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SimChart 20 Post-Case Quiz Questions and Answers 100% correct
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SimChart 20 Post-Case Quiz
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SimChart 20 Post-Case QuizPrecertification may be done via:
A. phone, fax, and/or email.
B. email.
C. phone.
D. fax. - answerA. phone, fax, and/or email.
What process indicates that a patient's insurance company has verified a service is
covered by the patient's policy, reviewed the medical necessity for the service, and
agreed that it is medically
appropriate?
A. Reimbursement
B. Claim overview
C. Advanced Directive
D. Precertification - answerD. Precertification
Documentation for precertification can include which of the following?
A. Diagnosis
B. Proposed procedure
C. Insurance ID number
D. Diagnosis, proposed procedure, and insurance ID number - answerD. Diagnosis,
proposed procedure, and insurance ID number
Providing the diagnosis when requesting precertification for a procedure will help the
insurance
carrier to determine what?
A. Patient viability
B. Medical necessity
C. Diagnosis code
D. Procedure code - answerB. Medical necessity
Services that usually require preauthorization or precertification include:
A. laboratory tests.
B. routine "wellness" examinations.
C. emergency room services.
D. inpatient hospitalization. - answerD. inpatient hospitalization.
True or false? There is nothing that needs to be indicated on an insurance claim
regarding preauthorization. - answerFalse - When a preauthorization is received for a
procedure, the insurance carrier will supply a
preauthorization number that should be included on the claim.
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