AAPC CPB: Chapter 9 Practical Application Exam Updated 2024/2025 Actual Questions and answers with complete solutions
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Course
AAPC CPB
Institution
AAPC CPB
Case 7 - Clearinghouse Rejection Report
Status: 7/6/20XX Contents: REJ - untimely filing; UTF
Patient Name: Smith, Hattie
Patient Number: MRN7862
Payer: AAPC Health Plan
Submission Date: 7/5/X2
Date of Service: 12/23/X1
Charge: $1200.00
Provider: Dailey, David
According to this clearinghou...
AAPC CPB : Chapter 9 Practical Application Exam Case 7 - Clearinghouse Rejection Report Status: 7/6/20XX Contents: REJ - untimely filing; UTF Patient Name: Smith, Hattie Patient Number: MRN7862 Payer: AAPC Health Plan Submission Date: 7/5/X2 Date of Service: 12/23/X1 Charge: $1200.00 Provider: Dailey, David According to this clearinghouse rejection report, what actions should be taken on the claim for Hattie Smith, Date of Service 12/23/20X1?I. Review claim and ensure DOS is correct. If DOS is incorrect, correct claim and resubmit. II. No changes should be made to the claim, write off the balance. III. Override the edit and force the claim to process. IV. Review claim and ensure DOS is correct. If DOS is correct, file an appeal with reasoning to explain why claim was not submitted timely. a. II only b. I and III c. I and IV d. III and IV - c. I and IV According to this clearinghouse rejections report, what actions should be taken on the claim for David Adams, Date of Service 11/19/20XX? I. Review the medical records to verify the ICD -10-CM code is correct. II. Review the ICD -10-CM codebook to verify it is a correct diagnosis code. III. Adjust the charge as this is not a covered diagnosis by the insurance carrier. IV. Override the clearinghouse edit as this is a valid code. a. II and III b. I and II c. I, II, and IV d. II and IV - b. I and II Case 1 - Clearinghouse Rejections Report Status: 11/19/20XX Contents: C4450 - Principal Diagnosis Code must be valid; REJECTED BY SYSTEM EDI; Rejected Patient Name: Adams, David Patient Number: 384594 Payer: HEALTHSPRINGMEDICARE Submission Date: 11/19/XX Date of Service: 11/09/XX Charge: $557.00 Provider: Post, Alexis Response Feedback:
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