Administrative Procedures Flashcards

A patient has two insurance plans. Which plan is billed first when the patient is a child whose parents are both insured and not divorced?

Answer: The plan of the parent with the earlier birthday in the calendar year

The birthday rule makes the parent whose birthday falls earlier in the year the primary payer.

Which of the following is a recommended practice when taking a telephone message for a provider?

Answer: Record date, time, caller name, callback number, reason for call, and your initials

A complete message includes who, when, how to reach them, why, and who took it.

What does the acronym ICD-10-CM primarily code?

Answer: Diagnoses and conditions

ICD-10-CM is the system for coding diagnoses; CPT codes procedures.

A check written by a patient is returned by the bank marked 'NSF.' What does NSF mean?

Answer: Non-sufficient funds

NSF stands for non-sufficient funds, meaning the account lacked money to cover the check.

Which type of appointment scheduling is MOST appropriate for a provider who wants to reserve certain times each day for emergencies and walk-ins?

Answer: Open office hours or buffer blocks

Open hours or buffer time leave flexibility for walk-ins and urgent cases.

In the problem-oriented medical record (POMR), the acronym SOAP stands for:

Answer: Subjective, Objective, Assessment, Plan

SOAP organizes documentation into Subjective, Objective, Assessment, and Plan.

Which statement about the minimum necessary standard under HIPAA is correct?

Answer: It requires limiting use and disclosure of PHI to only what is needed for the purpose

Minimum necessary limits PHI use and disclosure to what is needed, with exceptions such as treatment and disclosures to the patient.