Which of the following Medicare policies determines if a particular item or service is
covered by Medicare? - National Coverage Determination (NCD)
A
... [Show More] 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 and coding specialist use to submit a claim with
supporting documents? - Claims attachment
Which of the following terms is used to communicate why a claim line item was denied or
paid differently than it was billing? - Claim adjustment codes
On a CMS-1500 claim form, which of the following information should the billing and
coding specialist enter into Block 32? - Service facility location information
A provider's office receives a subpoena requesting medical documentation from a patient's
medical record. After confirming the correct authorization, which of the following actions
should the billing and coding specialist take? - Send the medical information pertaining to
the dates of service requested
Which of the following is the deadline for Medicare claim submission? - 12 months from the
date of service
Which of the following forms does a third-party payer require for physician services? -
CMS-1500
A patient who is an active member of the military recently returned from overseas and is in
need of specialty care. The patient does not have anyone designed with power of attorney.
Which of the following is considered a HIPAA violation? - The billing and coding specialist
sends the patient's records to the patient's partner.
Which of the following terms refers to the difference between the billing and allowed
amounts? - Adjustment
Which of the following HMO managed care services requires a referral? - Durable medical
equipment
Which of the following explains why Medicare will deny a particular service or procedure?
- Advance Beneficiary Notice (ABN) [Show Less]