NHI Administrative Duties and Records 3 — Questions and Answers
Question 1: When a patient's insurance claim is denied, what is the appropriate next administrative step?
- Immediately bill the patient for the full amount
- File an appeal with supporting documentation (Correct answer)
- Write off the claim as a loss
- Contact the state medical board
Correct answer: File an appeal with supporting documentation
Filing an appeal with supporting clinical documentation gives the practice the opportunity to have the denial reconsidered by the insurer.
Question 2: Which scheduling method blocks off chunks of time for specific types of appointments such as physicals or procedures?
- Wave scheduling
- Cluster scheduling (Correct answer)
- Open booking
- Double booking
Correct answer: Cluster scheduling
Cluster scheduling groups similar appointment types together in designated time blocks to improve workflow efficiency.
Question 3: What does a 'superbill' contain in a medical office?
- A list of all staff salaries for the month
- Diagnosis and procedure codes used to generate a patient invoice (Correct answer)
- A summary of all insurance contracts on file
- Monthly overhead expense tracking
Correct answer: Diagnosis and procedure codes used to generate a patient invoice
A superbill is a document containing diagnosis (ICD) and procedure (CPT) codes that serves as the basis for billing patients and insurers.
Question 4: In medical transcription, what is the role of the administrative medical assistant when reviewing a transcribed report?
- Rewrite the physician's dictation in simpler language
- Proofread for accuracy, spelling, and formatting errors (Correct answer)
- Add clinical opinions and diagnoses as needed
- Translate the report into patient-friendly language
Correct answer: Proofread for accuracy, spelling, and formatting errors
The administrative medical assistant proofreads transcribed documents for accuracy, correct spelling of medical terminology, and proper formatting.
Question 5: Which form is used by patients to designate another person to make healthcare decisions on their behalf?
- Advance beneficiary notice (ABN)
- Healthcare power of attorney (Correct answer)
- HIPAA authorization form
- Assignment of benefits form
Correct answer: Healthcare power of attorney
A healthcare power of attorney legally designates a person to make medical decisions for a patient who becomes unable to do so.
Question 6: What is the standard recommended minimum time to retain adult patient medical records?
- 1 year after the last visit
- 3 years after the last visit
- 7 years after the last visit (Correct answer)
- 10 years after the last visit
Correct answer: 7 years after the last visit
Most states and medical guidelines recommend retaining adult patient records for at least 7 years, though requirements vary by state.
Question 7: A patient who does not speak English arrives at the front desk. What is the best administrative response?
- Ask the patient to bring a family member next time
- Use a professional medical interpreter or translation service (Correct answer)
- Communicate only through written notes in English
- Reschedule the appointment until a bilingual staff member is available
Correct answer: Use a professional medical interpreter or translation service
Federal law requires healthcare facilities to provide language assistance services to patients with limited English proficiency at no cost.
NHI Administrative Duties and Records 3
When a patient's insurance claim is denied, what is the appropriate next administrative step?