1. Which means that the patient and/or insured has authorized the payer to reimburse the provider directly?
a. accept assignment
b. medical necessity
c. assignment of benefits
d. coordination of benefits
2. Providers who do not accept assignment of Medicare benefits do not receive information included on the
______, which is sent to the patient.
a. Medicare Summary Notice
b. ledger
c. encounter form
d. electronic flat file
3. The transmission of claims data to payers or clearinghouses is called claims
a. assignment.
b. submission.
c. adjudication.
d. processing.
4. A series of fixed-length records submitted to payers to bill for health care services is an electronic
a. funds transfer.
b. remittance advice.
c. flat file format.
d. source document.
5. Which is considered a covered entity?
a. private-sector payers that process electronic claims
b. provider that submits paper-based CMS-1500 claims
c. small self-administered health plan that processes manual claims
d. EHNAC, which accredits clearinghouses
6. A claim that is rejected because of an error or omission is considered a(n)
a. clean claim.
b. delinquent claim.
c. open claim.
d. closed claim.
7. The chargemaster is a(n)
a. encounter form used by physicians and other providers to collect data about office procedures provided to
inpatients.
b. data entry screen used by coders to assign diagnosis and procedure codes to generate a diagnosis-related
group.
c. document used by third-party payers and government plans to generate national provider identification
numbers.
d. computer-generated list used by facilities, which contains procedures, services, revenue codes, and charges.
8. Which supporting documentation is associated with submission of an insurance claim?
a. accounts receivable aging report
b. electronic remittance advice
c. common data file
d. claims attachment
This study source was downloaded by 100000888893651 from CourseHero.com on 09-12-2024 20:22:43 GMT -05:00
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller YourAssignmentHandlers. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $14.99. You're not tied to anything after your purchase.
