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NCCT BILLING AND CODING QUESTIONS WITH COMPLETE ANSWERS.
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NCCT BILLING AND CODING QUESTIONS WITH COMPLETE ANSWERS.
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NCCT BILLING AND CODINGQUESTIONS WITH COMPLETE
ANSWERS
It ccis ccimportant ccto ccmake ccthe ccpatient ccaware ccof ccthe ccmailing ccaddress, ccinterest
ccrates, ccand cclength ccof ccagreement ccwhen ccsetting ccup cca cc- ccAnswer ccpayment
ccarrangement.
What ccis ccthe cccorrect ccterm ccfor cca ccdoctor ccwho ccenters ccinto ccan ccagreement
ccwith cca ccthird ccparty ccpayer ccon cccharges, ccdiscounts, ccand ccservices ccrendered ccto
cctheir ccpolicyholders ccwithin ccthe ccnetwork? cc- ccAnswer ccPAR cc(participating
ccprovider) cca ccphysician ccwho ccenters ccinto ccan ccagreement ccwith cca ccpayer ccto
ccoffer ccdiscounts ccon cccharges ccrendered ccto cctheir ccpolicy ccholders.
What ccshould cca ccpractice's ccfinancial ccpolicy ccalways ccexplain? cc- ccAnswer ccwhat ccis
ccrequired ccfrom ccthe ccpatient ccand ccwhen ccpayment ccis ccdue
A ccpatient cchad cca ccprocedure ccwhich ccwas ccbilled ccat cc$200.00. ccThe ccallowed
ccamount ccwas cc$150.00 ccand cche cchas cc$50.00 ccleft ccto ccmeet ccof cchis ccdeductible.
ccHis ccco-insurance ccis cc20%. ccHow ccmuch ccdoes ccthe ccpatient ccowe? cc- ccAnswer
cc$80
ccThe ccpatient ccin ccthis ccquestion ccis ccresponsible ccfor cc20%. cc$150 ccallowed
ccamount. cc20% ccof cc$150 ccallowed ccis cc$30. ccPatient ccstill ccowes cc$50 ccdeductible.
ccPatient ccwould ccowe cc$80 cctotal.
The ccphysician cccharges cc$100 ccfor cca ccvisit. ccThe ccinsurer ccallowable ccamount ccis
cc$80. ccThe ccpatient cchas cca cc$200 ccdeductible, ccwhich cchas ccnot ccbeen ccmet.
ccWhich ccof ccthe ccfollowing ccwill cchappen? cc- ccAnswer ccThe ccpatient ccwill ccbe ccbilled
cc$80. cc
The ccallowed ccamount ccis ccnow ccthe cccost ccof ccthe ccservice, ccso ccsince ccthe
ccdeductible ccis ccnot ccmet, ccthe ccpatient ccwill ccbe ccresponsible ccfor ccthe ccentire cc$80.
,Which ccof ccthe ccfollowing ccdocuments ccfrom ccthe ccinsurance cccarrier ccshould ccthe
ccpayment ccposter ccread ccand ccpost ccthe ccpayments ccor cccontractual ccadjustments
ccto ccthe ccpatient ccaccount? cc- ccAnswer ccremittance ccadvice. cc
A ccremittance ccadvice ccis ccused ccto ccpost ccpayments ccfrom ccinsurance cccarriers.
The ccinsurance ccand cccoding ccspecialist ccreceived ccan ccEOB ccand ccis ccposting ccthe
ccpayments ccto ccthe ccpatient ccaccounts. ccAccording ccto ccthe ccfollowing ccinformation
ccbelow, cchow ccmuch ccdoes ccthe ccpatient ccstill ccowe ccfor ccthis ccservice?
Non-participating ccprovider
Copay: cc$20, ccpaid ccat cctime ccof ccservice
Deductible ccamount ccthat ccpatient ccpaid: cc$100
Accepted ccfee ccfor ccservice: cc$250
Insurance ccpayment: cc$75 cc- ccAnswer cc$55
Total cccharges ccare cc$250.00 ccof ccwhich ccthe ccpatient cchas ccpaid cc$20.00 ccand
cc$100.00. ccThis ccnow ccleaves cca ccbalance ccof cc$130.00, ccof ccwhich ccthe ccinsurance
cccompany ccpaid cc$75.00. ccThis ccnow ccleaves cca ccbalance ccdue ccfrom ccthe ccpatient
ccof cc$55.00.
Which ccof ccthe ccfollowing ccare ccthe ccsteps ccto ccposting cca ccMedicare ccpayment ccto
ccthe ccpatient's ccaccount? cc- ccAnswer ccReview ccthe ccEOB., ccAdjust ccany cccontractual
ccagreements., ccSend ccthe ccbilling ccstatement ccif ccthere ccis cca ccbalance.
First ccthe ccEOB ccshould ccbe ccreviewed ccto ccmake ccsure ccall ccthe ccinformation ccis
cccorrect ccand ccthe cccorrect ccpatient ccis cccredited. ccAny ccpayments ccare ccposted ccand
ccall ccthe ccadjustments ccare ccmade. ccOnce ccthese cctasks ccare ccfinished, ccthe ccsystem
ccwill ccgenerate cca ccstatement ccof ccany ccbalances ccdue ccto ccsend ccto ccthe ccpatient.
ccThere ccis ccno ccneed ccto cccheck ccthe cccopay ccsince ccthe ccsystem ccwill
ccautomatically cchave ccthis ccinformation ccon ccthe ccstatement ccto ccthe ccpatient.
Which ccof ccthe ccfollowing ccdoes cca ccthorough ccunderstanding ccof ccthe ccExplanation
ccof ccBenefits cc(EOB) ccsupplied ccby ccthe ccpayer ccallow ccthe ccinsurance ccand cccoding
ccspecialist ccto ccdo? cc- ccAnswer ccApply ccwrite-offs., ccBill ccpatients cccorrectly.,
ccResolve ccpayment ccissues.
Which ccof ccthe ccfollowing ccinformation ccwill ccthe ccinsurance ccand cccoding ccspecialist
ccneed ccto ccapply ccthe ccpayment cccorrectly ccwhen ccin ccreceipt ccof ccan ccinsurance
ccEOB ccand cccheck ccfor ccpayment? cc- ccAnswer ccaccount ccnumber, ccdate ccof
ccservice, ccpatient ccname
The ccdifference ccbetween ccthe ccbilled ccamount ccand ccthe ccallowed ccamount ccfor
ccservices ccfrom cca ccparticipating ccprovider ccis cc- ccAnswer ccadjusted ccby ccthe
ccprovider.
When cca ccpatient ccsees cca ccparticipating ccprovider, cche ccreceives cca ccdiscount. ccThis
ccdiscounted ccamount ccis cccalled ccthe ccallowed ccamount. ccThe ccdifference ccbetween
, ccthe ccbilled ccamount ccand ccthe ccallowed ccamount cccannot ccbe cccharged ccto ccthe
ccpatient ccwhen ccseeing cca ccparticipating ccprovider.
The ccpatient ccmakes cca ccco-payment ccof cc$50. ccTo ccwhich ccsection ccof ccthe
ccpatient's ccaccount ccshould ccthe ccpayment ccbe ccapplied? cc- ccAnswer ccCredit
Which ccof ccthe ccfollowing ccis ccused ccto ccpost ccpatient ccpayments ccin ccprovider
ccoffices, ccelectronically ccor ccmanually? cc- ccAnswer ccledgers
The ccledger cckeeps cctrack ccof ccall ccpayments ccand ccoutstanding ccbalances ccfor ccthe
ccpatients
A ccthird ccparty ccpayer ccsent cca ccreport ccto ccthe cchospital ccexplaining ccthe ccpayments
ccof ccmultiple ccclaims ccsubmitted ccfor ccten ccpatients ccin ccthe ccmonth ccof ccNovember.
ccWhich ccof ccthe ccfollowing ccis ccthe cctitle ccof ccthat ccdocument? cc- ccAnswer
ccremittance ccadvice
A ccremittance ccadvice ccis ccused ccto ccpost ccpayments ccfrom ccinsurance cccarriers. ccIt
ccwill ccexplain ccthe ccreasons ccfor ccpayments ccor ccdenials, ccthe ccallowable ccamounts,
cccopayments, ccpatient ccbalances, ccetc. ccA ccremittance ccadvice ccis ccsent ccmonthly
ccand ccincludes ccall ccof ccthe ccpatients ccseen ccby ccthat ccpractice, ccwith ccthat
ccinsurance.
What ccis ccthe cccorrect ccprocess ccfor ccposting ccthe ccelectronic ccremittance ccadvice
ccand ccExplanation ccof ccBenefits ccto ccthe ccpatient's ccaccount? cc- ccAnswer ccUpload
ccinformation ccfrom ccthe cccarrier ccfile, ccadjust ccand ccsave
The ccpayer ccprovided ccthe ccfollowing ccinformation ccon cca ccpatient's ccaccount: cc
Charge cc- cc$189.00
Discounted ccAmount cc- cc$74.59
Patient ccResponsibility cc- cc$30.00
Amount ccPaid ccto ccProvider cc- cc$84.41 cc
What ccis ccthe ccpayer ccallowed ccamount ccfor ccthis ccclaim? cc- ccAnswer cc$114.41
The ccallowed ccamount ccin ccthis ccscenario cccan ccbe ccfound ccusing ccone ccof cctwo
ccmethods. ccThe ccfirst ccis ccto cctake ccthe cccharge ccamount cc($189) ccand ccsubtract
ccthe ccdiscounted ccamount cc($74.59), ccwhich ccwould ccbe cc$189- cc$74.59 cc=
cc$114.41. ccThe ccsecond ccis ccto cctake ccthe ccpatient's ccresponsibility cc($30) ccand ccadd
ccit ccto ccthe ccamount ccpaid ccto ccthe ccprovider cc($84.41), ccwhich ccwould ccbe cc$30 cc+
cc$84.41 cc= cc$114.41.
Which ccof ccthe ccfollowing ccmanaged cccare ccpayer ccdenials ccindicates ccfront ccend
ccuser ccerror? cc- ccAnswer ccincorrect ccinsurance ccinformation
When ccdealing ccwith cca ccMedicare ccdenied ccclaim, ccit ccis ccappropriate ccto ccwrite ccoff
ccthe ccamount ccdenied ccwhen ccthe ccclaim ccwas ccsubmitted cc- ccAnswer ccfor
ccexperimental ccprocedures.
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