Administrative Skills Flashcards
7 cards from real AMCA practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Administrative Skills flashcards as text
Which form is used to submit professional medical claims electronically to Medicare?
Answer: CMS-1500
The CMS-1500 form is the standard claim form used by physicians and other professional providers billing Medicare and most other payers.
What is the function of an Advance Beneficiary Notice (ABN) in a Medicare-participating practice?
Answer: To inform the patient that Medicare may not cover a service and they may be billed
An ABN must be given before a non-covered service so the patient can decide whether to proceed knowing they may owe the cost.
Which scheduling system allows patients to arrive at any time during a set window rather than at a specific appointment time?
Answer: Open-access scheduling
Open-access scheduling lets patients walk in or book same-day during open blocks without a fixed time slot.
A medical assistant receives a subpoena for a patient's records. The appropriate response is to:
Answer: Notify the physician and practice attorney before releasing any records
A subpoena requires legal review; the physician and practice attorney must be notified to determine the proper response.
What does 'accounts receivable' represent in a medical practice?
Answer: Money owed to the practice for services rendered
Accounts receivable is the total amount owed to the practice by patients and insurance companies for services already provided.
Which type of insurance plan requires patients to select a primary care physician and obtain referrals for specialist visits?
Answer: HMO
HMOs (Health Maintenance Organizations) typically require a designated PCP and referrals to access specialist care.
When a claim is denied due to a 'coordination of benefits' issue, it usually means:
Answer: Two insurers need to determine which pays primary and which pays secondary
Coordination of benefits (COB) rules determine the order in which multiple insurance plans pay when a patient has dual coverage.