A patient presents to the provider with chest pain and shortness of breath. After an unexpected ECG
result, the provider calls a cardiologist and summarizes the patient's symptoms. What portion of HIPAA
allows the provider to speak to the cardiologist prior to obtaining the patient's consent? - Answer -Title
II
A physician is contracted with an insurance company to accept the allowed amount. The insurance
company allows $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? - Answer -$40
Which of the following sections of the medical record is used to determine the correct Evaluation and
Management code used for billing and coding? - Answer -History and physical
A billing and coding specialist is reviewing a CMS-1500 claim form. The assignment of benefits box has
been checked yes. The checked box indicates which of the following? - Answer -The provider receives
payment directly from the payer.
Which of the following do physicians use to electronically submit claims? - Answer -Clearinghouse
Which of the following should the billing and coding specialist include in an authorization to release
information? - Answer -The entity to whom the information is to be released
Which of the following describes the content of a medical practice aging report? - Answer -An overview
of the practice's outstanding claims
, HIPAA transaction standards apply to which of the following entities? - Answer -Health care
clearinghouses
When a physician documents a patient's response to symptoms and various body systems, the results
are documented as which of the following? - Answer -Review of systems
Which part of Medicare covers prescriptions? - Answer -Part D
Which of the following indicates a claim should be submitted on paper instead of electronically? -
Answer -The claim requires an attachment.
Medicare enforces mandatory submission of electronic claims for most providers. Which of the
following providers is allowed to submit paper claims to Medicare? - Answer -A provider's office with
fewer than 10 full-time employees
Which of the following is the correct term for an amount that has been determined to be uncollectable?
- Answer -Bad debt
Which of the following statements is correct regarding a deductible? - Answer -The deductible is the
patient's responsibility.
Which of the following statements is true regarding the release of patient records? - Answer -Patient
access to psychotherapy notes may be restricted.
Why does correct claim processing rely on accurately complete encounter forms? - Answer -They
streamline patient billing by summarizing the services rendered for a given date of service.
When posting payment accurately, which of the following items should the billing and coding specialist
include? - Answer -Patient's responsibility
A dependent child whose parents both have insurance coverage comes to the clinic. The billing and
coding specialist uses the birthday rule to determine which insurance policy is primary. Which of the
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