Patient Encounter practice questions

Answer: B) Notify staff to review it

• AIncorrect. Deleting can lose data.
• BCorrect. Flag it so the appropriate staff can decide whether to merge.
• CIncorrect. Duplicates cause errors.
• DIncorrect. Merging needs review.

Answer: C) Continued employer coverage after leaving a job

• AIncorrect. It's employer continuation.
• BIncorrect. It's paid continuation.
• CCorrect. The former employee usually pays the full premium.
• DIncorrect. It's employer continuation.

Answer: B) What they may owe

• AIncorrect. This is clinical.
• BCorrect. It explains the patient's payment obligations.
• CIncorrect. This is unrelated.
• DIncorrect. This is clinical.

Answer: D) A percentage

• AIncorrect. It is owed after the deductible.
• BIncorrect. That is a copayment.
• CIncorrect. The patient pays coinsurance.
• DCorrect. Coinsurance is a percentage; a copay is a fixed amount.

Answer: A) With no cost-sharing for the patient

• ACorrect. Copays and deductibles don't apply.
• BIncorrect. They're covered without cost-sharing.
• CIncorrect. They're covered without cost-sharing.
• DIncorrect. They're covered.

Answer: A) It is the amount she may owe for covered services during the coverage period, usually a year, before her plan begins to pay

A deductible is the amount a patient may owe for covered services during a coverage period (usually one year) before the plan begins to pay. It is different from a copayment (fixed fee), coinsurance (percentage share), and the premium (the cost of keeping coverage).

• ACorrect. CMS defines a deductible as the amount a person could owe for covered services during a coverage period (usually one year) before the plan begins to pay. Until she meets it, she pays the allowed amount for services subject to the deductible.
• BIncorrect. That describes a copayment: a fixed amount paid for a covered service, usually at the time of service.
• CIncorrect. That describes coinsurance: the patient's share of costs calculated as a percentage of the allowed amount, which usually applies after the deductible is met.
• DIncorrect. That describes the premium, which keeps the coverage active and is not counted as cost sharing or toward the deductible.

Answer: D) It pays after Medicare as secondary coverage

• AIncorrect. It's medical coverage.
• BIncorrect. It works with Medicare.
• CIncorrect. Medicare pays first.
• DCorrect. It's for Medicare-eligible military retirees.

Answer: D) Consent from a parent or legal guardian, unless a state-law exception applies

Minors generally need consent from a parent or legal guardian before treatment. State laws create exceptions such as emancipation, specific sensitive services and emergencies.

• AIncorrect. Minors generally can't legally consent to their own care. A visit being low-risk doesn't create an exception.
• BIncorrect. Only a parent or legal guardian normally has authority to consent for a minor. Being an adult relative doesn't give that authority.
• CIncorrect. A photo ID confirms who the patient is. It doesn't give a non-emancipated minor the legal capacity to consent.
• DCorrect. Parents or legal guardians usually make medical decisions for minors. State laws allow exceptions such as emancipation, the mature minor doctrine, certain sensitive services and emergencies.

Answer: A) Certain spouses and children of disabled or deceased veterans

• ACorrect. It's run by the VA.
• BIncorrect. That's TRICARE.
• CIncorrect. That's Medicare.
• DIncorrect. That's CHIP or Medicaid.

Answer: A) The most a patient pays for covered care in a plan year

• ACorrect. After it's reached, the plan pays 100%.
• BIncorrect. That's the premium.
• CIncorrect. It's an annual cap.
• DIncorrect. It's the patient's cap.