Administrative Skills Flashcards

Which of the following best describes a 'matrix' in appointment scheduling?

Answer: Blocked time periods when the provider is unavailable

A scheduling matrix blocks off times when the provider is out, in surgery, or otherwise unavailable for appointments.

When a patient's account is sent to a collection agency, which step must occur first according to standard billing practice?

Answer: Send the patient a final notice and allow a response period

Patients must receive adequate notice and opportunity to respond before their account is escalated to collections.

What is the main purpose of a charge capture process in medical billing?

Answer: To ensure all billable services are documented and coded

Charge capture ensures every service provided is recorded with the appropriate code so it can be billed to the payer.

Under HIPAA, which of the following is NOT considered protected health information (PHI)?

Answer: A patient's de-identified statistical health data

Fully de-identified data that cannot be linked to a specific individual is not considered PHI under HIPAA.

A patient requests a copy of their medical records. Under HIPAA, within how many days must the practice respond?

Answer: 30 days

HIPAA requires covered entities to provide access to records within 30 days of the request, with one possible 30-day extension.

Which ICD-10-CM guideline requires coding to the highest level of specificity?

Answer: Use the most specific code available

ICD-10-CM guidelines direct coders to use the most specific code that accurately reflects the documented diagnosis.

What does 'prior authorization' mean in the context of medical office administration?

Answer: Insurance approval required before certain services are rendered

Prior authorization is insurer approval obtained before providing specific services or prescribing certain medications to ensure coverage.