Deductibles, Coinsurances & Collections
Mastering Patient Collections: A Quiz on Deductibles & Coinsurances
Test your understanding of patient collections, insurance deductibles, and coinsurances with our engaging quiz. This quiz is designed for healthcare professionals looking to enhance their billing knowledge and improve their patient interactions.
- 10 multiple choice and open-ended questions
- Covers practical scenarios in patient billing
- Assess your knowledge and learn from your mistakes
James is coming in as a new patient appointment. His insurance is BCBS PPO. You run the eligibility and James has a $25 copay, 20% coinsurance $1,500 deductible. How much money do you need to collect from James at time of check out for just an office visit?
Just the $25 copay
$25 copay plus 20% coinsurance for all procedure codes
Only 20% of the remaining deductible
Collect in full for each code, which will go towards his deductible
What does "Allowed amount" in insurance terms mean?
The amount of money were allowed to collect from the patient
How much money were allowed to charge the insurance
Allowed amount of visits a patient is allowed to have in one year.
Maximum amount in which payment is based for covered health care services.
Mary-Lou is coming in for an excision. She has Medicare primary and AARP as her secondary. Medicare shows she has a $0 copay, 20% coinsurance and a $226 remaining deductible. Her secondary AARP will not verify and comes up as inactive. What are your steps to resolve this problem?
Nothing, patient has MCR/AARP no collections are ever due
Verify insurance ID's are correct with patient, make needed changes, rerun eligibility.
Verify insurance ID numbers are correct, rerun eligibility, if still inactive call AARP to verify coverage.
Ask patient if she has another secondary insurance aside from AARP.
Brad is an established patient and has BCBS HMO. Dr. Solomon wants to book him for an ED&C. What is your first step?
Verify insurance coverage then book the appointment for next available time slot.
Create the appointment for 2 weeks out. Reverify the insurance, ensure an MA fills out authorization sheet, notify Allie once authorization sheet has been scanned so she can obtain authorization.
Just book the appointment for next available date.
Tell the patient that we will call him once we receive authorization to book the appointment
Briefly describe how you find out what to collect from a patient who has Humana with a $0 Copay, 0% coinsurance and a $500 deductible for the following codes: 99203, 17000, & 17110. And how much are you collecting?
Which Medicare Plans cover the patients deductible?
A&B
G
D
C&F
Ms. Duff has $112 remaining on her Part B deductible. She has a Medigap Plan K policy through AARP and was seen as a new patient. She also had a biopsy from her left shoulder. I know that Plan K will not cover her deductible and, looking at the Medicare fee schedule, that the allowable for her visit is at least $112. What are we going to be sharing with Ms. Duff?
Ms. Duff, would you mind paying $112 for your remaining deductible today?
Ms. Duff we are going to be billing you for your $112 deductible.
We will share nothing as the patient isn't responsible to pay anything.
Ms. Duff today $112 is due, will you be paying by cash, credit card or care credit? Any overage, we will bill you.
Jolene calls in wanting to know why she has a bill from Luminary Dermatology. Describe in detail, your steps on how you obtain this information within EMA and how you would explain/break down the bill to the patient.
Last minute add on patient, Monica has Aetna and claims that her insurance pays 100%. EMA eligibility is down and you haven't had a chance to run her insurance to find out if the policy is even active, so you just give the patient benefit of the doubt and allow her to leave without paying anything towards todays visit.
True
False
Tricare for Life and Tricare Prime coverages are the same and no eligibility needs to be ran as they pay 100%
True
False
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