Exam (elaborations)
(ME2550) Healthcare Settings, Claim Cycle, and Claims Processing week_3_test Review with Verified Solutions
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- Ultimate Medical Academy
(ME2550) Healthcare Settings, Claim Cycle, and Claims Processing
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Question 12.5 out of 2.5 points
What can a physician do if an authorization is denied because a test is deemed "medically
unnecessary?"
Selected Answer:
present clinical reasons to the medical director in attempt to appeal
Question 2
2.5 out of 2.5 points
A plan specified facility where managed care plans require their patients to get laboratory and
radiology tests performed is called
Selected Answer:
network
Question 3
2.5 out of 2.5 points
When insurance carriers do not pay claims in a timely manner, what effect does this have on the
medical practice?
Selected Answer:
Decreased cash flow
Question 4
0 out of 2.5 points
What should be done if an insurance claim denial is received because a billed service was not a
program benefit?
Selected Answer:
Rebill with a letter of explanation from the physician
This study source was downloaded by 100000888893651 from CourseHero.com on 09-12-2024 20:25:14 GMT -05:00
https://www.coursehero.com/file/28131138/week-3-test-me2550-Idocx/
, Question 5
2.5 out of 2.5 points
Pending or resubmitted insurance claims may be tracked through a _____ file
Selected Answer:
tickler
Question 6
2.5 out of 2.5 points
An insurance claim with an invalid procedure code would be
Selected Answer:
rejected
Question 7
2.5 out of 2.5 points
The average amount of accounts receivable should be _____ times the charges for 1 month of
services.
Selected Answer:
1.5 to 2
Question 8
2.5 out of 2.5 points
When receiving payment from a private insurance carrier, check the amount of payment on the
EOB with the
Selected Answer:
patient's financial accounting record
This study source was downloaded by 100000888893651 from CourseHero.com on 09-12-2024 20:25:14 GMT -05:00
https://www.coursehero.com/file/28131138/week-3-test-me2550-Idocx/
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