Sample Questions for Developing a Pre-Employment Quiz Below are a list of sample questions compiled by your peers throughout the industry. Some are general; others are directed at front office, registration, coding, billing and/or collection staff. Please feel free to use these questions along with questions specific to your practice to develop a test to find our what your candidates (or current staff) really know 1) List the specific information you would verify/check if you were verifying coverage or benefits on a private insurance patient. 2) What information is necessary to verify a workers compensation claim? 3) What does UPIN stand for? 4) What is the name of the standard form for billing claims for physician services? 5) What Is the definition of Medigap? 6) What is a "Place of Service Code"? 7) Which carrier requires a 'Type of Service code? 8) List two circumstances under which Medicare would be the secondary carrier. 9) What does COB mean? 10) What does PPO stand for? 11) What does HMO stand for? 12) What Is the difference between a HMO plan and a PPO plan? 13) What does POS stand for? 14) What does POP stand for? 15) What is the role of the PCP in managed care? 16) Provide a simple definition of the term capitation 17) Four types of medical decision making are recognized. The second one is low complexity. List the other three. 18) What is a global package? 19) What is a CPT used for? 20) What is ICD-9 used for? 21) What is RBRVS? 22) What is a modifier? 23) To what level are you required by Medicare to take lCD-9 codes? 24) What is an EOMB? 25) What can you do to protect the physician's right to be paid for services that you know are not covered by Medicare? 26) How much can you collect from a Medicare patient? 27) How much can you collect from a Medicaid patient? 28) If a patient has Medicaid and Medicare coverage, which do you file first? 29) What is an R&S report? 30) When should co-pays be collected on managed care patients? 31) What is a referral? 32) What is an authorization? 33) What are HCPCs codes used for? 34) What is "concurrent care? 35) When can you appeal a 'concurrent care" denial? 36) What is HCFA? 37) Who is the local Medicare Part B carrier? 38) Define the term "global package". 39) Define the term "unbundled". 40) Where are modifiers used? Where are they found? 41) What does the term 'highest specificity' mean? 42) What does "otomy" mean? 43) What does "ectomy" mean? 44) What does separate procedure" mean in the CPT guidelines. 45) What is the CCl? 46) Can you ever bill a diagnostic laparoscopy with any other procedure? If so, when? 47) Define the term "preexisting" 48) What is the most common pre-existing clause for commercial group policies? 49) What is a "site of service" reduction? 50) How are multiple procedures typically adjudicated? 51) How often are CPT codes updated? 52) What are the following modifiers used to report: • -80 • -20 • -22 • -52 • -75 • -57 • -79 • -GA 53) Describe the difference between a refile and appeal (Medicare). 54) Can you bill Medicare patients for "N0 Show" office visits? 55) What percent does Medicare typically reimburse? 56) What is a "gatekeeper? 57) How should bilateral procedures be billed to: • Medicare • Medicaid • Commercial payers 58) If Dr. Jones sends Ima Sickalot to Dr. Smith for treatment of her diabetes, should Dr. Smith code Ima's first visit as a consultation or an initial visit? 59) What services are billed to DMERC carriers? 60) What is an "add-on" code and what impact do they have on adjudication/reimbursement?