AAPC CPB: Chapter 12 Review Questions And Answers With Verified Solutions Graded A+
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Course
AAPC CPB
Institution
AAPC CPB
Blue Cross/Blue Shield offers which type of Medicare plan?
a. Medicare Plus
b. Medicare Advantage
c. Medicare Part G
d. Medicare Add-on - Answer-b. Medicare Advantage
A claim is submitted for a patient who suffered a fractured femur. The diagnosis code that was submitted
is S82.401A, with the...
AAPC CPB : Chapter 12 Review Blue Cross/Blue Shield offers which type of Medicare plan? a. Medicare Plus b. Medicare Advantage c. Medicare Part G d. Medicare Add -on - Answer -b. Medicare Advantage A claim is submitted for a patient who suffered a fractured femur. The diagnosis code that was submitted is S82.401A, with the CPT® fracture care code 27230. Does the diagnosis code support medical necessity for the service provided? a. Yes, the diagnosis code supports the CPT® code billed. b. Yes, the procedure code is supported by the ICD -10-CM code. c. No, the diagnosis code does not support the CPT® fracture care code. d. A diagnosis code is not necessary when reporting CPT® codes. - Answer -c. No, the diagnosis code does not support the CPT® fracture care code. A participating provider of Blue Cross/Blue Shield sees a patient in the ER. The charges equal $500.00. The patient has a $1000 deductible of which none has been met, and a $75.00 ER copay. How much should be collected from the patient at the time of compl etion of the ER visit? a. $75.00 b. $1000.00 c. $500.00 d. Wait for the EOB as a contractual write -off will apply. - Answer -a. $75.00 A patient seeks care from a neurologist without a referral from the patient's primary care physician, which is required by the insurance company. What is the likely outcome for neurologist's claim? a. The claim will be paid at a 75% of fee. b. The claim will be paid at 50% of fee. c. The claim will be denied. d. The claim will be paid at full rate. - Answer -c. The claim will be denied. A patient's insurance member card is issued by: a. the physician's office. b. the employer. c. the state. d. the insurance company. - Answer -d. the insurance company. A Blue Cross/Blue Shield insurance plan that allows members to choose any provider, but offers higher levels of coverage when members obtain services from network providers would be an example of: a. Health Maintenance Organization (HMO) b. Point of Service (POS) c. Preferred Provider Organization (PPO) d. Indemnity - Answer -c. Preferred Provider Organization (PPO) A savings account that allows individuals to save pre -tax dollars to reimburse for healthcare expenses is known as a(n): a. Flexible Spending Account (FSA) b. Health Savings Account (HSA) c. Employer Savings Account (ESA) d. Both a and b - Answer -d. Both a and b
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