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127 Cards in this Set
- Front
- Back
Bronchoscopy means the same as: |
bronchoscopic examination |
|
A percutaneous lung biopsy is: |
removal of small bits of tissue by puncture of the suspected lesion through the skin |
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A term for occurring in sudden, periodic attack is: |
paroxysmal |
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Air and blood in the pleural cavity is called: |
pneumohemothorax |
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Absence of voice is called |
aphonia |
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A disease process that causes decreased ability of the lung to perform their ventilatory function and can result from several other chronic disorders of the respiratory organs is called: |
COPD |
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A term that means "pertaining to the windpipe and the bronchi" is: |
tracheobronchial |
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bradypnea means: |
abnormally slow breathing |
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the trachea is the: |
windpipe |
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Thoracic refers to the; |
chest |
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plastic surgery of the nose is: |
rhinoplasty |
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labored or difficult breathing is: |
dyspnea |
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a machine for prolonged artifical respiration? |
ventilator |
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the term pneumatically pertains to the: |
heart and lungs |
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the lidlike structure that covers the voice box during the swallowing of food is called the: |
epiglottis |
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A respiratory condition characterized by paroxysmal dyspnea and wheezing is called: |
Asthma |
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A chronic disease characterized by increased size of alveoli and destructive changes of their walls called: |
emphysema |
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Absence of breathing is termed: |
apnea |
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rhinitis is inflammation of the: |
nose |
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the term pulmonary refers to the: |
lungs |
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Pharyngyitis is inflammation of the: |
throat |
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Chronic laryngitis is most likely to cause what? |
aphonia |
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material raised from inflamed membranes of the respiratory tract is called? |
sputum |
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spirometry is |
the measurement of the amount of air taken into and expelled from the lungs |
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the sudden blocking of an artery by a foreign material is called |
embolism |
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pneumonia is |
inflammation of the lungs |
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the throat is the |
pharynx |
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tracheotomy means |
incision of the windpipe through the skin and muscles of the neck overlaying it |
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the term for a whistling sound made during respiration is: |
wheeze |
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the largest volume of air that can be expelled after maximal inspiration is called |
vital capacity |
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abnormally fast breathing and spell it |
hypernpea |
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across the windpipe and spell it |
transtracheal |
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blood in the pleural cavity and spell it |
hemothorax |
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inflammation of the bronchi and spell it |
bronchitis |
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normal respiration and spell it |
Eupnea |
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pertaining to the windpipe and spell it |
tracheal |
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radiography of the bronchi and spell it |
bronchography |
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time limits stated in individual health insurance policies about an insurance company's obligation to pay benefits are the same for all insurance companies? true or false? |
FALSE |
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there is standardization of format for the explanation of benefit document for all private insurance carriers true or false? |
false |
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insurance companies are rated according to the number of complaints received about them true or false? |
true |
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The status of electronic insurance claims may be accessed quickly electronically or telephonically by digital response systems true or false? |
True |
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Inquiries about insurance claims may be in writing or by telephone true or false? |
True |
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In the case of medicare part B redetermination, carriers have been instructed to pay an appealed insurance claim if the cost of the hearing process is more than the amount of the claim true or false? |
True |
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Routine use of too many nonspecific diagnostic codes may result in downcoding true or false? |
true |
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in any type of overpayment situation, always cash the third-party payers check and write a refund check payable to the originator of the overpayment true or false? |
true |
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if the provider is notified by a commercial insurance carrier that an overpayment has been made investigate the refund request true or false? |
true |
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a level 1 medicare re determination (appeal) may be made either by telephone, in writing or by submitting a CMS-20027 form true or false? |
true |
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a peer review is usually done before the appeal process true or false? |
false |
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the highest level of a medicare re determination is with an administrative law judge hearing. |
false |
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if an insured is in disagreement with the insurer for settlement of a claim, a suit must begin within... |
3 years |
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if a payment problem develops with an insurance company and the company ignores claims and exceeds time limits to pay a claim, it is prudent to contact the |
state insurance commisioner |
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the document together with the payment voucher that is sent to a physician who has accepted assignment of benefits is refereed to as an |
EOB |
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AN INSURANCE CLAIMS REGISTER PROVIDES A |
follow-up procedure for insurance claims |
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pending or resubmitted insurance claims may be tracked through a |
tickler file |
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There are several way to file pending insurance claims. What is the best way to file so that timely follow-up can be made? |
File by patients last name |
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A follow up effort made to an insurance company to locate the status of an insurance claim is called a/an |
inquiry |
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if an insurance claim has been lost by the insurance carrier. the procedures to follow is to ... |
ask if there is a backlog of claims at the insurance office |
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An example of a technical error on an insurance claim is |
Duplicate dates of servuce |
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An insurance claim with an invalid procedure code would be |
rejected |
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what would you do if an insurance carrier requests information about another insurance carrier |
provide the information |
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what would you do if an insurance claim denial is received because a billed service was not a program benefit? |
Send the patient a statement with a notation of the response from the insurance company |
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What should be done if an insurance company denies a service stating it was not medically necessary and the physician believes it was? |
re bill with a letter of explanation from the physician |
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if an insurance company admits that a patient signed an assignments of benefits document and that it inadvertently paid the patient instead of the physician the insurance company should... |
pay the physician within 2-3 weeks and honor the assignment even before the company recovers its money from the patient. |
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the total number of levels of predetermination that exist in the medicare program is |
five |
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the first level of appeal in the medicare program is |
redetermination |
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the correct method to send documents for a medicare reconsideation (level2) is by |
certified mail with return reciept requested |
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a request for a medicare administrative law judge hearing can be made if the amount in controversy is at least |
$120 |
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an insured person cannot bring legal action against an insurance company until _____ days after a claim is submitted to the insurance company |
60 |
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Documentation from private insurance carriers sent to participating providers that accompanies payment and describes the response to claim is referred to by the acronym ________ |
EOB |
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Monitoring the activities of insurance companies and making sure that the interests of the policyholders are protected is the job of the insurance ____________. and spell it |
commission |
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all requests of the insurance commissioner must be submitted in writing and include the _________ signature. and spell it |
patient's |
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a suspense or follow-up file used to track pending insurance claims is also called a/an _________ and spell it |
tickler |
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overdue payment on an insurance claim is referred to as ________________ and spell it |
Delinquent claims
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An insurance claim that is pending because of need for additional information is also referred to as being in _________ and spell it |
suspended claim |
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If the medical practice receives payment from an insurance company that is more than the contract rate, it is called a/an________ and spell it |
overpayment |
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Generally, if a bill has not been paid, the physician rebills the patient every ____________ days. |
30 |
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if inadequate payment was received from an insurance company for a complicated procedure, the insurance billing specialist should file an __________ on behalf of the physician. and spell it |
appeal |
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It is often the practice administrator who is responsible for the business portion of the practice. true or false? |
true |
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a large percentage of reimbursement in a physician's office is generated from third-party payers. true or false? |
true |
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information provided on the patient registration form will prove critical to any billing and collection efforts. true or false? |
true |
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When no business or home telephone number is listed on the patient registration form, this may be an indication of a future nonpaying patient true or false? |
true |
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a collection rate of 80% to 85% should be a goal for the practice administrator in charge of collections in the physicians office. true or false? |
false |
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most medical practices operate with a set of fees that must be applied to all patients in the practice true or false? |
true |
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when a physician offers a discount, it must apply to the total bill, not just the portion that is paid by the patient true or false? |
true |
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it is legal to offer patients a cash discount when the entire fee is paid at the time of service true or false? |
true |
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in most situations, both private insurers and the federal government ban waiting the copayment portion of the patient's fee. true or false? |
true |
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you should not give patients the option of asking if they would like to pay not or have a bill sent true or false? |
true |
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in trying to collect an unpaid balance, a telephone interview is preferred to a personal interview true or false? |
false |
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If a patient writes "paid in full" on a check against an account that will not be paid in full with the check, the acceptance of the check indicates an acceptance of the "paid in full" remark true or false? |
false |
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one person or one department should handle all billing questions true or false? |
true |
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the best and most effective collection statements include and handwritten note true or false? |
true |
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refunds may be made by check on accounts in which payment was made by credit card true or false? |
false |
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a patient has $600 balance and agrees to a payment plan of $100 in six installments. If he or she skips the third installment and sends in $25 the following month, the physician can send the account to a collection agency true or false? |
true |
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when a physician continues to treat a patient with an overdue account, the courts have viewed this as an extension of cred. therefor patients who fall into this delinquent status should be referred elsewhere true or false? |
true |
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according to the FDCPA, debtors can never be contacted at work true or false? |
false |
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medicare accounts may not be written off until sequential statements have been sent with an increasing intensity in the collection message and genuine collection efforts has been made true or false? |
true |
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statements should not be sent to a patient who has filed for bankruptcy true or false? |
true |
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insurance billing specialists who handle checks or cash should be bonded and insured true or false? |
true |
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cash flow is |
the ongoing availability of cash in the medical practice. |
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when insurance carriers do not pay claims in a timely manner, what effect does this have on the medical practice? |
Decreased cash flow |
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what does the insurance billing specialist need to monitor and be able to evaluate the effectiveness of the collection process? |
accounts recievable |
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accounts that are 90 days or older should not exceed |
15% to 18% of the total accounts receivable |
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what should be done to inform a new patient of office fees and payment polices?` |
All of the above |
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The patient is likely to be the most cooperative furnishing details necessary for a complete registration process |
before any services are provided |
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professional courtesy means |
applying a discount (percentage) to the entire fee |
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when collecting fees your goal should always be to |
collect as much as poddible |
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the most common method of payment in the medical office is |
personal checks |
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when the physicians office receives notice that a check was not honored the first thing to do is to |
call the bank or the patient |
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accounts receivable are usually aged in time periods of |
30,60,90, and 120 days |
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employment of billing service is called |
outsiurcing |
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the first statement should be |
presented at the time of servuce |
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the first telephone call to the patient to try to collect on an account should be made |
after there is no response from the third statement |
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what is the name of the act designed to address the collection practices of the third party debt collectors and attorneys who regularly collect debts for others? |
fair debt collection practices act |
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All collection calls should be placed |
after 8am and before 9pm |
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which group accounts would a collector target when he or she begins making telephone calls? |
60-90 day accounts |
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in making collection telephone calls to a group of accounts, how should the agents be organized to determine where to begin? |
organize the accounts according to amounts owed and start with the largest amount |
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when writing a collection letter |
use a friendly tone and ask why payment hasnt been made |
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if an insurance company seems to be ignoring all efforts to trace a claim, send a copy of the |
history of the account |
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in a bankruptcy case, most medical bills are considered |
unsecured debt |
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which type of bankruptcy is considered "wage earners bankruptcy?" |
chapter 13 |
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the unpaid balance due from patients for services that have been rendered is called ___________ spell it |
accounts recievable |
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the patient information sheet is also known as the_________ spell it |
intake sheet |
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the patient registration sheet should be updated at least every spell it |
6 months |
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the maximum time during which a legal collection suit may be rendered staging a debtor is referred to as a _______________ spell it |
statue of limitation |
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patients accounts turned over to a collection agency should have a/an ____________________ sent by certified mail. spell it |
letter of withdraw |
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in dealing with an estate claim, a call to the ________ can be made periodically to check on the status of the estate. spell it |
executor |
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A/an _________ is a claim on the property of another as security for debt spell it |
lien |