Exam (elaborations)
SimChart 20 Questions and Answers 2024
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Exam of 1 pages for the course SimChart at SimChart (SimChart 20)
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SimChart 20Mora Siever is calling to ask the status of her prior authorization for physical therapy.
This was submitted two days ago via the insurance carrier's online portal. How would
your respond to Ms. Siever? - answer Let me check with the insurance company and I
can call you back.
The preauthorization request can be found in what part of the patient's EHR? - answer
Forms
An x-ray report would be documented in which section of the patient record? - answer
Radiology
What process indicates that a patient's insurance company has verified a service is
covered by the patient's policy, reviewed the medical necessity for the service, and
agreed that it is medically appropriate? - answer Precertification
Precertification may be done via: - answerphone, fax, and/or email.
Services that usually require preauthorization or precertification include: - answer
inpatient hospitalization.
True or false? Preauthorization is only required by managed care plans. - answer False
True or false? There is nothing that needs to be indicated on an insurance claim
regarding preauthorization. - answer False
Providing the diagnosis when requesting precertification for a procedure will help the
insurance carrier to determine what? - answer Medical necessity
Documentation for precertification can include which of the following? - answer
Diagnosis, proposed procedure, and insurance ID number
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