NR 511 Week 1: Quiz1

Question 1

1 / 1 pts

The phrase usual and customary refers to:

The success rate of a specified procedure.

How much an insurer will charge to provide coverage.

Correct Answer

How charges for a service compares with charges made to other persons receiving similar services and

supplies.

How an insurer evaluates the need for an ordered diagnostic test.

The phrase usual and customary refers to the comparison of charges with other like charges for services and

supplies received in the immediate vicinity as well as in a broader geographic area.

Question 2

1 / 1 pts

What must you do as an advanced practice registered nurse (APRN) before billing for visits?

Correct!

Obtain a provider number and familiarize yourself with the rules and policies of the third-party payer.

Provide evidence of continuing medical education

Obtain a Drug Enforcement Administration (DEA) number.

Establish a collaborative agreement with a physician.

To bill your clients for services, you must obtain a provider number and familiarize yourself with the rules and

policies of each payor.

Question 3

1 / 1 pts

Which one of the following is true regarding the importance of documentation?

Correct!

It allows you to communicate your findings to other providers and serves as a record for the visit.

It is only important in order to bill the patient for your service.

It is only important for defending yourself in the event of a law suit.

It allows you to communicate your findings with the general public.

The purposes of documentation are to record the patient's report of symptoms, PMH, lifestyle and family

factors, positive and negative findings on physical exam and the provider's plan. Documentation is important

for billing purposes, communication with other providers and in the case litigation.

Question 4

1 / 1 pts

Which of the following statements does not belong in the past medical history portion of your chart note?

Correct Answer

Your patient had lab work done at their last appointment; CBC was normal.

Your patient’s father passed away from lung cancer.

Your patient had a cholecystectomy 3 years prior.ou Answered

Your patient has an allergy to penicillin.

Allergies, family history and surgical history all belong in the history portion of your note. Test results are

objective findings and should be in the diagnostic tests (objective) section of the note.

Question 5

1 / 1 pts

In relation to writing a patient encounter note, the acronym SOAP stands for which of the following?

Correct!

Subjective, objective, assessment, plan.

Symptoms, observations, assessment, plan.

Symptoms, objective findings, assessment, plan.

Subjective, outward findings, assessment, plan.

The acronym SOAP stands for subjective, objective, assessment and plan.

Question 6

1 / 1 pts

Most health maintenance organizations (HMOs) use a reimbursement mechanism called capitation. What

does this mean?You Answer

The HMO reimburses the provider on a fee-for-service basis.

The HMO is not responsible for provider reimbursement.

The HMO reimburses the provider only if the patient has paid their deductible.

Correct Answer

The HMO reimburses the provider a predetermined fee per client per month based on the client’s age

and sex.

The reimbursement mechanism called capitation that some HMOs use is one in which the HMO reimburses

the provider a set fee per client per month based on the client's age and sex. HMOs are prepaid,

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