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
| Question | Answer |
|---|---|
| The patient opted to have a tubal ligation performed. Which of the following is needed in order for the third party payer to cover the procedure? | pre-certification |
| When a capitation account is applied to the ledger it is also know as a | monthly payment amount |
| Which of the following is the correct procedure for keeping a Worker's Compensation patient's financial and health records when the same physician is also seeing the patient as a private patient? | separate financial health records must be used |
| When posting transactions for electronic claims submission, it is necessary to enter which of the following items onto the claim | physician's office fee |
| 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 |
| 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 |
| A patient was seen in the office. Charges were recorded and submitted to the patient's insurance, and an EOB was received by the office with a payment of $70.89. These transactions should be recorded in the | patient ledger |
| 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 is a referral from a provider required? | when contained in the individual policy |
| The provider is paid the same rate per patient whether or not they provide services and no matter which services were provided. This payment is known as | capitation |
| 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 | patient's date of birth, patient's name, patient's insurance ID number |
| When a document is changed in an EHR, the original document is | hidden |
| When filling out an electronic insurance claim, the insurance and coding specialist processes which of the following forms | CMS-1500 |
| Which of the following patient information is needed to determine a Medicaid sliding fee scale? | poverty level, number of dependents, salary |
| Which of the following protects federal healthcare programs from fraud and abuse by healthcare providers who solicit referrals? | anti-kickback statute |
| which of the following should an insurance and coding specialist do when checking for completion of new patient's registration form? | check that demographics are completed, make sure that the patient's name matches the insurance card, make sure that the registration form is signed and dated |
| Claims are often rejected because a provider needs to obtain | pre-authorizations |
| when following up on a denied claim, an insurance and coding specialist would have which of the following information available when speaking with the insurance company | date of service, physician's NPI, patient's insurance ID number |
| the insurance and coding specialist is billing the insurance company of a 66 year old woman who has Medicare and is covered under her husband's private insurance. Which of the following should be billed first | the husbands insurance |
| which of the following Medicare parts covers inpatient hospital stays | part A |
Created by:
jessica8653
Popular Medical sets