oanne is on the phone with a patient dealing with
oanne is on the phone with a patient dealing with a concern that will take another minute to resolve when the phone rings with a second call. What should she do?
Question 1 options:
Answer the second call and deal with the caller’s needs before returning to the first call
Ignore the second call until she has completed the first call
Place the first caller on hold and answer the second call, ask if she can put the caller on hold, wait for a response, then finish the first call
Answer the phone, immediately say “hold please”, then return to the first call
Question 2 (1 point)
Dr. Jones finds that while he likes to give his patients scheduled appointment throughout the day, there are often patients who come late for appointments and cause his schedule to run behind. What scheduling method could he choose to alleviate this problem while still having scheduled appointments?
Question 2 options:
Affinity
Open
Stream
Wave
Question 3 (1 point)
Why should the MOA ask the patient for the reason for the appointment during booking?
Question 3 options:
The physician may only see clients with specific symptom groups.
It gives the doctor time to submit referral requests to specialists before the patient visit
The MOA can ensure the required amount of time with the doctor is booked, and any necessary equipment is organized.
It makes it easier to set priorities making sure clients with interesting problems are seen first.
Question 4 (1 point)
The average length of an appointment with a Family Physician is:
Question 4 options:
10 – 15 min
5 -7 min
30 – 40 min
20 -25 min
Question 5 (1 point)
Patients need to show their health card:
Question 5 options:
Only when they register as a new patient
At the beginning of every visit
Only when the information on the card has changed
Only at their first visit
Question 6 (1 point)
Patricia is entering claims for submission and notices that the Schedule of Benefits has marked one of the OHIP services the physician provided as requiring independent consideration. What should the MOA do to complete submission of this claim?
Question 6 options:
Nothing. Independent consideration claims are filed just like any other OHIP claim
Ask another MOA to review the claim before submission
Carefully review all elements of the claim to ensure accuracy before claims submission
Obtain supporting documentation from the physician and fax it to the MOH
Question 7 (1 point)
Dr. Broderick has asked the MOA to triage as she books appointments. The MOA should:
Question 7 options:
Assess the severity of each patient’s needs so the most serious needs can be seen first
Book all appointments for similar needs together to make the best use of equipment
Validate the patient’s health cards to ensure prompt payment
Ensure patients have been given instructions about what to bring with them to their appointment
Question 8 (1 point)
James didn’t show up for his appointment. What should the MOA do first?
Question 8 options:
Strike through James’ name in the appointment book and write N/S next to it
Call James to tell him he can’t come and see the doctor until he pays the $50 missed appointment fee
Call the next patient booked to tell them to come early
Erase James’ name from the appointment book and call him to reschedule
Question 9 (1 point)
Nelson needs to go to the lab to get some blood taken for testing. How should the MOA book his appointment?
Question 9 options:
Call the lab for appointment options and have Nelson select the most convenient
Appointments are not required for routine blood work
Forward the lab requisition to the lab and then tell Nelson to call the lab to book his appointment
Ask Nelson if he has any other commitments and then fax the appointment request to the lab
Question 10 (1 point)
Nadia works at a busy medical clinic. How should she answer the phone?
Question 10 options:
“Thank you for calling the Uptown Clinic. How may I direct your call?”
She should just say “hello” to avoid violating PHIPA
“Good morning. Uptown Clinic. Nadia speaking.”
“Good morning. Uptown Clinic. How can I help you?”
Question 11 (1 point)
A patient is having trouble deciding whether she should go ahead with a risky procedure. She asks the MOA what they would do in a similar situation. The MOA should:
Question 11 options:
Book the patient an appointment with the doctor to discuss her concern
Refuse to answer the question
Suggest the patient seek counselling from another professional
Advise the patient about the pros and cons of the procedure
Question 12 (1 point)
Dr. Sanders uses alphabetical filing for his practice. What is a potential disadvantage of using this system?
Question 12 options:
Patient charts will be difficult to locate without a Master Patient Index
Correlation with a computerized practice management system is difficult.
Duplication of patient identifiers can occur in larger practices
Patient charts can be easily misplaced
Question 13 (1 point)
Which type of booking is commonly used to accommodate emergencies or short appointments?
Question 13 options:
Wave
Affinity
Stream
Double-Column
Question 14 (1 point)
Who is the legal owner of all the information stored in the patient’s record?
Question 14 options:
Government
Physician
Insurance company
Patient
Question 15 (1 point)
Which of the following payment models does NOT include capitation payments?
Question 15 options:
Fee for Service (FFS)
Family Health Group (FHG)
Family Health Network (FHN)
Comprehensive Care Model (CCM)
Question 16 (1 point)
When opening mail, which documents should be prioritized in the stack given to the physician to review?
Question 16 options:
Medical journals
Patient information
Financial information
Drug information
Question 17 (1 point)
Which of the following is an example of a service that is insured under the Ontario Health Insurance Plan?
Question 17 options:
Consultation
Telephone advice
Form completion
Back to School Notes
Question 18 (1 point)
How long do people who are new to Canada have to wait, after registering, for health coverage to become active?
Question 18 options:
3 months
24 hours
1 month
1 year
Question 19 (1 point)
What does the diagnostic code in an OHIP claim represent?
Question 19 options:
The health services the clients have received
The physician diagnosis on which treatment decisions are based
The financial compensation the physician receives for seeing the client in the office
The fee schedule for procedures that have been provided
Question 20 (1 point)
Which of the following would not be eligible to bill the Ontario Health Insurance Plan?
Question 20 options:
Optometrists
Midwives
Chiropractors
Dentists
Question 21 (1 point)
Lisa is recording an OHIP claim for procedure and the doctor has listed the service code with an “A” suffix. What does the “A” suffix mean?
Question 21 options:
The provider assisted with the service
The provider performed only the technical portion of the service
An anesthetist performed the service
The provider or their staff performed the service
Question 22 (1 point)
What is the deadline for claims submission when using EDT?
Question 22 options:
1st day of the month
18th day of the month
10th day of the month
last day of the week
Question 23 (1 point)
The itemized statement of all paid and rejected claims that is received by the provider by the first week of the month following a claim submission is called:
Question 23 options:
Claims Error Report
File Reject Message
Remittance Advice
Batch Edit Report
Question 24 (1 point)
Nancy notices that a claim from the most recent OHIP submission she filed has been rejected. What is her responsibility with respect to this claim?
Question 24 options:
The file had a corruption and she should resubmit the claim as is
She should correct any errors and resubmit the claims for payment
OHIP won’t pay for the service so she should charge the patient for the service
She should inform the physician that he can no longer submit claims for the rejected service
Question 25 (1 point)
What is the primary goal of effective communication?
Question 25 options:
Therapeutic relationship
Wellness
Mutual understanding
Respect for boundaries
Question 26 (1 point)
Many specialists prefer to receive referral requests by fax instead of by phone. What is the advantage of faxed requests?
Question 26 options:
They allow the office to respond more quickly to requests
They can reduce the risk of errors when information is shared
They are less likely to lead to violation of patient confidentiality
They are a more reliable method of ensuring messages get through to the recipient
Question 27 (1 point)
The report received within 24 hours of submitting a claim through EDT that notifies the sender that a claims batch has been received and meets technical specifications:
Question 27 options:
Remittance Advice
File Reject Message
Error Report
Batch Edit Report
Question 28 (1 point)
Dr. Peterson has indicated that a claim is to be submitted under the HCP payment program. What are the most likely circumstances of the services claimed?
Question 28 options:
The services claimed are insured under OHIP
The patient was being checked to see if they could return to work after being injured
The patient normally resides in Quebec
The service was provided to a new patient who moved to Ontario from New Brunswick 1 month ago
Question 29 (1 point)
The most frequent type of assessment in family practice is:
Question 29 options:
Mini
Intermediate
General
Minor
Question 30 (1 point)
When should billing information be entered?
Question 30 options:
on the last day of the week
on the day of service
when the Ministry of Health requests it
once a month on the 18th
Question 31 (1 point)
How long after the service date can a claim still be submitted for payment?
Question 31 options:
6 months
30 days
1 year
2 months
Question 32 (1 point)
The Reciprocal Billing Agreement does not apply services provided to patients from:
Question 32 options:
Nunavut
Manitoba
Ontario
Quebec
Question 33 (1 point)
The alphabetical prefix of a service code indicates:
Question 33 options:
Who has rendered the service
The complexity of a service
The diagnosis related to the service
Type, location or circumstances of a service
Question 34 (1 point)
How should information in the patient chart be organized?
Question 34 options:
In order by report number
Reverse chronological order
Alphabetical order
Chronological order
Question 35 (1 point)
Dr. Bondar is moving to a distant city to open a practice closer to her family, and will no longer be able to care for her current patients. How long is she responsible to keep the patients’ medical records after the last service date?
Question 35 options:
10 years
1 year
3 years
Forever
Question 36 (10 points)
How should you answer the following telephone calls?
a. “This is Oliver Kim. I need a physical to get my driver’s license. Is there any cost associated with that?”
b. “Hello. This is Dr. Masters. I need to talk to Dr. Anderson.”
c. “This is Mel Baker. I need a prescription for antibiotics for my sore throat. Please call it in to Middleton Pharmacy and I’ll pick it up there.”
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