When does cms send - Study guides, Class notes & Summaries

When is the principle diagnosis applicable? - Inpatient Hospital coding The term "encounter records" means: - claim What is the name of the act designed to address the collection practices of third- party debt collectors and attorneys who regularly collect debts for others? - Fair debt collection practices act (FDCPA) Medigap insurance may cover - the deductible not covered under Medicare Which of the following coding manuals is used primarily to identify products, supplies, and servic...

CRCR EXAM WITH CORRECT CHOICES, CERTIFIED AND VERRIFIED What are collection agency fees based on? - CORRECT ANSWER-A percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or what other rule? - CORRECT ANSWER-Birthday In what type of payment methodology is a lump sum or bundled payment negotiated between the payer and some or all providers? - CORRECT ANSWER-Case rates What customer service improvements might improve the patie...

Which of the following Medicare policies determines if a particular item or service is covered by Medicare? Correct 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? Correct Answer Denied A billing and coding specialist should routinely analyze which of the following to determine the number of outstanding claims? Correct Answer Aging report ...

CMCA PRACTICE EXAM 136 Questions with Verified Answers The Joint Commission (JC) requires the Factors that Affect Learning must be assessed for a hospital or hospital owned physician practice as well as other health care facilities. When assessing this element what does this include? A. The patient's ability to read, method of learning and understanding. B. Any language or physical disabilities. C. Cultural beliefs. D. All the above - CORRECT ANSWER D. All the above Report cop...

2023 AAPC CPB Final Exam Questions and Answers (2022/2023) (Verified Answers) AGRADE Health plan, clearinghouses, and any entity transmitting health information is considered by the Privacy Rule to be a: Correct Answer: covered entity Which of the following is not a covered entity in the Privacy Rule Correct Answer: healthcare consulting firm A request for medical records is received for a specific date of service from patient's insurance company with regards to a submitted claim. No authori...

2023 AAPC CPB Final Exam Questions and Answers (2022/2023) (Verified Answers) AGRADE Health plan, clearinghouses, and any entity transmitting health information is considered by the Privacy Rule to be a: Correct Answer: covered entity Which of the following is not a covered entity in the Privacy Rule Correct Answer: healthcare consulting firm A request for medical records is received for a specific date of service from patient's insurance company with regards to a submitted claim. No au...

Which of the following Medicare policies determines if a particular item or service is covered by Medicare? - 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? - Denied A billing and coding specialist should routinely analyze which of the following to determine the number of outstanding claims? - Aging report Which of the following should a billing...

AAPC CPB Final questions with complete solution Health plan, clearinghouses, and any entity transmitting health information is considered by the Privacy Rule to be a: - Correct Answers-covered entity Which of the following is not a covered entity in the Privacy Rule - Correct Answers-healthcare consulting firm A request for medical records is received for a specific date of service from patient's insurance company with regards to a submitted claim. No authorization for release of information...

Which of the following is considered the final determination of the issues involving settlement of an insurance claim? - Adjudication A form that contains charges, DOS, CPT codes, ICD codes, fees and copayment information is called which of the following? - Encounter form A patient comes to the hospital for an inpatient procedure. Which of the following hospital staff members is responsible for the initial patient interview, obtaining demographic and insurance information, and documenting the ch...

Which of the following Medicare policies determines if a particular item or service is covered by Medicare? - correct 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? - correct answer Denied A billing and coding specialist should routinely analyze which of the following to determine the number of outstanding claims? - correct answer Aging repo...