RCM Core Day 1 Review

Question 1

What is an insurance premium?

Answer 1

A scheduled payment the insured pays in exchange for the insurer to pay a sum of money when an event occurs.

Question 2

True or False: If a patient has health insurance, their procedure will always be covered?

Answer 2

False

Question 3

What is a co-pay?

Answer 3

A fixed amount a member pays to the provider for a covered health care service, usually at the time the service is received.

Question 4

Which system allows health care staff to share vital patient information electronically, improving the speed, quality, safety, and cost of patient care?

A. Workflow systems
B. Billing systems
C. Document systems

Answer 4

C. Document Systems

Question 5

What are CPT, Revenue, and HCPCS codes used for?

A. Medical Coding
B. Charting
C. COB Determination

Answer 5

A. Medical Coding

Question 6

Claims processing, payment posting, and collections happen during what area of service?

A. Front
B. Middle
C. Back

Answer 6

C. Back

Question 7

True or False: In following HIPAA guidelines, a patient is only required to sign a Release of Information form when they are considered inpatient.

Answer 7

False

Question 8

A patient who chooses not to use their insurance benefit to pay for services is considered:

A. Uninsured
B. Under Insured
C. Self Pay

Answer 8

C. Self Pay

Question 9

A patient who receives care and returns home the same day is considered:

A. Inpatient
B. Outpatient

Answer 9

B. Outpatient

Question 10

True or False: The claim generation stage of the claim lifecycle includes the documentation of the patient/provider encounter and translation to ICD-10 and CPT/HCPCS Codes

Answer 10

True