Administrative Duties and Records Flashcards
7 cards from real NHI practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Administrative Duties and Records flashcards as text
In the context of medical billing, what is a 'clean claim'?
Answer: A claim free of errors that can be processed without additional information
A clean claim contains all required information and is free of errors, allowing the insurer to process and adjudicate it without requesting additional data.
Which scheduling technique allows two patients to be booked at the same appointment time, with one seen by the physician and one completing intake paperwork?
Answer: Double booking
Double booking places two patients in the same time slot, relying on intake procedures and staggered readiness to keep the provider productive.
When verifying a patient's insurance eligibility, which information is most critical to confirm?
Answer: Coverage effective dates, deductible status, and co-pay amounts
Confirming coverage dates, deductible status, and co-pay amounts ensures accurate billing and informs the patient of their financial responsibility before the visit.
What is the correct action when a patient verbally requests changes to their demographic information at check-in?
Answer: Have the patient complete and sign a demographic update form
Patients should complete and sign a demographic update form so changes are documented and the updated information can be verified before entering it into the system.
Which ICD code set is used in the United States for documenting diagnoses in medical records and claims?
Answer: ICD-10-CM
ICD-10-CM (International Classification of Diseases, 10th Revision, Clinical Modification) is the US standard for coding diagnoses on claims and health records.
A patient presents a Medicare card and a secondary insurance card. In what order should the claims be filed?
Answer: Medicare first, then submit the secondary claim with the Medicare Explanation of Benefits
Medicare is filed as the primary payer first; once the Explanation of Benefits (EOB) is received, the secondary claim is filed with that EOB attached.
What is the best practice for handling a telephone message that requires physician follow-up?
Answer: Document the message in the patient's chart or EHR and route it to the physician for action
Documenting telephone messages in the patient's chart or EHR and routing them to the physician ensures the communication is tracked, actionable, and part of the medical record.