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| 5777760964 | Patient account record | also known as the patient ledger | 0 | |
| 5777763420 | record retention | Mandated by Federal and /or State Law, and is the storage of documentation for an established period of time | 1 | |
| 5777770442 | claims that are handwritten or typed | have higher error rates, resulting in payment delays | 2 | |
| 5777775858 | The major reason the patient was seen | When treated by the provider, would be the first-listed code reported | 3 | |
| 5777781264 | When filling out the CMS-1500 form | the policy holders name should appear Last, First, MI- separated by commas | 4 | |
| 5777785828 | No date | is necessary and should be left blank when entering Signature on File in Block 12 | 5 | |
| 5777790411 | Commercial Claims Completion Instructions | Although recognized worldwide, it is important to check with each payer to check for updates, determine if they need alternate information on the claim and discover any new implementations in claims completion requirements | 6 | |
| 5777797981 | At age 65 or older | If an individual or their spouse paid Medicare taxes while they were working, they do not have to pay a monthly premium for Medicare part A | 7 | |
| 5777808034 | An All-Inclusive Care for the Elderly Programs' | goal is to help people stay independent and live in their community for as long as possible | 8 | |
| 5777812030 | A benefit period | begins with the first day of hospitalization and ends when a patient has been out of the hospital for 60 consecutive days | 9 | |
| 5777818533 | Medicare | is the first payer for CHAMPVA | 10 | |
| 5777821037 | Emergency services and family planning services | are exempt from copayments from Medicaid recipients | 11 | |
| 5777825188 | TANF | An acronym that stands for Temporary Assistance for Needy Families | 12 | |
| 5777828093 | TRICARE Standard | was previously known as CHAMPUS | 13 | |
| 5777830441 | MTF | An acronym that stands for Military Treatment Facilities | 14 | |
| 5777839171 | Four | The number of Regions in TRICARE | 15 | |
| 5777865162 | Retired Reserve Component Service Members | are eligible for retirement at 60 years of age | 16 | |
| 5777871954 | features of TRICARE | include: a guaranteed access to timely medical care, priority at Medical Treatment Facilities, assistance in finding a Primary Care Manager | 17 | |
| 5777882540 | Eligible for TRICARE Prime | Active Duty, Family members of Active Duty Sponsors, Retirees, and family members who are under age 65 | 18 | |
| 5777887099 | Referral | a request for a member to receive treatment from another provider | 19 | |
| 5777893463 | Co-payments | are to be paid at the time of the visit | 20 | |
| 5777900895 | The check-in procedure | for a patient who is new to the provider's office is more extensive than for a returning patient | 21 | |
| 5777911150 | Code of Federal Regulations | To accurately process health insurance claims, especially for government programs like Medicare and Medicaid, a health insurance specialist should become familiar with this | 22 | |
| 5777923662 | The Food and Drug Act | authorizes the Federal Government to monitor the purity of foods and safety of medicines | 23 | |
| 5777930206 | NOT an example of Billing Abuse | Falsifying certificates of medical necessity plans of treatment | 24 | |
| 5777935209 | The National Correct Coding Initiative (NCCI) | is a Medicare Program that was developed by CMS to reduce inappropriate expenditures | 25 | |
| 5777947403 | The Consolidated Omnibus Budget Reconciliation Act | states that participants maintain, at their own expense, and at the same rate, health care plan coverage that would have been lost due to a triggering event. For example: termination of employment | 26 | |
| 5777960740 | A managed care patient | must obtain a referral from a primary care manager or case manager before scheduling an appointment with a specialist | 27 | |
| 5777976115 | 48 hours | Medicare coverage for observation services is limited to not more than | 28 | |
| 5778014339 | Optical scanning of paper claims | uses a scanner to convert printed or handwritten characters into text that can be viewed by an Optical Character Reader | 29 | |
| 5778028508 | The Medically Unlikely Edits Project | Implemented by CMS to improve the accuracy of Medicare payments by detecting and denying unlikely Medicare Claims on a pre-payment basis | 30 | |
| 5778038844 | Block 18 | If the patient received inpatient services and has not been discharged at the time the claim is completed, the appropriate insertion in would be to leave the discharge date blank. | 31 | |
| 5778047273 | Medicare Part A | covers institutional providers for inpatient services | 32 | |
| 5778053032 | submit one claim for all | The correct procedure for submitting the claimwhen the same payer issues primary, secondary or supplemental policies would be to | 33 | |
| 5778058148 | Medicaid | is always the payer of last resort | 34 | |
| 5778060881 | examples of what would be covered under Medicaid | Categorically needy, medically needy and special groups | 35 | |
| 5778063937 | Primary Care Manager | A doctor assigned to sponsor and is part of the TRICARE Provider Network | 36 | |
| 5778067297 | Federal and State Laws | require employers to maintain workers' compensation coverage for employees for work-related illnesses and injuries | 37 | |
| 5778070701 | Workman's Compensation | The previous name for Worker's Compensation | 38 | |
| 5778079540 | The Office of Worker's Compensation Program (OWCP) | provides wage replacement benefits, medical treatment and vocation rehabilitation | 39 | |
| 5778083362 | Survivor Benefits | are calculated according to the employee's earning capacity at the time of illness or injury | 40 | |
| 5778088575 | Medically necessary services | are NOT furnished primarily for the convenience of the recipient or the provider | 41 | |
| 5778093380 | The Superbill and Encounter Form | are documents used by providers to record services and diagnoses rendered during the office visit | 42 | |
| 5778097021 | Claims from the payer that are denied | are NOT moved to the closed claims file. They are still considered an open claim | 43 | |
| 5778100431 | direct payments of all claims, a 5% higher fee schedule and publication of PAR directory to all Medicare patients | Special Incentives mandated by Congress to increase the number of health care providers signing participating provider agreements with Medicare | 44 | |
| 5778120661 | The employer must NOT | be notified by mail when an injured worker presents for the first visit or personal referral from the employer | 45 | |
| 5778125148 | The shaded area in each line is used to: | Enter supplemental information, to support reported services, if instructed by the payer | 46 | |
| 5778130708 | The worker does NOT | physically have to be on company property to qualify for Worker's Compensation | 47 | |
| 5778136212 | A Health Care Finder | is one who assists Primary Care Providers with pre-authorizations and referrals | 48 |
