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KDuvall Test

Enter the letter for the matching Answer
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1.
COnsists of two levels: Current Procedural Terminology, and National Codes (or HCPCS Level II codes)
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2.
Which organization is responsible for administering the Certified Healthcare Reimbursement Specialist certification exam?
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3.
The concept that every procedure or service reported to a third-party payer must be linked to a condition that justifies that procedure or service is called?
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4.
The exchange of information between provider and third-party payer, using a standardized machine-readable format, is called....
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5.
A person who performs services for another under an express or implied agreement and who is not subject to the other's control, or right to control.
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6.
The healthcare provider cannot collect the fees from the patient
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7.
A notice sent by the insurance company that contains payment information about a claim
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8.
National codes are associated with...
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9.
The process of assigning diagnoses, procedures, and services using numeric and alphanumeric characters is called....
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10.
Which certification fulfills the need for an entry-level coding credential?
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11.
The CPT coding system is published by the...
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12.
Provides protection from claims that contain errors and omissions resulting from professional services provided to clients (also called professional liability insurance)
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13.
Which type of insurance should be purchased by health insurance specialist independent contractors?
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14.
Which type of insurance guarantees repayment of financial loss resulting from an employee's act or failure to act?
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15.
Medical malpractice insurance is a type of what insurance?
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16.
The administrative agency within the federal department of health and human services.
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17.
Published by the AMA and includes 5 digit numeric and alphanumeric codes and descriptions for procedures and services
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18.
The principles of right and or good conduct
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19.
Documentation submitted to an insurance company requesting reimbursement for health care services provided is called a....
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20.
If the health plan preauthorization requirements are not met by providers,..
A.
Medical Necessity
B.
Centers for Medicare and Medicaid Services
C.
Bonding
D.
Remittance Advice
E.
Hold Harmless Clause
F.
Errors and Omissions Insurance
G.
AMBA
H.
Certified Coding Assistant (CCA)
I.
Electronic Data Interchange
J.
Medical Malpractice
K.
Health Insurance Claim
L.
Ethics
M.
AMA
N.
Current Procedural Terminology (CPT)
O.
Coding
P.
HCPCS
Q.
Liability
R.
Healthcare Common Procedure Coding System
S.
Independent Contractor
T.
Payment of the Claim is denied
Type the Answer that corresponds to the displayed Question.
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21.
The process of reporting diagnoses, procedures and services as numeric and alphanumeric characters on an insurance claim is....
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22.
Prior approval for treatment
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23.
The documentation submitted to the payer requesting reimbursement is called a...
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24.
Which mandates workers' compensation insurance to cover employees and their dependenat against injury and death occurring during the course of employment?
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25.
An insurance agreement that guarentees repayment for financial losses resulting from an employee's act or failure to act. Protects employers financial operations.
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26.
Linking every procedure or service code reported on the claim to an ICD-9 condition code t hat justifies the necessity for performing that procedure or service
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27.
A report detailing the results of processing a claim
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28.
Which clause is implemented if the requirements associated with preauthorization of a claim prior to payment are not met?
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29.
Which report is sent to the patient to detail the results of claims processing?
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30.
Data published in the Occupational Outlook Handbook indicates the job opportunities for health insurance specialists will increase by what percentage?

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