual basis accounting (Correct answer)
- Single-entry bookkeeping
- Modified cash basis accounting
Correct answer: Accrual basis accounting
Accrual accounting recognizes transactions when they occur, providing a more accurate picture of financial performance than cash basis.
Question 6: What is the main purpose of a collections policy in a medical office?
- To prevent patients from making complaints
- To establish consistent procedures for collecting patient balances and managing delinquent accounts (Correct answer)
- To reduce the number of insurance plans accepted
- To eliminate the need for an accounts receivable team
Correct 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.
CMAS CMAS Financial Management & Accounting 2
What is a superbill in medical office billing?