4669175745 | 1. Administrative medical office responsibilities include | Claims submissions | 0 | |
4669175746 | 2. A claims assistant professional | Works for the consumer and helps patients file insurance claims | 1 | |
4669175747 | 3. The amount of money an insurance billing specialist earns is dependent on which of the following factors | Knowledge,experience, and size of employing institution | 2 | |
4669175748 | 4. A billing specialist is entrusted with | Holding patient's medical information in confidence, collecting monies, and being a reliable resource for coworkers | 3 | |
4669175749 | 5. Medical etiquette refers to | Consideration for others | 4 | |
4669175750 | 6.Medical ethics include | Standards of conduct | 5 | |
4669175751 | 7. What should you do if you discover that a patient of your physician employer is under the care of another physician for the same ailment? | Notify your physician | 6 | |
4669175752 | 8. A Self-employed medical insurance biller that does independent contracting is responsible for | Advertising, billing, and accounting | 7 | |
4669175753 | 9. The doctrine stating that physicians are legally responsible for both their own conduct and that of their employees is known as | Respondeat superior, let the master answer, and vicarious liability | 8 | |
4669175754 | 10. Why are multiskilled health practitioners in demand? | They are cross-trained to provide more than one function, they are often competent in more than one discipline, and they offer more flexibility to their employer. | 9 | |
4669175755 | 11. Confidential information includes | Everything that is heard about a patient, everything that is read about patient, and everything that is seen regarding a patient | 10 | |
4669175756 | 12. What is the correct response when a relative calls asking about a patient? | Have the physician return the telephone call | 11 | |
4669175757 | 13. Confidentiality is automatically waived in cases of | Gunshot wounds, child abuse, and extremely contagious diseases | 12 | |
4669175758 | 14. When an Insurance billing specialist bills for a physician and completes the Medicare claim form with the information that does not reflect the true situation | He or she may be subject to fines and imprisonment | 13 | |
4669175759 | 15. Electronic media refers to | Routers with-dial-up phones, the Internet, and transmissions that are physically moved from one location to another | 14 | |
4669175760 | 16. When does the physician-patient contract to begin? | When the physician accepts the patient agrees to treat the patient | 15 | |
4669175761 | 17. Most physician patient contracts are | Implied | 16 | |
4669175762 | 18. When a patient carries private medical insurance, the contract for treatment exists between | The physician and the patient | 17 | |
4669175763 | 19. Emancipated minor is | It person younger than the age of 18, and lives independently | 18 | |
4669175764 | 20. Who does the contract exists between in a Worker's Compensation case? | The physician and the insurance company | 19 | |
4669175765 | 21. In health insurance the insured is also known as | The subscriber, the member, and the policyholder | 20 | |
4669175766 | 22. The reason for the coordination of benefits statement in a health insurance policy is | To prevent duplication or overlapping of payments for this in a medical expense | 21 | |
4669175767 | 23. When a medical facility is sent correct reimbursement for management company for professional services, the site receives | The check | 22 | |
4669175768 | 24. If a child has health insurance coverage from two parents according to the birthday law | The plan of the person who has the coverage longer is the primary payer | 23 | |
4693292488 | 25. According to the birthday law, if both the mother and the father have the same birthday | The plan of the person who has coverage longer is the primary payer | 24 | |
4669175769 | 26. Conditions that existed did before the health insurance policy was issued are called | Pre-existing conditions | 25 | |
4669175770 | 27. An attachment to an insurance policy excludes certain illnesses or disabilities that would otherwise be covered is referred to as a | Exclusion | 26 | |
4669175771 | 28. What is the correct term used to determine if the procedure is covered and medically necessary? | Preauthorization | 27 | |
4669175772 | 29. Mr. Ott was laid off from his job. He is protected by cobra, which requires his employer to | Extend group health insurance coverage for 18 months | 28 | |
4669175773 | 30. What is the minimum number of employees that a company must have to meet the criteria of the consolidated Omnibus Budget Reconciliation Act (COBRA), for continued medical benefits if employee is laid off from a company? | 20 | 29 | |
4669175774 | 31. The patient intake sheet is also called a | Patient registration form | 30 | |
4669175775 | 32. The first document obtained in the initial patient visit is a | Patient information form | 31 | |
4669175776 | 33. Assignment of benefits is | Used only by nonparticipating physicians, never used by participating physicians, the transfer of the physicians right to collect an amount payable to the patient, and the transfer of ones legal right to collect an amount payable under an insurance contract | 32 | |
4669175777 | 34. Encounter form may also be known as a | Patient service slip | 33 | |
4669175778 | 35. The Source document for insurance claim data is the | CMS 1500 | 34 | |
4669175779 | 36. It is advisable to process insurance claims | In batches, grouping claims of patients who have the same type of insurance coverage | 35 | |
4669175780 | 37. When the physician services have been submitted to the patient's insurance company by the physicians office, the patient should | Be sent a monthly statement indicating the insurance company has been billed | 36 | |
4669175781 | 38. A health record is considered | Medical information, and a medical record | 37 | |
4669175782 | 39. Reasons for documentation are | Defense of a professional liability claim, and insurance carriers require accurate documentation that supports procedure and diagnostic codes | 38 | |
4669191623 | 40. When a patient fails to return for Initial treatment, documentation should be made | In the patient's medical record, in the appointment book, and on the financial record or ledger card | 39 | |
4669191624 | 41. A diseased condition or state is known as | Morbidity | 40 | |
4669191625 | 42. What does co- morbidity stand for? | Underlying diseases or other conditions present at the time of the visit | 41 | |
4669191626 | 43. A new patient is one who | Has previously received professional services from a physician or another physician of the same specialty who belongs to the group practice within the past 3 years | 42 | |
4693292489 | 44. And established patient is one who | 43 | ||
4669191627 | 45. In dealing with managed-care plans, a referral is | Both B AND C. The same as the consultation, the transfer of the total or specific care of a patient from one physician to another, and the term used when requesting an authorization for the patient to receive services elsewhere | 44 | |
4669191628 | 46. When a discussion takes place with the patient concerning the risks and benefits of treatment options it is considered | Counseling | 45 | |
4669191629 | 47. Once an individual has been found guilty of committing the Medicare or Medicaid problem related crime | Exclusion from program participation is mandatory | 46 | |
4669191630 | 48. Which of the following cases should not use fax transmission? | Transmission of documents relating to information on sexually-transmitted diseases, any routine transmission of patient information, and transmission of documents relating to alcohol treatment | 47 | |
4669191631 | 49. Who may accept the subpoena | The prospective witness , or an authorized person | 48 | |
4669191632 | 50. TRICARE | Government sponsored program that provides hospital and medical services for dependence of active duty uniform service members, military retirees and their families, and survivors of uniformed services | 49 | |
4669191633 | 51. CHAMPVA | Provides coverage for spouses and children of veterans with total, permanent, service-connected disabilities or for the surviving spouses pand children of veterans who died as a result of service connected disabilities | 50 | |
4669191634 | 52. Disability income Insurance | A form of health insurance that provides periodic payments to replace income when the insured is unable to work as a result of illness, injury, or disease | 51 | |
4669191635 | 53. Health maintenance organization (HMO) | And organization that provides a wide range of comprehensive health care services for a specified group at a fixed periodic payment | 52 | |
4669191636 | 54. Independent practice association (IPA) | A medical capitation plan in which treatment is delivered via a clinic or an independent physician that provides a number of basic medical services for a fixed capitation payment per month | 53 | |
4669191637 | 55. Medicaid | The program sponsored jointly by federal and state governments for medically indigent persons, aged individuals who meet certain financial requirements, and the disabled | 54 | |
4669191638 | 56. Medicare | The hospital insurance system and supplemental medical insurance for those older than 65 years of age created by the 1965 amendment to the Social Security act | 55 | |
4669191639 | 57. State disability or unemployment compensation disability. (UCD) | Insurance that covers off the job injury or sickness and is paid by deductions from a person's paycheck | 56 | |
4669191640 | 58. Worker's Compensation insurance | The contract that ensures a person against on-the-job injury or illness | 57 | |
4669202107 | 59. Attending physician | Provider who sends the patient for tests or treatment | 58 | |
4669202108 | 60. Consulting physician | Provider whose opinion is requested by another physician about evaluation and management of a specific problem | 59 | |
4669202109 | 61. Attending physician | Provider who is the medical staff member legally responsible for the care and treatment given to a patient | 60 | |
4669202110 | 62. Ordering physician | Individual who directs the selection, preparation, administration of tests, medications, or treatment | 61 | |
4669202111 | 63. Treating or performing physician | Provider who renders a service to a patient | 62 | |
4669202112 | 64. Consultation | Services rendered by a physician whose opinion is requested by another physician for evaluating a patients Illness | 63 | |
4669202113 | 65. Referral | Transfer of the title care of the patient from one physician to another | 64 | |
4669202114 | 66. Concurrent care | Providing similar services to the same patient by more than one physician on the same day | 65 | |
4669202115 | 67. Continuity of care | Providing treatment for patient and subsequent referral by the treating physician to another physician for treatment of the same condition | 66 | |
4669202116 | 68. Counseling | Discussion with the patient, family, or both for diagnostic results and instructions for treatment | 67 | |
4669202117 | 69. Critical care | Intensive care provided during an acute life threatening condition that requires constant bedside attention by the physician | 68 | |
4669202118 | 70. Emergency | Care provided during a life-threatening condition in the hospital emergency department | 69 | |
4669202119 | 1. The health insurance claim form (CMS-1500) | Universal claim form | 70 | |
4669202120 | 2. An Insurance claim form contains no Staples or highlighted areas and on which the barcode area has not been deformed is called | A physically clean claim | 71 | |
4669202121 | 3. An insurance claim submitted with errors is referred to as | Dirty claim | 72 | |
4669202122 | 4. What is the protocol to follow up on receiving a request for an attending physician statement from insurance company on a patient who is applied for health insurance? | Request a fee from the insurance company before sending the attending physicians statement | 73 | |
4674670463 | 5. If you receive a request with accompanied with the correct authorization asking to abstract medical information from a patient's medical record | Send only the information requested | 74 | |
4674670464 | 6. Office visits may be grouped on the insurance claim form if each visit | Is consecutive, uses the same procedure code, and results in the same fee | 75 | |
4674670465 | 7. OCR Is the acronym for | Optical character recognition | 76 | |
4674670466 | 8. OCR Guidelines for the CMS-1500 claim form state | It should not be be photocopied because it cannot be scanned | 77 | |
4674670467 | 9. To conform to CMS - 1500 OCR guidelines | Do not fold insurance claims forms when Mailing, do not use symbols with data on insurance claim forms, do not strike over errors when making a correction | 78 | |
4674670468 | 10. How should blocks be treated on an OCR CMS-1500 claim form that do not need any information? | Leave the block blank | 79 | |
4674670469 | 11. The CMS - 1500 claim form is divided into which of the following major sections? | Patient and physician information | 80 | |
4674670470 | 12. A group of insurance claims sent at the same time from one facility is known as a | Batch | 81 | |
4674670471 | 13. A clearinghouse is a | And entity that receives the transmission of insurance claims, separates the claims, and sends each one electronically to the correct insurance payer | 82 | |
4674670472 | 14. Insurance claims transmitted electronically are usually paid in | Two weeks or less | 83 | |
4674670473 | 15. The most important function of a practice management system is | Accounts receivable | 84 | |
4674670474 | 16. The employers identification number is assigned by | The IRS | 85 | |
4674670475 | 17. A clearinghouse | Transmits claims to the insurance pear, performs software edits, and separates the claims by Carrier | 86 | |
4674670476 | 18. Insurance claims form data are gathered | Before the service is rendered, during the time the service is rendered, and after the service is rendered | 87 | |
4674670477 | 19. Back up copies of office records should be stored | Away from the office | 88 | |
4674670478 | 20. When a medical practice has its own computer and transmits claims electronically directly to the insurance carrier the system is known as | Carrier direct | 89 | |
4674670479 | 21. A computer printout that is used to look for errors below an insurance claim is transmitted electronically is called | An Insurance Billing Worksheet | 90 | |
4674670480 | 22. Back and forth communication between user and computer that occurs during online real time is called | Interactive transmission | 91 | |
4674670481 | 23. The CMS-1500 is also known as | The basic paper claim | 92 | |
4674670482 | 24. ASCA Required | All claims sent to Medicare should be submitted electronically | 93 | |
4674670483 | 25. The uniform claim form task force was replaced by | The national uniform claim committee | 94 | |
4674670484 | 26. In 2012, the CMS - 1500 claim form was revised to version 02-12 to accommodate | ICD-10 diagnosis codes | 95 | |
4693372136 | 27. An insurance claim form that contains no Staples or highlighted areas and on which the barcode area has not been deformed is called | A physically clean claim | 96 | |
4693372137 | 28. An insurance claim submitted with errors is referred to as | A dirty claim | 97 | |
4693372138 | 29. When I patient has dual coverage, the insurance that is considered the primary insurance is | Generally, the policy held by the patient | 98 | |
4693372139 | 30. When completing a claim form, if any question is on answerable | Leave the Space blank | 99 | |
4674670486 | 31. The appropriate method for entering the date of service on a claim form is: January 4, 2016 | 01042xxx | 100 | |
4693372140 | 32. Office visits may be grouped on the insurance claim form if each visit | Is consecutive uses the same procedure code, and results in the same feet | 101 | |
4674670487 | 33. The number issued to physicians by the Internal Revenue Service for income tax purposes is known as: | TIN | 102 | |
4674670488 | 34. Which which of the following is a lifetime 10 digit number issue to physicians that replaces all other numbers assigned by various health plans? | NPI | 103 | |
4674670489 | 35. Medicare providers who charge patients a fee for supplies and equipment such as crutches, urinary catheters, and walkers must send the claims two: | A specific DM E fiscal intermediary | 104 | |
4674670490 | 36. When medications are considered to be experimental the claim should be sent to the: | Insurance carrier with the copy of the invoice from the supply house | 105 | |
4693372141 | 37. 0CR is the acronym for | Optical character recognition | 106 | |
4693372142 | 38. OCR guidelines for the See CMS - 1500 claim form state | It should not be photocopied because it cannot be scanned | 107 | |
4693372143 | 39. To conform to CMS 1500 OCR guidelines | D all of the above. Do not fold insurance claim forms when mailing, do not use symbols with data on insurance claims forms, and do not strike over errorswhen making a correction on and insurance claim form | 108 | |
4693372144 | 40. The CMS- 1500 claim form is divided into which of the following major sections? | Patient and physician information | 109 | |
4674670491 | 41. Data that is made unintelligible to unauthorized parties is referred to as: | Encrypted | 110 | |
4693372145 | 42. Insurance claims transmitted electronically her usually paid in | Two weeks or less | 111 | |
4693372146 | 43. A clearinghouse is | Into tea that receives transmission of insurance claims, separates the claims, and since each one electronically to the correct insurance payer | 112 | |
4693372147 | 44. A group of insurance claims sent at the same time from one the facility is known as | Batch | 113 | |
4674670492 | 45. A provider is not considered a covered entity under HIPPA under which of the following circumstances? | For the provider has fewer than 10 employees and submit claims only on paper to Medicare | 114 | |
4674670493 | 46. ASC X12Version 5010 allows providers to submit claims | With ICD-10-CM/PCS codes | 115 | |
4674670494 | 47. Supplemental documents that provide additional medical information to a claim or referred to as | Claim attachments | 116 | |
4693372148 | 48. The employers if Acacian number is assigned by | The internal revenue services | 117 | |
4693372149 | 49. The most important function of a practice management system is | Accounts receivable | 118 | |
4693372150 | 50. Back and forth communication between user and computer that occurs during online real time is called | Interactive transaction | 119 | |
4693372151 | 51. When a medical practice has its own computer and transmits claims electronically directly to the insurance carrier, this system is known as | Blah blah blah blah blah ha ha Ha ha ha | 120 | |
4674670495 | 52. A transmission report which identifies the most common reasons for claim denial is the | Rejection analysis report | 121 | |
4674670496 | In correct sequencing of patient information on an electronic claim results in inaccuracies that violate the HIPPA standard transaction for Matt and I are known as | Syntax errors | 122 | |
4674670497 | The HIPPA security rule addresses security of electronic PHI in what area? | Administrative safeguards, technical safeguards, and physical safeguards | 123 | |
4674670498 | The most common type of physical access control to limit access to areas where medical charts are kept is | Locks on doors | 124 | |
4674670499 | To maintain confidentiality, individuals should develop passwords composed of | More than five characters, with upper and lowercase characters | 125 | |
4674670500 | To ensure that the data has been effectively backed up on the practice management system, verification of original records to stored information should be performed | Weekly | 126 | |
4674670501 | Which of the following is the best way to protect computer is it from prevent data file man damage during Power outages? | All offices should install uninterruptible Power supplies | 127 | |
4674670502 | Clean claim | An insurance claim that is submitted with in the program or policy time limit and correctly completed | 128 | |
4674670503 | Dirty claim | An insurance claim that is submitted with errors | 129 | |
4674670504 | Electronic claim | An insurance claim that is submitted via a dial-up modem or direct data entry | 130 | |
4674670505 | Incomplete claim | Hey Medicare claim that is missing required information | 131 | |
4674670506 | In valid claim | A Medicare claim that contains complete necessary information, but is not logical or incorrect | 132 | |
4674670507 | Paper claim | An insurance claim that is submitted on paper including optically scanned claims | 133 | |
4674670508 | Pending claim | An insurance claim held in suspense do to review or other reason | 134 | |
4674670509 | Rejected claim | An insurance claim that requires investigation and needs further clarification | 135 | |
4674670510 | Operative report is missing from the insurance claim | Submit all attachments with patients name and insurance identification number | 136 | |
4674670511 | America's oldest to privately owned, prepaid medical group is the | Ross-Loos medical group | 137 | |
4674670512 | Which plan allows members of kaiser Permanente medical care program to seek medical help from non-Kaiser physician's? | Point of service (POS) | 138 | |
4674670513 | Kaiser Permanente's medical plan is a closed panel program, which means | It limits the patient's choice of personal physician | 139 | |
4674670514 | A significant contribution to HMO development was the | Healthcare maintenance act of 1973 | 140 | |
4674670515 | How does an HMO receive payment for the services it's physicians provide? | Pre-paid health plan | 141 | |
4674670516 | When an HMO is paid a fixed amount for each patient served without considering the actual number or nature of services provided to each person, this is known as | Capitation | 142 | |
4674670517 | How are positions paid who work for a prepaid group practice? | Salary paid by independent group | 143 | |
4674670518 | The name of an organization of physicians sponsored by a state or local medical Association that is concerned with the development and delivery of medical services and the cost of healthcare | Foundation for medical care | 144 | |
4674670519 | In an independent practice association (IPA) physicians are | Not employees and are not paid salaries | 145 | |
4674670520 | And organization that gives members freedom of choice among physicians and hospitals and provides a higher level of benefits if the providers listed on the plan are you used is called | PPO- preferred provider organization | 146 | |
4674670521 | A physician owned business that has the flexibility to deal with all forms of contract medicine and also offers its own plans is a | PPG | 147 | |
4674670522 | A program that offers a combination of HMO style cost management and PPO style freedom of choice is a | Point of service plan | 148 | |
4674670523 | practitioners in an HMO program may come under peer review by a professional group called | Quality improvement organization | 149 | |
4674670524 | When a physician sees a of patient more than is medically necessary it is called | Churning | 150 | |
4674670525 | Referral of a patient recommended by one specialist to another specialist is known as | Tertiary care | 151 | |
4674670526 | What is the correct procedure to collect a co-pay on a managed-care plan? | Collect the copayment when the patient arrives for the office visit | 152 | |
4674670527 | Medicare part A is run by | The Center for Medicare and Medicaid services | 153 | |
4674670528 | Medicare is a | Federal health insurance program | 154 | |
4674670529 | The letter D following the identification number on the patient's Medicare card indicates a | Widow | 155 | |
4674670530 | The letters preceding the number on the patient's Medicare ID card indicate | A railroad retiree | 156 | |
4674670531 | Part A of medicare covers | Blood transfusions | 157 | |
4674670532 | Part B of Medicare covers | Diagnostic tests | 158 | |
4674670533 | Medicare part A benefits period ends when a patient | Has not been a bed patient in any hospital or nursing facility for 60 consecutive days | 159 | |
4674670534 | Part B Medicare annual deductible is | 160 | ||
4674670535 | Medicare provides a one time baseline mammographic examination for women ages 35 to 39 and prevented mammograms for women for 40 years or older | Once a year | 161 | |
4674670536 | The frequency of Pap tests that may be billed for a Medicare patient who is a lower risk is | Once every 24 months | 162 | |
4674670537 | Medigap insurance may cover | The deductible not covered under Medicare | 163 | |
4674670538 | When in Medicare beneficiary has employer supplemental coverage, medicare referrals to these plans as | MSP | 164 | |
4674670539 | Some senior HMO's may provide services not covered by Medicare, such as | I glasses and prescription drugs | 165 | |
4674670540 | A state-based group of doctors working under government guidelines reviewing cases for hospital admission and discharge is known as | A PRO | 166 | |
4674670541 | A participating physician with the medical Medicare plan agrees to except | 80% of the Medicare approved charge | 167 | |
4674670542 | In the Medicare program there is a mandatory assignment for | Clinical laboratory tests | 168 | |
4674670543 | A Medicare pre-payment screen | Identifies claims to review for medical necessity, and monitors the number of times given procedures can be built during one year | 169 | |
4674670544 | When a Medicare patient signs an advance beneficiary notice, the procedure code for the service provided must be modified using the HCPCS Level two modifier | -GA | 170 | |
4674670545 | Under the prospective payment system (PPS) hospitals treating Medicare patients are reimbursed according to | Pre-established rates for each type of illness treated based on diagnosis | 171 | |
4693210158 | Payments to hospitals for Medicare services are classified according to | DRG's | 172 | |
4693210159 | The 1987 omnibus Budget reconciliation act (OBRA) established the | MAACC | 173 | |
4693292490 | The HCPCS national alpha numeric codes are referred to as | Level II codes | 174 | |
4693292491 | Organizations handling claims from hospitals, nursing facilities, intermediate care facilities, long-term care facilities, and home health agencies are called | Fiscal intermediaries | 175 | |
4693292492 | The time limit for submitting a medical claim is | The end of the calendar year following the fiscal year in which services were performed | 176 | |
4693292493 | When a Medicare carrier transmits a medigapCarrier, it is referred to as a | Crossover claim | 177 | |
4693292494 | And explanation of benefits document for a patient under the Medicare program is referred to as the | Medicare remittance advice document | 178 | |
4693292495 | A claims assistance professional (CAP) | May act on the Medicare beneficiaries behalf as a client representative | 179 | |
4693292496 | When a remittance advice (RA) is received from Medicare, the insurance billing specialist should | Post each patients name and the amount of payment on the day sheet and the patients ledger card | 180 | |
4693292497 | If a check is received from Medicare and it is obvious that it is an overpayment, the insurance billing specialist should | Deposit the check and then right to Medicare notifying them of the overpayment | 181 | |
4693292498 | The Social Security act of 1935 | Set up the public assistance programs | 182 | |
4693292499 | The federal emergency relief administration made funds available to pay for | Medical expenses of the needy unemployed | 183 | |
4693292500 | The Medicaid program was a direct result of | A law passed by Congress in 1950 | 184 | |
4693292501 | In the Medicaid program, Congress authorized vendor payments for Medicare, which are payments from the | Welfare agency directly to the physician | 185 | |
4693292502 | The medically needy and geriatric population (aged) | Require help in meeting costs of medical care | 186 | |
4693292503 | DEFRA and CHAP we're responsible for | Expanding Medicaid eligibility requirements | 187 | |
4693292504 | Medicaid is administered by the | State government with partial federal funding | 188 | |
4693292505 | The federal aspects of Medicaid are the responsibility of | CMS | 189 | |
4693292506 | State children's health insurance programs (SCHIPs) | Operate with federal grant support under title V of the Social Security act | 190 | |
4693292507 | The Omnibus budget reconciliation act (OBRA) | Provided assistance for the aged and disable who are receiving Medicare and who's incomes are below the poverty level | 191 | |
4693292508 | Medicaid is available to needy and low income people such as | All of the above. The blind, the disabled, and The aged ( 65yrs or older | 192 | |
4693292509 | Basic maternal and Child health program MCHP provisions offered in all states include | 193 | ||
4693292510 | If a physician excepts Medicaid patients, the physician must except | The Medicaid allowed amount | 194 | |
4693292511 | Medicaid eligibility must always be checked for the | Both a and B. The month of service and the type of service | 195 | |
4693292512 | The Medicaid service for prevention, early detection, and treatment for welfare children is known as | EPSDT | 196 | |
4693292513 | To control escalating health care costs by curbing unnecessary emergency department visits and emphasizing preventive care, Medicaid reform has involved | Managed care programs | 197 | |
4693292514 | Medicaid managed care patient claims should be sent to the | Managed care organization and not the Medicaid fiscal agent | 198 | |
4693292515 | The time limit to the pillar claim varies from state to state, but is usually | 30 to 60 days | 199 | |
4693292516 | Hey program that contracts with CMS to review medical necessity and appropriateness of inpatient medical care is known as a | QIO | 200 | |
4693292517 | A participating position with the Medicare plan agrees to accept | 80% of the Medicare approved charge | 201 | |
4693292518 | In the Medicare program, there is mandatory assignment for | Clinical laboratory tests | 202 | |
4693292519 | A Medicare pre-payment screen | Both A and B. Identifies claims to review for medical necessity, and monitors the number of times given procedures can be billed during a specific time frame | 203 |
Medical Billing Flashcards
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