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The Medicare limiting charge limits a nonparticipating provider to be able to charge what percent of the fee listed in the Medicare nonparticipating fee schedule?


A) 5 percent
B) 20 percent
C) 115 percent
D) None of these are correct. they are paid the same.

Correct Answer

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What phrase in the Status column of the Statement Management dialog box is used to indicate that the transaction has been billed but not fully paid?


A) Ready to Send
B) Sent
C) Done
D) Completed

Correct Answer

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When will a patient statement be created if a check mark appears in the Print Statement Now box?


A) immediately when the box is checked
B) when the insurance payment is applied
C) when the current insurance payment is saved
D) when the Medisoft program is closed

Correct Answer

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What column of the Statement Management dialog box is used to indicate the format for a statement?


A) Stmt #
B) Status
C) Type
D) Media

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In the Apply Payment/Adjustments to Charges dialog box, $320.00 is entered in the Charge field and $295.00 is entered in the Allowed field. What amount will automatically be entered in the Adjustment field?


A) $0
B) $25.00
C) $295.00
D) $320.00

Correct Answer

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Which of the following is the last possible step in processing a remittance advice?


A) compare the RA to the original insurance claim
B) identify the reasons for denials or payment reductions
C) bill the patient's secondary health care plan if appropriate
D) review the payment amount against the expected amount

Correct Answer

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You are entering payment details in the Deposit dialog box and need to enter some specific details about the payment. What box would be used to enter this information?


A) the Payment Method box
B) the Description/Bank No. box
C) the Deposit Code box
D) the Insurance box

Correct Answer

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What type(s) of statement may be indicated by the Type field in the General tab of the Statement dialog box?


A) standard
B) remainder
C) patient
D) standard and remainder

Correct Answer

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Which of the following is a likely result if a clerical error is made on a claim?


A) Reimbursement is denied.
B) Reimbursement is made at a reduced rate.
C) Payment is not received.
D) Reimbursement is denied or made at a reduced rate.

Correct Answer

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Which tab in the Statement dialog box provides a place to include notes about the statement?


A) General tab
B) Transactions tab
C) Notes tab
D) Comment tab

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Take backs should be applied ____________ most of the time.


A) to the patient's first charge
B) to the patient's next charge
C) to the same charge that had the overpayment
D) evenly between all the patient's charges

Correct Answer

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In what dialog box must patient accounts be adjusted to a zero balance?


A) the Open Report dialog box
B) the Deposit List dialog box
C) the Apply Payment/Adjustments to Charges dialog box
D) the Transaction Entry dialog box

Correct Answer

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The amount the provider bills and the rate specified in the contract with the payer usually


A) are the same.
B) differ.
C) are negotiable.
D) change daily.

Correct Answer

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A second deposit is entered with a ____________ in order to adjust the patient accounts of those covered by a capitated plan.


A) matching amount
B) negative amount
C) zero amount
D) capitation amount

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What type of patient statements are sent electronically to a processing center, which then prints and mails them?


A) electronic
B) paper
C) fax
D) guarantor

Correct Answer

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What may a remittance advice contain?


A) multiple claims
B) claims for a number of different patients
C) a limit of one claim per patient
D) multiple claims and claims for a number of different patients

Correct Answer

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What step in reviewing a remittance advice comes after comparing the RA to the original insurance claim?


A) compare the RA to the original insurance claim
B) identify the reasons for denials or payment reductions
C) bill the patient's secondary health care plan if appropriate
D) review the payment amount against the expected amount

Correct Answer

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An RA that is sent in ____________ is an electronic remittance advice (ERA) .


A) paper format
B) electronic format
C) fax format
D) All of these are correct.

Correct Answer

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What phrase in the Status column of the Statement Management dialog box is used to indicate that the transaction has not been billed?


A) Ready to Send
B) Sent
C) Done
D) Completed

Correct Answer

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A patient in an indemnity plan receives services valued at $430 according to a provider's usual fee, but the allowed charge is only $380. How much does the patient pay for coinsurance if the insurer reimburses 80 percent of the allowed charges?


A) $76
B) $86
C) $304
D) $344

Correct Answer

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