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1. LESSON 7 - COMPREHENSIVE HEALTH INSURANCE BILLING, CODING, AND REIMBURSEMENT CHP 1 QUESTIONS WITH COMPLETE ANSWERS. $12.49   Add to cart
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1. LESSON 7 - COMPREHENSIVE HEALTH INSURANCE BILLING, CODING, AND REIMBURSEMENT CHP 1 QUESTIONS WITH COMPLETE ANSWERS.
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  • NATIONALLY REGISTERED CERTIFIED CODING SPECIALIST
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  • NATIONALLY REGISTERED CERTIFIED CODING SPECIALIST

1. LESSON 7 - COMPREHENSIVE HEALTH INSURANCE BILLING, CODING, AND REIMBURSEMENT CHP 1 QUESTIONS WITH COMPLETE ANSWERS.

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  • November 7, 2024
  • 12
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

Subjects

  • 1 lesson 7 comprehensive health insurance billi

Written for

  • NATIONALLY REGISTERED CERTIFIED CODING SPECIALIST
  • NATIONALLY REGISTERED CERTIFIED CODING SPECIALIST

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LucieLucky

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1. LESSON 7 - COMPREHENSIVE
HEALTH INSURANCE BILLING, CODING,
AND REIMBURSEMENT CHP 1
QUESTIONS WITH COMPLETE
ANSWERS

Managed llCare ll- llAnswer llDescribes lla llsystem llin llwhich llhealthcare lldelivery llis
llmonitored
Under llmanaged llcare lla llhealthcare llprovider llwill llcontract llwith lla llhealth llinsurance
llcompany, llreferred llto llas lla llpayer


Payer ll(payor) ll- llAnswer llIn llthis llcontract llthe llprovider llagrees llto llfollow llguidelines
lland llaccept llnegotiated llfees llwith llthe llaim llto llcontrol llhealthcare llcosts


Physician's llPractice ll- llAnswer llGenerally llcategorized llas: ll
llSolo/Private llPractice
llSmall llGroup ll(3-9 llphysicians)
llLarge llGroup ll(10 llor llmore llphysicians)


Solo/Private llPractice ll- llAnswer llThe llstaff llmay llconsist llof lla:
llNurse
llReceptionist
llMedical llBiller lland/or
llOffice llManager


*The llreceptionist ll& llmedical llbiller llare lloften llcross-trained llfor llcoverage llpurposes

Small-Group llPractice ll- llAnswer llThe llphysicians llmay llhave llthe llsame llspecialty
EX: llThe llgroup llmay llconsist llof ll4 llor ll5 llGP's
Frequently llcontract llout lltheir llbilling lland llaccounts llreceivable

Small-Group llPractice llStaff ll- llAnswer llMedical llReceptionists
Medical llOffice llAssistant

, Medical llRecords llClerk
Medical llAdministrative llAssistant

Medical llOffice llAssistant ll- llAnswer llVerifies llInsurance
Assists llwith llscheduling
Checks llpatients llin llor llout
Compile lland llrecord llmedical llrecords, llreports, lland llcorrespondence

Large-Group llPractice ll- llAnswer llEX: llSpecialized llpractice, llsuch llas lla llback llinstitute,
llwhich llmight llconsist llof llan llorthopedic llsurgeon, llneurosurgeon, llinternist,
llchiropractor, llphysiatrist, llpain llspecialist, llexercise llphysiologist, lland lla llteam llof
llphysical lland lloccupational lltherapists
Commonly llhandle llclaims lland llaccounts llreceivable llin llhouse
May llemploy llseveral llpeople

Multispecialty llClinic ll- llAnswer llA llgroup llof llphysicians llwith llseveral llspecialties llwho
llhave llformed lla llclinic llor lloutpatient llcenter llto llprovide llservices llunder lleach llspecialty
EX: llAn lloutpatient llcenter llthat llprovides lltreatment llfor lladult llgeneral llinternal
llmedicine, lldiseases llof llthe llcirculatory llsystem lland lldiabetes, lldiseases llof llthe
llnervous llsystem, llgynecology, llosteopathic llmanipulative lltreatment, lland llother
llservices.


Hospital ll- llAnswer llMost llhospitals llare llowned llby llcorporations
The llstaff llresponsibiities llof llthe llbilling llor llfinancial lldepartment lllocated llon llsite llare
lllimited llto llanswering llbasic llquestions
Handling lland llprocessing llof lldata lland llclaims llare llmost lloften llaccomplished lloff llsite

Health llSystems ll- llAnswer ll3 llor llmore llhospitals llwith lldifferent llnames llto llactually llbe
lla llpart llof llone llcorporation llin lla llmetropolitan llarea
EX: llHospital llCorporation llof llAmerica ll(HCA), llAscension llHealth, lland llTenet llHealth
llCare llCorporation ll
Centralize lltheir llbilling lland llcollections llgeographically
Staff llresponsible llfor llprocessing llclaims llwill llbe lllocated lloff llsite

Patient llFinancial llServices ll- llAnswer llThese llpositions llare llpart llof llrevenue llcycle llor
llpatient llfinancial llservices:
llBilling
llRevenue llIntegrity
llCollections
llSupport llServices
llOthers


Revenue llCycle ll- llAnswer llThe llmanagement llof llhealthcare llreimbursement llfor
llservices llrendered
This llincludes llcalculating llpatient lland llpayer llresponsibility llthrough llclaims llprocessing
lland llcollection llof llpayment

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