AAPC CPB: Chapter 9 Questions And Answers With Verified Solutions Graded A+
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Course
AAPC CPB
Institution
AAPC CPB
A family has health insurance coverage from both the father and mother. The father's birthday is May 29,
1989 and the mother's birthday is May 26, 1990. Which insurance would be primary for their three
children?
A. The father's insurance would be primary because he was born before the mother.
B...
AAPC CPB : Chapter 9 A family has health insurance coverage from both the father and mother. The father's birthday is May 29, 1989 and the mother's birthday is May 26, 1990. Which insurance would be primary for their three children? A. The father's insurance would be primary because he was born before the mother. B. The mother's insurance would be secondary because she was born after the father. C. The mother's insurance would be primary based on the month and day of her birthday. D. The father's insurance would be primary based on the month and day of his birthday. - Answer -C. The mother's insurance would be primary based on the month and day of her birthday. A physician writes an order for his patient to be admitted to the hospital for observation for suspected dehydration. The patient is observed for 8 hours and discharged to home following hydration therapy. This patient is considered to be: A. Outpatient B. Inpatient C. New patient D. Established patient - Answer -A. Outpatient 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 - Answer -c. rejected 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 - Answer -c. total cost of all of the procedures the physician will perform Failure to post a contractual adjustment to a patient's account will: A. have no effect on the patient's account balance B. have no effect on the A/R C. leave a balance on the patient's account that should not be there D. decrease the workload of the billing staff - Answer -C. leave a balance on the patient's account that should not be there 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? 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. - Answer -d. Review the status report to identify the reasons for rejection, make needed corrections and resubmit for payment. Given the following information, determine the provider's fee schedule for 99203 New office patient visit using the following values: - National conversion factor $35.99
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