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Practice Mgt Mod1 > rq > Flashcards

rq Flashcards

1
Q

first step before treatign pt

A
  • pt contact insurance to select you as primary dentist
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2
Q

d4342

A

shoudl be by quadrant, SRP

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3
Q

code when comp ex when new pt to office

A

D0150, 120 is periodic

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4
Q

Office fee: $300
Pt does not have insurance, but she is the sister of your dental assistant 20% family and friends courtesy
3. What is the COLLECTIONS for scenario E?

A

240

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5
Q

Office fee: $300
Pt does not have insurance, but she is the sister of your dental assistant 20% family and friends courtesy
3. What is the production for scenario E?

A

300

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6
Q

Office fee: $300
Pt does not have insurance, but she is the sister of your dental assistant 20% family and friends courtesy
3. What is the adjustment/write off for scenario E?

A

60

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7
Q

Office fee: $300
Pt does not have insurance, but she is the sister of your dental assistant 20% family and friends courtesy
3. What is the pt paymeny for scenario E?

A

240

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8
Q

false about mistakes

A

all negative outcomes preventable

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9
Q

Ifa pt use
does not speak english, which model of the pt provider relationship should you
a. Deliberative
b. Informative
c. Interpretive
d. Paternalistic
e. Whichever the patient chooses

A

e

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10
Q

In most cases, who determines what procedures are covered by the pts insurance contract?
a. The pt
b. The pts employer
c. The dental practice
d. All of the above

A

b

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11
Q

Office fee $300
Out of network w Fuzzy Monkey PPO insurance
- The dentist does not have a contract w the insurance company
- Patients contract says it covers the procedure at 80%

PRODUCTION??

A

300

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12
Q

Office fee $300
Out of network w Fuzzy Monkey PPO insurance
- The dentist does not have a contract w the insurance company
- Patients contract says it covers the procedure at 80% (w equivalent in network maximum for procedures set at $240)

Collection??

A

insurance pays 80% of 240 at 192
pt pays difference at 108

total 300

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13
Q

Office fee $300
Out of network w Fuzzy Monkey PPO insurance
- The dentist does not have a contract w the insurance company
- Patients contract says it covers the procedure at 80% (w equivalent in network maximum for procedures set at $240)

adjustment??

A

0

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14
Q

Office fee $300
Out of network w Fuzzy Monkey PPO insurance
- The dentist does not have a contract w the insurance company
- Patients contract says it covers the procedure at 80% (w equivalent in network maximum for procedures set at $240)

Collection on day of procedure??

A

pts 108

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15
Q

Office fee $300
Pt does not have insurance
14. What does the patient pay for Scenario A?

A

300

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16
Q

Office fee $300
Pt does not have insurance
write off

A

0

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17
Q

Office fee $300
Pt does not have insurance
production?

A

300

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18
Q

Office fee $300
Pt does not have insurance
collection

A

300

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19
Q
  1. The patient’s financial responsibility for a given procedure is called the:
A

copay

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20
Q

Which is FALSE regarding dental student debt and financial stress?
a. Overall debt for dental school graduates have been increasing
b. The cost of doing dentistry such as the cost of CE, equipment, and materials
contributes to financial stress
c. One way to mitigate effects of debt stress on ethical decision-making is by having
an emergency fund
d. Having debt often means that you will have no choice in how to act, and will be forced into unethical behavior
e. Factors like practice location, marriage, citizenship status can contribute to the pressures of debt on ethical decision making

A

d

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21
Q

Which of the following is false regarding an ethical dilemma
a. Ethical dilemma is when 2 or more ethical principles are in conflict
b. No matter what course of action is taken, some ethical principle is compromised:
there is no perfect solution
c. There must be different courses of action to choose from
d. Ethical dilemma is when a behavior violates one or more ethical principles
e. A decision must be made about which course of action is best

A

d

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22
Q

The amount a pt is required to pay before any insurance benefit will begin is called the a. Balance
b. Deductible
c. UCR
d. CO-Pay

A

b

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23
Q

Who issues, revokes, and suspends dental licenses
a. State board
b. USDE
c. Bureau of enforcement and investigation
d. Commissions of dental competency assessments (CDCA)
e. Commision on Dental Accreditation (CODA)

A

a,d

24
Q

Below are the 5 ADA ethical principles and examples of each; which one is mismatched with the example?
a. Justice - present pt with all possible treatment options regardless of their insurance status or perceived ability to pay for the tx
b. Nonmaleficence - you refuse to extract a non restorable tooth for a pt whose BP is 200/120
c. Autonomy- the pt chooses to have a gold crown on #8 even though you think gold crowns on anterior teeth are ugly
d. Beneficence - you recommend RCT on #10 because you need to complete your school requirements for graduation
e. Veracity - you discuss w/the pt the risks, benefits, and alternatives of tx for a RCT on necrotic #30

A

d

25
Q

Office fee: $300
In-network w Fuzzy Monkey PPO insurance
Dentist’s contract with the insurance company says maximum billable for service is $240 Patients contract says it covers the procedure at 80%
Pt has maxed out of their benefits for the year
25. What is the ADJUSTMENT/WRITE-OFF for Scenario C?

A

60

26
Q

Office fee: $300
In-network w Fuzzy Monkey PPO insurance
Dentist’s contract with the insurance company says maximum billable for service is $240 Patients contract says it covers the procedure at 80%
Pt has maxed out of their benefits for the year
25. What is the COLLECTION for Scenario C?

A

240

27
Q

Office fee: $300
In-network w Fuzzy Monkey PPO insurance
Dentist’s contract with the insurance company says maximum billable for service is $240 Patients contract says it covers the procedure at 80%
Pt has maxed out of their benefits for the year
25. What is the PRODUCTION for Scenario C?

A

300

28
Q

Office fee: $300
In-network w Fuzzy Monkey PPO insurance
Dentist’s contract with the insurance company says maximum billable for service is $240 Patients contract says it covers the procedure at 80%
Pt has maxed out of their benefits for the year
25. What is the ins responsible for Scenario C?

A

0

29
Q

Office fee: $300
In-network w Fuzzy Monkey PPO insurance
Dentist’s contract with the insurance company says maximum billable for service is $240 Patients contract says it covers the procedure at 80%
Pt has maxed out of their benefits for the year
25. What is pt responsible for Scenario C?

A

240

30
Q

t/f Apologizing to the pt for a mistake you made should be avoided because it can cause you to be sued

A

false

31
Q

In a typical private practice, overhead is generally what % of revenue:
a. 80-90%
b. 60-75%
c. 30-40%
d. 50-55%
e. 20-30%

A

b

32
Q

Which patient-provider relationship model is the WORST?
a. Deliberative
b. Informative
c. Interpretative
d. Paternalistic
e. None of the models is better or worse than another

A

e

33
Q

You are doing your 1st molar endodontics on tooth #3 and are having trouble finding the MB2 canal. Which of the following is the LEAST acceptable way to proceed
a. Complete the RCT w/o finding MB2, inform the pt that if the symptoms do not resolve you will refer to endo to attempt to find the canal
b. Temporize the tooth and refer to an endo
c. Temporize the tooth and bring pt back for another visit to try and find the MB2
canal
d. Inform the pt you have not been able to find one of the canals, discuss
risk/benefits/alternatives, and complete the RCT with 3 cleaned and obturated
canals with patient consent
e. Inform the pt that the tooth is not restorable and offer to do extraction and implant for no additional charge

A

e

34
Q

What is the biggest contributing factor in overhead?
a. Equipment and technology
b. Staffing

c. Building and Maintenance
d. Space available for storage
e. Dental Supplies

A

e

35
Q

Office fee: $300
In-network w Fuzzy Monkey PPO insurance
Dentist’s contract with the insurance company says maximum billable for service is $240 Patients contract says it covers the procedure at 80%
Pt pays $48 on day of service (20% of $240)
Insurance sends check for $192 (often 8-12 weeks)

PRODUCTION

A

300

36
Q

Office fee: $300
In-network w Fuzzy Monkey PPO insurance
Dentist’s contract with the insurance company says maximum billable for service is $240 Patients contract says it covers the procedure at 80%
Pt pays $48 on day of service (20% of $240)
Insurance sends check for $192 (often 8-12 weeks)

WRITEOFF

A

60

37
Q

Office fee: $300
In-network w Fuzzy Monkey PPO insurance
Dentist’s contract with the insurance company says maximum billable for service is $240 Patients contract says it covers the procedure at 80%
Pt pays $48 on day of service (20% of $240)
Insurance sends check for $192 (often 8-12 weeks)

COLLECTIONS

A

240

38
Q

Office fee: $300
In-network w Fuzzy Monkey PPO insurance
Dentist’s contract with the insurance company says maximum billable for service is $240 Patients contract says it covers the procedure at 80%
Pt pays $48 on day of service (20% of $240)
Insurance sends check for $192 (often 8-12 weeks)

COLLECTIONS DAY OF

A

48

39
Q

What is the typical cost of a Dexis Sensor?
a. 1,000
b. 500
c. 10,000
d. 5,000
e. 7,500

A

c

40
Q

Frequency limitations commonly apply to which of the following
a. Radiographs
b. Comprehensive oral examinations
c. Prophylaxis
d. Prosthodontics
e. All of the above usually have frequency limitations

A

e

41
Q

A year later, Mrs. Doe now has Aetna PPO and calls to ask prior to her appt what will happen if Aetna does not pay the full fee. The office does not have a contract with Aetna PPO. you should tell her:
a. Tell her not to worry, the office routinely writes off patient copayments
b. The office accepts Aetna PPO but she would be responsible if the carrier paid less than your fee
c. Refer her to the front desk since you don’t know anything about insurance
d. Advise the pt to go to a contracted/participating office

A

b

42
Q

What is the best definition of a fee schedule?
a. A contract of fees between your office and a centralized dental supplier
b. A schedule of how many payments a pt needs to make and on what timetable for
a given procedure
c. A complete listing of fees for the services you offer aligned with a CDT
code
d. None of the above

A

c

43
Q

What is the estimated cost of turnover of an employee to the organization?
a. 1-3 months salary
b. 3-6 months salary
c. 6-9 months salary
d. 9-12 months salary
e. 12-15 months salary

A

c

44
Q

what pt provider model aligns most abotu what benefits dentist

A

none

45
Q

t/f One effective way to speed up conflict resolution is to instruct the upset individual to calm down
a. True
b. False

A

f

46
Q

In order to receive a dental license, every candidate must pass the live patient examination, such as ADEX or WREB
a. True b. False

A

a

47
Q
A

not sure, crown and RCT need preauth ad BLE to determine

48
Q

Mrs. Doe works for Walmart and presents with Delta Dental of Kansas. You have a contract with Delta Dental of PA. She had a routine prophylaxis and is calling about the fact that her carrier paid $50.00 which is $15 less than your usual fee. The carrier made the payment prior to the end of your billing cycle. You should tell her:
a. We are a participating office and she will not need to pay the balance when she gets her bill from the practice
b. Your office does not accept Delta Dental of Kansas so she will have to pay the difference
c. We are a participating office and therefore will/have already written off the balance
d. Both a and c are correct

A

b

49
Q

Which of the following is important for clear and successful patient communication
a. Not educating your team (front desk, assistants) on the value of the services the office offers
b. Using only the official “dental terms” and not simplifying for the patient
c. Explaining all treatment options in patient friendly terms, including the risk of no treatment
d. Avoiding photos and visual aids for patient education

A

c

50
Q

t/f

A

both true

51
Q

What
a. Unequal Cusp Removal
does UCR stand for?
b. Usual Customary Reasonable
c. Uniform Cost Rationale
d. Urgent Clinical Review
e. None of the Above

A

b

52
Q

Which of the following examples DOES NOT match the moral framework with which it is paired?
a. Consequentialism- academic integrity concerns because of the virtual exam format
b. Deontology - reviewing the entire informed consent process, including disclosing risks, benefits, and alternatives of proposed tx
c. Deontology - having to report child abuse even when the child asks you not to tell anyone
d. Consequentialism - policy on distribution of PPE during COVID-19
e. Consequentialism- investigational research study on COVID-19 Vaccines

A

a

53
Q

if your pt harmed as a result of you following policy, youre not responsible t/f

A

false

54
Q

Which of the following examples is the LEAST likely to be a mistake?
a. You would like to make more money, so you submit a code to insurance for a higher paying procedure rather than for the procedure you actually completed
b. Your patient aspirates a bur that fell out of your handpiece while you were prepping #14.
c. Your assistant hands the patient an envelope with the referral information that was meant for a different patient
d. Patient needs a root canal after you just delivered a crown on that tooth
e. Patient receives medication penicillin, to which they are allergic

A

a

55
Q

Which of the following is a MISMATCH between a common issue with the live patient
exam and the ethical concern?
a. Delaying treatment in order to “save” patient for the exam -violates
nonmaleficence
b. Treating the patient like an object as a means to an end - violates consequentialism
c. Advertising a free exam and x-rays without explaining the purpose of the exam - violates veracity
d. The test does not assess what it claims to evaluate - violates justice
e. Paying patients to participate in exam - may lead to patient coercion, violates
autonomy

A

b

Practice Mgt Mod1 (7 decks)

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