Well it is time for a self-check. These questions will help you see if you are understanding what has been covered. If you are unsure of the answers refer to the material covered in this Module. You will find a link to the answers below. (NOTE: You can have both the questions below and the pop up window with answers open at the same time, or if your screen size makes that difficult, you can print out the questions, answer them, and then compare them to the pop up window answers.)
Use the following list of definitions and match them to each of the revenue cycle control points listed in questions 01- 10.
- - Function primarily associated with the patient flow / access process. It provides for the identification of missing charges by allowing the comparison of arrived appointments to charges.
- - Collecting from insurers after the initial claim has been filed.
- - Collecting self-pay balances.
- - Gathering all demographic and insurance information.
- - Documented services are translated into billable charges.
- - Determining variances from expected payments.
- - The point of contact with the patient population.
- - Posting or applying payments / adjustments to the appropriate accounts / invoices.
- - The patient presents for check-in and check-out processes.
- - Filing claims and working audit trails or first line payer rejections.
01. Registration
02. Scheduling
03. In-House / Point-of-Service
04. Coding and Charge Capture
05. Claims Processing
06. Remittance Processing
07. Third Party Follow-up
08. Reimbursement Review
09. Patient Collections
10. Customer Service
11. - True or False - The single most important reason to acquire registration data prior to the encounter is so staff can access financial risk, verify eligibility, and obtain proper referrals and / or certifications from the carrier?
12. - True or False - The point-of-service control point should rarely be used to collect on existing self-pay balances because the patient may be offended?
Use the following list of definitions and match each of them to the appropriate method of charge capture in questions 13- 15.
- - The automated transfer of charge records from an outside system.
- - The most common method of charge capture.
- - The process of coders pulling charges directly from the medical record.
13. Charge Tickets
14. Chart Abstraction
15. Charge Interfaces
16. - True or False - Posting third party rejections is not critical to the remittance processing control point.
17. - True or False - Claims should be deemed unclaimed the moment they are rejected or 30 days post the original filing date.
18. - True or False - Setting expectations by educating patients on billing policies and guidelines is the first step during the patient collection process.
19. - True or False - Reimbursement review and customer service are likely the most under valued functions within the revenue cycle.
20. - True or False - The first priority of third party staff should be to contact payers regarding aged claims with no response.
|
