Aapc cpb chapter 1 - Study guides, Class notes & Summaries

AAPC CPB Chapter 11 ReviewA Medicare patient presents with an injury sustained at his part-time job. His injury status is verified by his company. After services are rendered, in what order are the claims submitted? a. The worker's compensation is primary, and Medicare is secondary b. Either may be filed first, whichever pays better c. Medicare is primary, and Worker's compensation is secondary d. The patient must pay for services and files claims himself - correct answer a. The wo...

AAPC CPB Chapter 1 Review FCA - correct answer False Claims Act (FCA): {"knowing" and "knowingly"}-Federal statue setting civil and criminal penalties to protect the government from being overcharged or sold substandard goods or services: -falsely billing the government -over-representing the amount of a delivered product ....or.... -under-stating an obligation to the government Minimum Necessary Standard. What should be sent if records are being requested?? - correct answer The ? r...

AAPC CPB Chapter 10 Review Study Questions 2024. What is the first step in working a denied claim? a. Resubmit the claim b. Contact the carrier c. Appeal the claim d. Determine and understand why the claim was denied - correct answer d. Determine and understand why the claim was denied The first step in working a denied claim is to understand why the claim has denied. Insurance carriers will use different denial codes on the remittance advice. Which of the following is a statement s...

AAPC CPB Chapter 13 ReviewWhich denial occurs when the claim is a liability case and was submitted to the health insurance? a. Coordination of Benefits b. Request for medical records c. Claim not covered by insurer d. Claim covered by other insurer - correct answer d. Claim covered by other insurer Similar to a coordination of benefits denial, a claim covered by other insurer denial occurs when the claim is a liability case such as auto or work-related accident. What is a rejected cl...

AAPC CPB Chapter 11-14 Questions & answers

AAPC CPB Chapter 13 Review Questions 2024. Which denial occurs when the claim is a liability case and was submitted to the health insurance? a. Coordination of Benefits b. Request for medical records c. Claim not covered by insurer d. Claim covered by other insurer - correct answer d. Claim covered by other insurer Similar to a coordination of benefits denial, a claim covered by other insurer denial occurs when the claim is a liability case such as auto or work-related accident. Wha...

AAPC CPB Chapter 1 ReviewFCA - correct answer False Claims Act (FCA): {"knowing" and "knowingly"}-Federal statue setting civil and criminal penalties to protect the government from being overcharged or sold substandard goods or services: -falsely billing the government -over-representing the amount of a delivered product ....or.... -under-stating an obligation to the government Minimum Necessary Standard. What should be sent if records are being requested?? - correct answer The ? req...

AAPC CPB Chapter 11 Review Practice Questions 2024. A Medicare patient presents with an injury sustained at his part-time job. His injury status is verified by his company. After services are rendered, in what order are the claims submitted? a. The worker's compensation is primary, and Medicare is secondary b. Either may be filed first, whichever pays better c. Medicare is primary, and Worker's compensation is secondary d. The patient must pay for services and files claims him...

Which coverage under TRICARE is a Medicare wrap around plan? a. TRICARE for Life b. TRICARE Reserve Select c. TRICARE Prime d. CHAMPVA - Answer a. TRICARE for Life A patient has Medicare and a Medigap policy. Box 13, signature on file, is checked off on the electronic claim submission. An EOMB is received with remittance notice MA19. What does the office need to do? a. Nothing. This means the claim has been crossed over to the Medigap plan. b. The biller must file the secondary in...

AAPC CPB Chapter 1Eight standard transactions were adopted for Electronic Data Interchange (EDI) under HIPAA. Which of the following is NOT included as a standard transaction? a. Payment and remittance advice b. Eligibility in a health plan c. Coordination of benefits d. Physician unique identifier number d. Physician unique identifier number We have an expert-written solution to this problem! HIPAA of 1996 includes a Security Rule that is established to provide what national standa...