Terms : Hide Images
| 4353980430 | which of the following should a bc use to sort aging reports | type of payer | 0 | |
| 4353981852 | in order to ensure that claims are submitted and received a bc should document all claims processed | on an insurance claims register | 1 | |
| 4353983837 | a patient who has a bluish discoloration of the skin which is the condition | low blood oxygen level | 2 | |
| 4354022071 | what should a bc collect form a patient during a initial visit | insurance card | 3 | |
| 4354031122 | if a bc practice management software cannot transmit claims directly to the third party payer which of the following must a specialist use to transmit/to catch errors by providers | clearinghouse | 4 | |
| 4354031831 | a patient authorization form is good for | 90 days | 5 | |
| 4354032403 | which institution works with cos to prevent overpayments | quality improvement organization | 6 | |
| 4354092783 | which of the following is the process a payer follows to determine if a claim should be paid | payer adjudication | 7 | |
| 4354095754 | a sinus procedure with a health maintenance organization requires which of the following | preauthorization | 8 | |
| 4354097206 | a bc is allowed to make which of the following id within HIPAA guidelines | call patients by name | 9 | |
| 4354101100 | a medicare provider billed medicare for 360.00 the allowed amount is 200 .for which of the following amount is the patient responsible | 40.00 | 10 | |
| 4354131320 | once a bc begins working on an aging report within the payer area which of the following criteria should she sort by next | date of service | 11 | |
| 4354133425 | the process of selecting the correct icd code ends with the final code being chosen form which of the following | tabular list of diseases | 12 | |
| 4354135736 | which of the following is the primary purpose of the HIPAA Act Title I | to allow for health care access ,portability ,and renewability | 13 | |
| 4354139832 | exchange of personal health information via a standardized format through computer systems is an example of which of the following technologies | EHR | 14 | |
| 4354200871 | billing a patient who is covered by medicare using a higher fee schedule than a patient who is not covered by medicare is an example of | abuse | 15 | |
| 4354201501 | which of the following is an electronic claim for format | ANSI ASC X12 837 | 16 | |
| 4354203724 | under CPT guidelines all services related to a surgical procedure are not additionally reimbursed during which of the following periods | global period | 17 | |
| 4354207577 | a patient payment is considered uncollectible .a billing and coding specialist should record an entry on the patients ledger as which of the following types of bad debt | write off | 18 | |
| 4354209344 | which of the following govt agencies has launched a website to help consumers identify sources of public and private coverage and initiated by icd 9 | DHHS: department of health and human services | 19 | |
| 4354211042 | which of the following is the priority action a billing and coding specialist should take to identify the areas of risk associated with billing compliance | perform internal audits to monitor billing process | 20 | |
| 4354213554 | which of the following forms is required for a medicare non covered procedure | ABN Advance Beneficiary Notice | 21 | |
| 4354215665 | which of the following should result from a provider committing abuse | administrative fines | 22 | |
| 4354218348 | a billing and coding specialist is filling out the cos 1500 claim form for a satellite office .which of the following blocks should the specialist use for the providers name and address | billing provider information and phone number | 23 | |
| 4354222001 | secondary to the cos 1500 claim form, which of the following forms is the next most significant piece of paperwork for obtaining patient financial information | medical record | 24 | |
| 4354224306 | which of the following are the three types of plans covered under Tricare programs | standard ,extra,and prime | 25 | |
| 4354226389 | which of the following is an example of why claims can be denied for reasons other than a processing error | not medically necessary | 26 | |
| 4354229312 | a patient is scheduled to have an endoscopy ,which of the following providers should perform the procedure | Gastroenterologist | 27 | |
| 4354230858 | which of the following speciality providers should perform an orchiopexy | urologist | 28 | |
| 4354233553 | which of the following actions should a B&C specialist take after receiving an EOB | apply the payment | 29 | |
| 4354236081 | the field "insured ID Number" on the Cms 1500 claim form is used to report which of the following pieces of the information | policy number | 30 | |
| 4354240743 | a patient who has a right tibia fracture receives a cast . upon X-ray ,the patient also received a diagnosis of a tumor on his right patella and is admitted to the facility for further treatment . Which should the B&C specialist code second | Right patella tumor | 31 | |
| 4354243573 | which of the following should treat a patient who is scheduled to undergo a surgical procedure and return home the same day | ambulatory care center | 32 | |
| 4354245712 | a B&C specialist should take which of the following proactive actions to prevent fraud and abuse | use the most up to date coding manuals | 33 | |
| 4354253468 | a patient is injured while working as a subcontractor .this claim should be filed with which of the following ? | the patients private insurance | 34 | |
| 4354256368 | when posting a payment to an account, in which of the following column should a B&C specialist record an insurance payment | credit column | 35 | |
| 4354258903 | which of the following describes how a B&C specialist should code a claim for a patient who falls in his yard at home and breaks his arms | E code on accident due to natural and environmental factors | 36 | |
| 4354261358 | which of the following forms must be signed to release documents to a 3rd party payer | release of information | 37 | |
| 4354265066 | a new patient who has a PPO presents to the office reporting stomach pains .For which of the following reasons does the patient have to pay out of pocket for this office visit | the patient has not met the deductible | 38 | |
| 4354268212 | a provider accepts pre-established payments for providing services to a patient enrolled for 1 year .which of the following plans does this describe | EPO | 39 | |
| 4354271382 | Which of the following actions should a B&C take when submitting a hard copy of the CMS 1500 claim form | complete the claim form on the computer | 40 | |
| 4354273117 | which of the following data elements delays claim processing if missing | secondary insurance or units of service | 41 | |
| 4354278722 | in which of the following locations should a B&C specialist find the contact info to appeal a claim | insurance company file | 42 | |
| 4354283532 | a b&c specialist determines that several patient have outstanding balances of greater than 90 days . Which of the following is used to determine outstanding balances | aging report | 43 | |
| 4354287188 | which of the following steps should a billing and coding specialist take when a patient is ineligible and a denied claim is retired to the provider | submit a new claim to the correct insurance carrier | 44 | |
| 4354289197 | which of the following is included in the release of information | expiration date | 45 | |
| 4354291848 | when a modifier -GA is used on a patients claim form . Which of the following forms should the patients sign | ABN | 46 | |
| 4354292999 | the cos 1500 claim form is used for which of the following types of claims | office outpatient | 47 | |
| 4354297224 | when interpreting an EOB it is necessary for billing and coding specialist to know which of the following | the EOB can include multiple patients on one form | 48 | |
| 4354300096 | a b&c specialist received payments for dates of service found on | an RA | 49 | |
| 4354304308 | 99214 cpt manual | established office visit | 50 | |
| 4354305047 | Nasal deformity | rhinoplasty | 51 | |
| 4354305894 | life cycle of a claim 1st step | collecting insurance info | 52 | |
| 4354307531 | allowed amount | amount of reimbursement an insurance payer agrees and patient agrees to ay a provider | 53 | |
| 4354312700 | what is excision | removal | 54 | |
| 4354323570 | what is an emancipated minor | a person younger than 18 years who lives independently who processes decision making rights | 55 | |
| 4354367696 | Date format | MMDDYYYY | 56 | |
| 4354370087 | information associated with aging report informs the B&C specialist about more than just the immediate claims pending | trend of non payment of the insurance payer | 57 | |
| 4354370706 | what is the OIG | investigates fraud and abuse | 58 | |
| 4354373267 | if a pre-auth is expired | claim will come back to provider as denied | 59 | |
| 4354375266 | how to verify copay prior to appointment | contact insurance carrier | 60 | |
| 4354376144 | medical necessity | charge capture process | 61 | |
| 4354376774 | clean claim | completed insurance claim form submitted with the program time limits that contains all the necessary information/doesn't need account number for submission | 62 | |
| 4354377562 | workers care | state mandated 3rd party payer | 63 | |
| 4354383127 | what is a deductible | specific amount of money must be paid each year before the policy benefit begins.should be collected first | 64 | |
| 4354393698 | fraud | filing for services not provided | 65 | |
| 4354395248 | switch of policies and now covered under partner | policy number needed | 66 | |
| 4354395930 | billing provider NPI | person who provided service | 67 | |
| 4354400592 | what is COB (coordinations of benefits ) | statements is included in most policies and contracts with providers | 68 | |
| 4354821827 | block 241 on cms 1500 form | leave blank | 69 | |
| 4354828090 | what is aging report | document that reports the status of insurance claims to the provider | 70 | |
| 4354833046 | how many volumes does the icd 9 use for outpatient services | Two :vol II to vol I | 71 | |
| 4354834971 | electronic claim submitted ,one service denied | retransmit claim with required info | 72 | |
| 4354836886 | which are federally funded | medicaid ,medicare,tricare | 73 | |
| 4354838014 | directional terminology | superior | 74 | |
| 4354839864 | if there is a diagnosis missing on a claim form | it prevents submission | 75 | |
| 4354841770 | supporting document needed for electronic claim | email an electronic file format of the supporting document | 76 | |
| 4354857778 | what is an insurance claim register | checking batch reports and scrubber reports on a schedule basis | 77 | |
| 4354859447 | cholelithiasis | stones in gallbladder | 78 | |
| 4354860574 | injury and poisoning supplemental codes begins with | E000 | 79 | |
| 4354860917 | ss# for medicare | no dashes with letter A | 80 | |
| 4354861697 | homeostasis | normal balance and function | 81 | |
| 4354866738 | what does electronic remittance advice include | referring provider | 82 | |
| 4354867249 | v-code | supplemental diagnosis code ,exposure to tuberculosis | 83 | |
| 4354868221 | patient paid in advance ,insurance co paid more | b&c specialist should refund the patient | 84 | |
| 4354868981 | capitation | A system of payment used by managed care plans in which physicians and hospitals are paid a fixed per capita mount for each patient enrolled over a stated period of time | 85 | |
| 4354882466 | Who implemented the NCCI in 1996 and initiated ICD9 | WHO | 86 | |
| 4354883449 | Guarantor | an individual who promise to pay the medical bill by signing a form agreeing to pay or who accepts treatment which constitutes an expressed promised | 87 | |
| 4354890963 | add on code | can be listed as the primary code | 88 | |
| 4354897532 | audit performed after payments os sent to 3rd party payer | prospective adult | 89 | |
| 4354899569 | Tricare prime (elgibility ) | active duty personnel | 90 | |
| 4354900437 | appendicitis | right lower quad | 91 | |
| 4354903214 | MDM-medical decision making | health care management process done after performing a history and physical examination on a patient that results in a plan of treatment | 92 | |
| 4358987107 | Part b | provider services | 93 | |
| 4358989647 | private insurance standards | NCCI | 94 | |
| 4359226553 | what type of physician would deal with thyroid issue and exposure to tuberculosis | Endocrinologist | 95 | |
| 4359002380 | Implied contract | at time appointment is made | 96 | |
| 4359063050 | Nephrolithiasis | kidney stones | 97 | |
| 4359065568 | if minor has no insurance who is responsible for the bill | guarantor | 98 | |
| 4359068676 | when you have a diagnosis and a manifestation diagnosis | combination code | 99 | |
| 4359070780 | when looking for an evaluation and management code where should you look first | place of service | 100 | |
| 4359074089 | when a procedure is pending FDA approval what symbol is next to the code | Flash symbol | 101 | |
| 4359075563 | what is the first section in the CPT manual | the evaluation and management section | 102 | |
| 4359082121 | if a procedure was done and a preauthorization has expired what is the next step to get the claim paid | file an appeal | 103 | |
| 4359083432 | what is Assignment of benefits | when a participating provider accepts what the insurance company is allowing for patient and in return the checks goes to the physician | 104 | |
| 4359086981 | balance due on the aging represents what | outstanding money owed to the practice | 105 | |
| 4359090337 | which tricare fee for service policy has the most flexibility when it comes to choosing a physician | tricare standard | 106 | |
| 4359091582 | HCPCS level II codes are used for | Ambulance Services | 107 | |
| 4359093331 | three key components of an evaluation and management | history,physical and medical decision making | 108 | |
| 4359096129 | in ICD 10 (tabular list) | parenthesis are used in the tabular list to enclose supplementary words that may be present or absent in the statement of disease or condition | 109 | |
| 4359100485 | Predetermination | the actual dollar amount the insurance company will pay | 110 | |
| 4359101759 | protected health information | includes body mass | 111 | |
| 4359102593 | federal register | resources for changes ,notices and proposals for centers for medicare/medicaid services | 112 | |
| 4359105702 | Medicare part b | covers emergency services | 113 | |
| 4359109756 | Primigravda | one pregnancy | 114 | |
| 4359113425 | what is the purpose of OIG (office of inspector general) | is to safeguard the health and welfare of the beneficiaries of dh's programs and to protect the integrity of dh's programs (fraud and abuse) | 115 | |
| 4359126795 | filing for services not provided is a fraudulent act | true | 116 | |
| 4359312049 | a billing and coding specialist is filling out the cos 1500 claim for for a satellite office . which of the following blocks should the specialist use for the providers name and address | Block 31 and 33 | 117 | |
| 4359316391 | what two codes do you need to process a medical claim | CPT and ICD | 118 |
