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Med billing and code
billing chapter 1 & 2
|What is another title for reimbursement specialist?
|health insurance specialist
|Coding is the process of reporting
|diagnoses, procedures, and services as numeric and alphanumeric characters on the insurance claim
|Which professional is considered a health care provider
|The mutual exchange of data between a provider and the payer is called:
|electronic data interchange
|Payment of claims may be denied if requirements are not met for which insurance rule
|The HCPCS coding system consists of how many levels
|Which of the following is a report that details to the patient the results of a processed claim
|explanation of benefits
|A health insurance specialist who exclusively files claims on behalf of patients would most likely pursue professional credentials with which organization
|An independent contractor should carry which type of insurance?
|Respondeat superior is Latin for which phrase?
|Let the master answer
|Medical malpractice insurance is considered what type of insurance?
|Which term or phrase defines the profession, delineates qualifications and responsibilities, and clarifies supervision requirements?
|scope of practice
|CHAMPUS stands for:
|Civilian Health and Medical Plan of the Uniformed Services
|CPT stands for:
|current procedural terminology
|The WHO, located in Geneva, Switzerland, is the originator of the ICD coding system. The acronym WHO is:
|World Health Organization
|Between 1965 and 1966, three government-sponsored programs for health care were instituted. These programs were:
|Medicare, CHAMPUS, Veteran’s Administration
|The government-regulated Medicaid program is also known as:
|Title XIX or Title 19
|If a liability insurer denies payment, a claim is filed with the patient’s insurance plan. What other documentation must accompany the claim?
|copy of written denial of responsibility from liability insurer
|Group health insurance is coverage available through whom
|A program responsible for providing health services to subscribers in a given geographical area for a fixed fee is known as a:
|health maintenance organization
|Which health care plan is designed for patients age 65 and older?
|When a person’s property is secured as payment for a debt, this is known as (a):
|The act that prohibits sharing of medical information among health insurers and financial institutions for use in making credit decisions is the
|Financial Services Modernization Act
|The Standard Unique Health Identifier for Health Care Providers is also known as the:
|Which event would be covered by automobile liability insurance?
|pain and suffering due to an accident
|Diagnoses are coded using the HCPCS coding system.
|For each procedure or service reported on a claim form, there must be a link to the condition that justifies the medical necessity of performing the procedure or service.
|The insurance specialist is expected to accurately code diagnoses and procedures or services rendered by the provider(s) in a practice.
|Because health insurance specialists are not providers of treatment, ethics are not important in their job.
|Consulting is a viable career option for a professional health insurance specialist.
|With respondeat superior, employees are free from any repercussions as a result of their negative actions or omissions while performing within the scope of their job.
|Disability insurance is designed to replace lost income as a result of a temporary or permanent illness or injury.
|Liability insurance is a policy that covers losses caused by the insured, an object of the insured, or on the premises covered by the insured.
|To file a liability claim, an insurance claim is always required.
|In 1988, Medicare began requiring physician offices to enter ICD-9-CM codes on the claims submitted for reimbursement.