What indicates a claim should be submitted on paper instead of electronically - The claim requires an attachment
What steps wold be part of a physicians practice compliance program - Internal monitoring and auditing
What is the third stage of the life cycle of a claim - Claims Adjudication
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NHA Practice Questions Billing and
Coding 2022 updated solution
What indicates a claim should be submitted on paper instead of electronically - The
claim requires an attachment
What steps wold be part of a physicians practice compliance program - Internal
monitoring and auditing
What is the third stage of the life cycle of a claim - Claims Adjudication
What is the advantage of electronic claim submission - Claims are expedited
In an outpatient setting what forms are used as a financial report of all services provided
to patients - Patient account record
What document is required to disclose an adult patient information - A signed release
from the patient
What is a type of claim that will be denied by the third party payer - Incomplete claim
What is a billing practice action - Documenting the patients chief complaint, history,
exam assessment and plan
A billing and coding specialist needs to know how much Medicare paid on a claim
before billing secondary should refer to - Remittance advice
What is the medical term for the sac that encloses the heart - pericardium
What is a constitutes of consultation - Services rendered by a physician whose opinion
is required by another
What is the purpose of running an aging report each month - To indicate which claims
are outstanding
CMS-1500 which box do you mark for workers Comp - 10a
What is a verbal or written agreement that gives approval to release protected health
information (PHI) - Consent
What part of Medicare covers prescriptions - Part D
The star symbol on CPT code books is used to indicate - Telemedicine
, Two providers of the same practice visit a patient in the ED using the same CPT codes,
the claim maybe denied due to - Duplication services
CMS 1500 what block is used to bill ICD codes - Block 21
A participating BCBS provider receives an explanation of benefits, the change was $100
BCBS allowed $80 applied $40 to deductible BCBS paid 80% how much should the
patient pay - $48
What is an example of an electronic claim submission - Claims submitted via a secure
network
When a patient has a condition that is both acute and chronic how should it be reported
- Code both sequencing acute first
What is the function of the respiratory system - Oxygenating blood cells
A provider receives a reimbursement from a 3rd party accompanied by which of the
following - Explanation of benefits
What is the portion of the account that the patient must pay after services rendered and
deductible is meet - Co-Insurance
What is the term for an amount that is uncontrollable - Bad debit
What was developed to reduce Medicare program expenditures by detecting
inappropriate codes - NCCI
When posting a payment accrual which should hte billing and coding specialist include -
Patients responsibility
What organization identifies improper payments made by CMS claims - Recovery Audit
Contractor (RAC)
Z codes are used to identify - Immunizations
Add modifier -50 codes when reporting - Bilateral procedure
Who is allowed to submit a paper claim to Medicare - A providers office with fewer than
10 full time employees
What described the status of a claim that does not include required pre auth - Denied
Crossover claim submitted by a participating provider is responsible for what percent -
0%
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