CPAT CPAT Patient Registration & Admissions 2 — Questions and Answers
Question 1: What is 'insurance eligibility verification' and when should it be performed?
- Confirming coverage before or at the time of service (Correct answer)
- Reviewing a patient's medical history
- Processing a claim after the visit
- Calculating patient cost-sharing after service
Correct answer: Confirming coverage before or at the time of service
Eligibility verification confirms active insurance coverage and benefits, and should ideally occur before the date of service.
Question 2: What information is typically captured in the master patient index (MPI)?
- Only billing codes and charges
- Unique patient identifiers and demographic data (Correct answer)
- Insurance claim status only
- Physician credentialing information
Correct answer: Unique patient identifiers and demographic data
The MPI is a database that uniquely identifies each patient using demographic and identifying information to prevent duplicate records.
Question 3: A patient presents to the emergency department and is unable to provide personal information. What registration process is used?
- Refuse registration until information is provided
- Use a temporary or 'John/Jane Doe' registration protocol (Correct answer)
- Bill the patient without registration
- Delay treatment until information is obtained
Correct answer: Use a temporary or 'John/Jane Doe' registration protocol
Temporary or alias registration allows care to proceed while complying with EMTALA requirements when patient information is unavailable.
Question 4: What is the purpose of obtaining an Advance Beneficiary Notice (ABN)?
- To obtain consent for surgery
- To notify Medicare patients that a service may not be covered so they can choose to proceed and accept financial responsibility (Correct answer)
- To verify Medicaid eligibility
- To document patient allergies
Correct answer: To notify Medicare patients that a service may not be covered so they can choose to proceed and accept financial responsibility
An ABN informs Medicare patients in advance if a service may be denied as not medically necessary, giving them the option to accept liability.
Question 5: Which of the following is an example of a duplicate medical record?
- A patient with two different diagnoses
- The same patient registered twice under different names or ID numbers (Correct answer)
- Two patients with the same last name
- A patient with both Medicare and Medicaid
Correct answer: The same patient registered twice under different names or ID numbers
Duplicate records occur when the same patient is entered into the system more than once, leading to fragmented care records and billing errors.
Question 6: What is 'pre-registration' in the revenue cycle?
- Registering a patient after discharge
- Collecting patient information and verifying insurance before the scheduled date of service (Correct answer)
- Submitting a claim to the payer
- Posting payments to patient accounts
Correct answer: Collecting patient information and verifying insurance before the scheduled date of service
Pre-registration streamlines the check-in process by gathering demographic and insurance information prior to the visit, reducing day-of delays.
CPAT CPAT Patient Registration & Admissions 2
What is 'insurance eligibility verification' and when should it be performed?