CBCS Patient Registration and Financial Responsibilities 1 — Questions and Answers
Question 1: During patient registration, which document authorizes the provider to bill the patient's insurance on their behalf?
- ABN
- Assignment of benefits form (Correct answer)
- HIPAA notice
- Prior authorization form
Correct answer: Assignment of benefits form
The assignment of benefits form authorizes the insurance company to pay the provider directly rather than reimbursing the patient.
Question 2: What is a co-payment in health insurance?
- The annual amount a patient must pay before insurance activates
- A fixed dollar amount paid by the patient at the time of service (Correct answer)
- The percentage the patient owes after the deductible
- The maximum out-of-pocket annual cost
Correct answer: A fixed dollar amount paid by the patient at the time of service
A co-payment (copay) is a fixed amount (e.g., $25) the patient pays at the time of each service visit, separate from the deductible.
Question 3: Which form must be provided to Medicare patients when a service may not be covered?
- CMS-1500
- Advance Beneficiary Notice (ABN) (Correct answer)
- Prior Authorization Request
- EOB
Correct answer: Advance Beneficiary Notice (ABN)
The Advance Beneficiary Notice (ABN) must be given to Medicare patients before rendering a service that may not be covered, informing them they may be responsible for the cost.
Question 4: What is the purpose of collecting a patient's demographic information at registration?
- To schedule future appointments only
- To ensure accurate claim submission and correct patient identification (Correct answer)
- To determine the patient's diagnosis
- To select the appropriate CPT codes
Correct answer: To ensure accurate claim submission and correct patient identification
Accurate demographic information (name, DOB, address, insurance ID) is critical for submitting error-free claims and preventing claim rejections.
Question 5: A patient's insurance card shows a group number and member ID. What is the group number used for?
- Identifying the individual patient
- Identifying the employer-sponsored plan (Correct answer)
- Authorizing a referral
- Determining the patient's deductible amount
Correct answer: Identifying the employer-sponsored plan
The group number identifies the employer or group plan sponsor under which the patient's coverage is provided, while the member ID identifies the individual.
Question 6: When a patient has two insurance plans, the patient's own insurance is typically considered:
- Secondary payer
- Tertiary payer
- Primary payer (Correct answer)
- Coordination payer
Correct answer: Primary payer
Coordination of Benefits (COB) rules generally designate the patient's own insurance as primary, with a spouse's or parent's plan as secondary.
CBCS Patient Registration and Financial Responsibilities 1
During patient registration, which document authorizes the provider to bill the patient's insurance on their behalf?