AAPC CPB - Chapter 9 Quiz with 100% Correct Answers

AAPC CPB - Chapter 9 Quiz with 100% Correct Answers When a claim has been paid, an EOB is sent to: a. the clearinghouse. b. the patient. c. the provider. d. the insurance company. - Answer️️ -b. the patient. Cost based fee schedules are developed using which of the following: a. RBRVS methodology b. total costs of every procedure or service listed in the CPT® c. total cost of all of the procedures the physician will perform d. malpractice insurance and office operating costs - Answer️️ -c. total cost of all of the procedures the physician will perform The purpose of EHNAC is to: a. monitor coding practices of providers. ©SOPHIABENNET@ Thursday, August 22, 2024 10:21 AM Certified Professional Biller By: American Academy of Professional Coders(AAPC) 2 b. adheres to standards for clearinghouses. c. promote interoperability, quality service and regulatory compliance. d. both b and c. - Answer️️ -d. both b and c. Prior authorization for a service or procedure is required by: a. the parent or legal guardian of a minor. b. the patient. c. the patient's insurance payer d. the physician performing the procedure or service. - Answer️️ -c. the patient's insurance payer Which of the following tasks is the most basic element of the billing process: a. Claims follow-up b. Status report monitoring c. Data entry d. Patient follow-up - Answer️️ -c. Data entry ©SOPHIABENNET@ Thursday, August 22, 2024 10:21 AM Certified Professional Biller By: American Academy of Professional Coders(AAPC) 3 At the clearinghouse level, when a claim is returned to the provider, it is considered to be: a. denied b. pending c. rejected d. incomplete - Answer️️ -c. rejected The function of a claim scrubber is to: a. identify errors that will prevent a claim from being paid. b. determine the reimbursement amount. c. determine patient's deductible amount. d. identify practice management errors. - Answer️️ -a. identify errors that will prevent a claim from being paid. A batch of claims is submitted to the clearinghouse for processing. The status report shows that twenty claims were acknowledged and forwarded on to the payer for payment and ten claims were rejected. What is the next step the medical biller should take in this situation? ©SOPHIABENNET@ Thursday, August 22, 2024 10:21 AM Certified Professional Biller By: American Academy of Professional Coders(AAPC) 4 a. Contact the clearinghouse to determine why the ten claims were rejected. b. Contact the payer to determine the reason the claims were denied. c. Notify the billing department manager of the rejected claims. d. Review the status report to identify the reasons for rejection, make needed corrections and resubmit for payment. - Answer️️ -d. Review the status report to identify the reasons for rejection, make needed corrections and resubmit for payment. Payments due from patients, payers, or other guarantors are considered to be: a. active receivable. b. accounts receivable. c. allowed receivable. d. accounts refundable. - Answer️️ -b. accounts receivable. The remittance advice is generated by