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Wookbook Chap 1 Test

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1.
List the duties of claims assistance professional.
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2.
List 4 reasons for a medical practices large accounts receivable.
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3.
Name some facilities where facility billing is used.
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4.
Name examples of NPP's (non-physician practitioners).
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5.
Name 3 job titles available after training in diagnostic and procedural coding & insurance claims completion.
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6.
Ability to input data & transmit insurance claims accurately directly or thru clearinghouse as well as maintain and update software applications as required by third-party payers is technical skill required of what job?
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7.
Define vicarious liability also known as respondent superior.
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8.
Name some skills required for an insurance billing specialist.
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9.
What type of insurance is needed if a claims assistant neglects to submit an insurance claim to a Medicare supplement insurance within the proper time limit?
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10.
Name some responsibilities & duties an ins billing rep may perform in general as well as performing collections.
A.
Knowledge of medical terminology, anatomy & physiology Expert use of procedural and diagnostic codes Precise reading skills Basic math Knowledge of compliance, billing & collection techniques Basic keyboarding & computer skills Generate claims
B.
Electronic Claims Processor
C.
1. Failure to verify insurance benefits 2. Failure to obtain authorization or pre-certification 3. Failure to collect copays and deductibles 4. Inadequate claims filing
D.
Abstracts health info from patient records Operates computer to create & transmit claims Acts as a link between the provider & third-party payers Insurance counselor to patients Bills secondary insurance and patients Updates knowledge
E.
Insurance billing specialist Medical Billing respresentative Reimbursement specialist
F.
Errors and omissions insurance.
G.
Physician assistant, nurse practictioner, certified nurse anesthetist, physical therapist, speech therapist, LCSW, certified registered nurse practicioner.
H.
When a physician is legally responsible for an employee;s conduct performed during employment.
I.
Hospitals, acute care hospitals, skilled nursing & long term care facilities, rehabilitation centers & ambulatory surgical centers.
J.
Help patients organize, file & negotiate health claims Assist consumer in getting maximum benefits Tells patients how much to pay providers to avoid overpayment.
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11.
To report incorrect information to an Aetna insurance is what?
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12.
Reporting incorrect information to a Medicare fiscal intermediary is what?
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13.
Insurance claims must be submitted within how many days to ensure continuous cash flow.
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14.
In certain circumstances, if two doctors treat the same patient for the same condition it may be what?
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15.
The amount of actual money available to the medical practice is known as what?
Type the Question that corresponds to the displayed Answer.
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16.
Standards of conduct by which an insurance billing specialist determines the propriety or his/her behavior in a relationship.

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Created by: mpeoples