Exam (elaborations)
NHA CBCS study guide Exam|271 Questions with 100% Accurate Answers
- Course
- Institution
NHA CBCS study guide Exam|271 Questions with 100% Accurate Answers
[Show more]
Seller
Follow
Victorious23
Reviews received
Content preview
NHA CBCS study guide Exam|271Questions with 100% Accurate Answers
When submitting claims, which of the following is the outcome if Block 13 is
left blank? - -The third-party payer reimburses the patient, and the patient is
responsible for reimbursing the provider
-Which of the following do physicians use to electronically submit claims? - -
clearinghouse
-When billing a secondary insurance company, which block should the billing
and coding specialist fill out on the CMS-1500 claim form? - -Block 9a
-A physician is contracted with an insurance company to accept the allowed
amount. The insurance company $80 of a $120 billed amount, and $50 of the
deductible has not been met. How much should the physician write off the
patient's account? - -$40
-Which of the following is a requirement of some third-party payers before a
procedure is performed? - -Preauthorization
-A prospective billing account audit prevents fraud by reviewing and
comparing a completed claim form with which of the following documents? -
-a billing worksheet from the patient account
-Which of the following documents is required to disclose an adult patient's
information? - -a signed release from the patient
-After reading a provider's notes about a new patient, a coding specialist
decides to code for a longer length of time than the actual office visit. Which
of the following describes the specialist's action? - -fraud
-Two providers from the same practice visit a patient in the emergency
department using the same CPT code. The claim may be denied due to which
of the following reasons? - -duplication of services
-Which of the following security features is required during transmission of
protected health information and medical claims to third-party payers? - -
encryption
-Which of the following billing patterns is a best-practice action? - -
documenting the patient's chief complaint, history, exam, assessment and
plan for care
, -A provider receives a reimbursement from a third-party payer accompanied
by which of the following documents? - -explanation of benefits
-Which of the following is a correct entry of a charge of $150 in Block 24F of
the CMS-1500 claim form? - -150 00
-A beneficiary of a Medicare/Medicaid crossover claim submitted by a
participating provider is responsible for which of the following percentages? -
-0%
-Which of the following coding manuals is used primarily to identify
products, supplies, and services? - -HCPCS level II manual
-A billing and coding specialist needs to know how much Medicare paid on a
claim before billing the secondary insurance. To which of the following
should the specialist refer? - -Remittance advice
-Which of the following is allowed when billing procedural codes? - -billing
using two-digit CPT modifiers to indicate a procedure as performed differs
from its usual five-digit code
-Which of the following types of health insurance plans best describes a
government-sponsored benefit program? - -TRICARE Prime
-Which of the following is the correct term for an amount that has been
determined to be uncollectable? - -bad debt
-Which of the following is a type of claim that will be denied by the third-
party payers? - -incomplete claim
-If a patient has osteomyelitis, he has problems with which of the following
areas? - -bones and bone marrow
-Block 17b on the CMS-1500 claim form should list which of the following
information? - -referring physician's national provider identifier (NPI) number
-Which of the following actions should the billing and coding specialist take
to effectively manage accounts receivable? - -collect copayment from the
patient at the time of service
-Which of the following acts applies to the Administrative Simplification
guidelines? - -Health Insurance Portability and Accountability Act (HIPAA)
-Which of the following is the primary information used to determine the
priority of collection letters to patients? - -the age of the account
, -Medicare enforces mandatory submission of electronic claims for most
providers. Which of the following providers is allowed to submit paper claims
to Medicare? - -A provider's office with fewer than 10 full-time employees
-In 1995 and 1997, which of the following introduced documentation
guidelines to Medicare carriers to ensure that services paid for have been
provided and we medically necessary? - -CMS
-Z codes are used to identify which of the following? - -immunizations
-Which of the following claims would appear on an aging report? - -a claim
that is delinquent for 60 days
-When a physician documents a patient's response to symptoms and various
body systems the results are documented as which of the following? - -
review of systems
-In an outpatient setting, which of the following forms is used as a financial
report of all services provided to patients? - -patient account record
-Which of the following is used by providers to remove errors from claims
before they are submitted to third-party payers? - -clearinghouse
-A patient has met a Medicare deductible of $150. The patient's coinsurance
is 20%, and the allowed amount is $600. Which of the following is the
patient's out-of-pocket expense? - -$120
-Which of the following modifiers should be used to indicate a professional
service has been discontinued prior to completion? - --53
-The explanation of payments received from the insurance company is often
referred to or called the: - -remittance advice
-A diseased condition or state is known as: - -morbidity
-A billing and coding specialist should add modifier -50 to codes when
reporting which of the following? - -a bilateral procedure
-When an electronic claim is rejected due to incomplete information, which
of the following actions should the medical billing specialist take? - -
complete the information and re-transmit according to the third-party
standards
-Accepting assignment on the CMS-1500 claim form indicates which of the
following? - -The physician agrees to accept payment under the terms of the
payer's program
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Victorious23. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $16.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
81989 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now