Role of Billing Specialist
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| What is a non-physician practitioner? | Called NPP - a person who can see patients and prescribe medications (i.e. nurse practicioner, physician assistant, physical therapist, speech therapist, LCSW); have their own provider # and can submit claims to third party payers.
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| The person who files and maintains health information records and distributes the mail to various departments within the office is called what? | File clerk
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| Insurance claims must be promptly submitted - ideally within how many business days to ensure continuous cash flow? | 1 to 5
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| What is cash flow? | It is the amount of actual money available to the medical practice.
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| Completion of what is necessary for a job as a coder? | An accredited program for coding certification or an accredited health information technology program.
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| What is medical ethics? | Medical ethics are standards of conduct generally accepted as moral guides for behavior.
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| Who is known as the "Father of Medicine" and conceived the Oath of Hippocrates? | Hippocrates, a Greek physician - about 5th century BC.
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| In 1980 the American Medical Association (AMA) adopted what? | A modern code of ethics called the Principles of Medical Ethics.
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| Illegal coding is considered illegal activity which is subject to what? | Penalties, fines, and/or imprisonment and can result in loss of morale, reputation and good will of the community.
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| The Internet Healthcare Coalition has developed what? | An eHealth Code of Ethics.
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| Reporting incorrect information to third party payers is what? | It is unethical, but may not be illegal depending on state laws.
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| The following is from the preamble of what organization: Health information management professionals strive for professional excellence through self-assessment and continuing education? | The American Health Information Management Association (AHIMA) code of ethics.
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| Coding services or procedures that were not performed for payment is an example of what? | Illegal coding
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| Physicians legal responsibility for the conduct and actions of their employees is called what? | Vicarious liability or respondent superior.
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| If an employee knowingly submits a fraudulent Medicare or Medicaid claim at the direction of the employer what can happen? | Both the employer and employee can be sued by the state or federal government.
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| An insurance biller should always check what? | Check with her employer to determine whether she is included in the medical professional liability insurance policy.
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| Among the things a medical biller will be expected to do is what? | Keep current and stay up-to-date by reading the latest health care industry association publications, participating in e-mail listserv discussions, joining a professional organization for networking, and attending seminars on billing and coding.
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