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NHA CBCS Chapter 4 - Payment Adjudication questions and answers already graded A+ 2025/2026
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NHA CBCS Chapter 4 - Payment Adjudication questions and answers already graded A+ 2025/2026
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NHA CBCS Chapter 4 - PaymentAdjudication
1. Account Number - ANS-Number that identifies particular episode of care, DOS , or
patient.
2. Accounts Receivable Department - ANS-Department that keeps music of what 3rd
birthday party payers the company is ready to hear from and what sufferers are due to
make a fee.
3. Advance Beneficiary Notice of Noncoverage - ANS-Form used whilst provider believes
Medicare will deny insurance because they deem the method useless.
4. After inquiring for an attraction the coverage employer have to: - ANS-- Respond inside
seventy two hours for pressing care.
5. - Within 30 days for denials of care not yet received.
6. - Within 60 days for services already received.
7. Age Trial Balance (ATB) - ANS-Status of an invoice pending fee from coverage and/or
affected person. (Managed in 30 day increments)
8. Aging Report - ANS-Measures the top notch balances in each account and enables
team of workers see what debts haven't been paid.
9. Appeals - ANS-Insurance Company must offer:
10. - Reasons declare become denied
11. - The right of the affected person to record an internal attraction
12. - Patients right to outside evaluation
13. - ID whether a Consumer Assistance Program is available
14. stability billing - ANS-Billing patients for prices in excess of the Medicare charge
schedule.
15. Batch - ANS-A organization of submitted claims.
16. Billed Amount (Actual Charge) - ANS-The amount the company costs for services; won't
be the same as the allowable rate.
17. Charge Description Manager (CDM) - ANS-Information approximately health care
offerings that patients have obtained and economic transactions which have taken
vicinity.
18. Cost Sharing - ANS-The balance the policyholder need to pay to the issuer.
19. Denial Codes - ANS-Group, CARCs, RARCs, Provider-Level
20. Explanation of Benefits (EOB) - ANS-Describes the offerings rendered, payment
protected, and advantages limits and denials.
21. Health Record Number - ANS-Number the company uses to ID an character sufferers
document.
22. Medicare Summary Notice ( MSN) - ANS-Document that outirs the amounts billed by
way of the company and what the affected person should pay the provider.
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