Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
NCCT Practice
NCCT State Practice
| Question | Answer |
|---|---|
| A Medicare patient presents to an outpatient presents to an outpatient hospital facility for a scheduled hysterectomy. To which Medicare plan should the facility submit the claim? | Medicare Part B |
| Which of the following protects federal healthcare programs from fraud and abuse by healthcare providers who solicit referrals? | Anti-Kickback Statute |
| In order to have claims paid as quickly as possible, the insurance specialist must be familiar with which of the following? | Payer's claim processing procedures |
| Which of the following should an insurance and coding specialist do when checking for completion of a new patient's registration form? | 1) Check that demographics are completed. 2) Make sure that the patient's name matches the insurance card. 3) Make sure that the registration form is signed and dated. |
| Collecting statistics on the frequency of copay collection at time of service is a step in the process of ___? | Managing A/R |
| A third party payer made an error while adjudicating a claim. Which of the following should the insurance and coding specialist do? | Resubmit the claim with an attachment explaining the error |
| When a capitation account is applied to the ledger it is also known as a ____? | Monthly prepayment amount |
| When there is a professional courtesy awarded to a patient's account the insurance and coding specialist should post the amount under the ____? | Adjustment column |
| When posting an insurance payment via and EOB, the amount that is considered contractual is the ____? | insurance allowed amount |
| Co-insurance is typically due ____? | After the claim has been adjudicated |
| If the insurance and coding specialist suspects Medicare fraud she should contact the ____? | OIG (Office of Inspector General) |
| When should a provider have a patient sign an ABN? | When the items may be denied and prior to performing the service |
| Which of the following are necessary to complete a CMS 1500 form? | 1) Diagnosis and CPT codes 2) physician information 3) demographic information |
| The patient opted to have a tubal ligation performed. Which of the following is needed in order for the third party payer (clearing house) to cover the procedure? | Pre-certification |
| When using an EHR system to enter CPT codes on a CMS 1500 claim form for electronic submission, which of the following should be entered on the claim form first? | The most resource-intensive procedure or service |
| When the patient calls to inquire about an account, which of the following does the insurance and coding specialist need to ask for before discussing the account? | Patients date of birth, patient's name, patient's insurance ID number |
| Which of the following defines the maximum time that debt can collected from the time it was incurred or became due? | Statute of limitations |
| Which of the following information is necessary to post payments from the RA/EOB? | Billed CPT codes, patient's name, date of service |
| Which of the following must be verified to process a credit card transaction? | Account number, credit card number, security code |
| A patient was seen in the office. Charges were recorded and submitted to the patient's insurance, and EOB was received by the office with a payment of $70.89. These transactions should be recorded in the _____? | patient ledger |
| When a document is changed in an EHR, the original documentation is _____? | hidden |
| Which of the following are violations of the Stark Law? | Accepting gifts in place of payment from patients, referring patients to facilities where the provider has a financial interest |
| When using the EHR to schedule a patient visit, which of the following screens should be used to complete the scheduling process? | patient search |
| When is a referral from a provider required? | When contained in the individual policy |
| The most effective method to manage patient statements and other financial invoices as well as avoid payment delays is to _____? | collect fees at the time of service |
| Which of the following financial reports produces a quarterly review of any dollar amount a patient still owes after all insurance carriers claim payments have been received? | Aging |
| If a married couple is covered under both spouses' health insurance and the husband wishes to schedule an appointment for an annual exam, he should call his primary care provider and _______? | schedule an appointment using both his insurance benefits and his wife's insurance benefits |
| Which of the following reports is used to follow up on outstanding claims to third party payers? | aging |
| Which of the following fees posted to the patient's account is an example of "usual, customary, and reasonable?" | allowed amount |
| When posting transactions for electronic claims submission, it is necessary to enter which of the following items onto the claim? | Physician's office fee |
| Which of the following Medicare parts covers inpatient hospital stays? | Part A |
| Developing an insurance claim begins ______? | when the patient calls to schedule an appointment |
| Which of the following regulations prohibits the submission of a fraudulent claim or making a false statement or representation in connection with a claim? | Federal False Claims Act |
Created by:
1berev2