Which of the following is considered the final determination of the issues involving the settlement of an insurance claim?
Adjudication - is the process
... [Show More] of putting an insurance claim through a series of edits for final determination.
Chapter 4
A form that contains charges, DOS, CPT codes, fees, and copayment information is called which of the following?
Encounter form is a form that contains charges, DOS, CPT code, ICD codes, fees, and copayment information.
page 67
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 chief complaint?
Admitting these duties clerk has Chapter 3
Which of the following privacy measures ensures protected health information (PHI)?
Using data encryption software on office workstations - encryption software ensures that electronically transmitted health information cannot be read by third parties. This privacy measure guarantees PHI.
Chapter 1
Which of the following planes divide the body into left and right?
Sagittal plane divides the body into right and left sections
Which of the following provisions ensures that an insured's benefits from all insurance companies do not exceed 100% of allowable medical expenses?
Coordination of benefits ensures that the insured benefits from all insured companies do not exceed 100% of allowable medical expenses.
page 16
Which of the following actions should be taken first when reviewing a delinquent claim?
Verify the age of the account is the first action.
page 45
Which of the following is the advantage of electronic claim submission?
Claims are expedited - submitting claims electronically is faster than submitting paper claims.
page 15
Which of the following components of an explanation of benefits expedites the process of a phone appeal?
Claim control number expedites the process of a phone appeal.
Chapter 4
The standard medical abbreviation "ECG" refers to a test used to assess which of the following body systems?
Cardiovascular system- which is a test that checks for problems with the electrical activity of the heart.
Chapter 5
Which of the following actions by a billing coding specialist (bcs) would be considered fraud?
Billing for a service not provided is considered fraud and can result in fines for the bcs and the physician page 6
The "> <" symbol is used to indicate new and revised text other than which of the following?
Procedures descriptors Chapter 5
On the CMS-1500 claim form, blocks 14 through 33 contain information about which of the following?
The patient's condition and the provider's information are found on the CMS-1500 at blocks 14 - 33 page 21 [Show Less]