Third party payer Study guides, Class notes & Summaries

NHA CBCS study guide Questions and Answers (2024 / 2025) (Verified Answers) When submitting claims, which of the following is the outcome if Block 13 is left blank? The third-party payer reimburses the patient, and the patient is responsible for reimbursing the provider Which of the following do physicians use to electronically submit claims? clearinghouse When billing a secondary insurance company, which block should the billing and coding specialist fill out on the CMS-1500 claim ...

Knowing which of the following can best assist a technician in the prevention of data entry errors? A. Names of medications B. Insurance co-payments C. Pharmacokinetics D. Physician contact informationAnswer - A. Names of medications Which of the following injectable drugs would be stored in refrigerator? A. Clindamycin B. Ciprofloxacin C. Cyanocobalamin D. Calcitonin-salmonAnswer - D. Calcitonin-salmon The requirement that a non-formulary medication be covered only if approv...

CMAA EXAM STUDY GUIDE QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS 100% VERIFIED when should an MA assistant schedule a return appointment for a pt when pt checks out proper protocol when following up on nonpayment and of claims from third party payers notify the pt of the claim; contact third party payer

NHA CEHRS FINAL PRACTICE TEST REVIEW QUESTIONS ONLY EXAM REVIEW QUESTIONS AND ANSWERS, VERIFIED/ how does the registration process begin in an outpatient setting? - -when a new patient calls the office for an appointment to see a provider. what does a front staff member do once they obtain information from a new patient? - -they create an account that includes the patient's identity, medical condition, and insurance/payment info. what does a front staff member do once they obtain info...

Advance Beneficiary Notice (ABN) A form provided to the patient when the provider believes Medicare will probably not pay for services received Allowed Amount The maximum amount a third-party payer will pay for a particular procedure or service Copayment a small fixed fee paid by the patient at the time of an office visit Coinsurance a provision under which both the insured and the insurer share the covered losses, typically 80:20 deductible specific amount of money a patient must pay out...

NHA CBCS exam review 2024/2025 (questions and answers verified) Which of the following Medicare policies determines if a particular item or service is covered by Medicare? - C ORRECT ANSWER-National Coverage Determination (NCD) A patient's employer has not submitted a premium payment. Which of the following claim statuses should the provider receive from the third-party payer? - C ORRECT ANSWER-Denied A billing and coding specialist should routinely analyze which of the following to ...

(ABN)Advanced beneficiary notice Ans: advanced notice that the patient may have to pay for lab testing that medicare will not cover. Insurance Ans: a way of reducing a person's exposure to risk of loss because another party (insurance company) assumes the risk. Reimbursement Ans: the compensation or repayment for healthcare services. First party Ans: the patient or the person responsible for the healthcare bill Second party Ans: the physician, hospital, clinic, nursing home, or oth...

The nurse is speaking to students about changes in maternal-newborn care. One change is that self-care has gained wide acceptance with clients and the healthcare community due to research findings that suggest that it has which effect? A) Shortens newborn length of stay B) Decreases use of home health agencies C) Decreases healthcare costs D) Decreases the number of emergency department visits Answer: C Explanation: A) Length of stay is often determined by third-party payer (insurance c...

ICD-10-CM Exam |Questions Solved 100% Correct What edition of the Federal Register would hospital facilities be especially interested in? A. July B. November or December C. October D. January - C. October What edition of the Federal Register would outpatient facilities be especially interested in? A. November or December B. October C. January D. July - A. November or December What is the largest third-party payer? A. American government B. Department of Health and Human Services C....

CBCS Practice Test Questions And Answers Which of the following sections of the medical record is used to determine the correct evaluation and management code used for billing and coding? - ANS history and physical A billing and coding specialist is reviewing a CMS-1500 claim form. The "assignment of benefits" box has been checked "yes." The checked box indicates which of the following? - ANS The provider receives payment directly from the payer Which of the following do physic...