MNT II: Billing and Coding Exam Practice Questions and Answers
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Course
MNT
Institution
MNT
MNT II: Billing and Coding Exam
Practice Questions and Answers
Health care provider or supplier agrees (or is required by law to accept the third party payer-approved
amount as full payment for covered services and not to bill the client for any more than the deductible
and coinsurance. - Ans:-...
capitation (in which providers are paid a "lump sum" per patient regardless of how many services the
patient receives).
Bundled payments have been proposed in the health care reform debate in the United States as a
strategy for reducing health care costs. - Ans:✔✔-Bundled Payment
A payment arrangement for health care service providers based on a set amount for enrolled persons
assigned to them rather than a payment per service provided. The provider is paid whether or not the
enrolled person seeks care. - Ans:✔✔-Capitation
A payment system that measures the intensity of care and services required for each patient, and
translates these measures into the amount of reimbursement given to the facility for care of a patient.
Payment if linked to the intensity of resource use. - Ans:✔✔-Case Mix Reimbursement System
An electronic list of a facility's services and supplies, billing codes and the associated charges. The charge
master must be kept updated to the latest codes and government billing regulations for health claims. -
Ans:✔✔-Charge Master
A request for payment for the service(s) provided by a health care provider. - Ans:✔✔-Claim
The 1500 claim form is the universal insurance claim form developed and approved by the AMA and
Centers for Medicare and Medicaid Services. This form is used by non-institutional providers/suppliers to
bill Medicare carriers, commercial/private insurance and billing of some Medicaid State Agencies. -
Ans:✔✔-1500 Claim Form
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