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
... [Show More] 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 form?
Block 9a
A physician is contracted with an insurance company to accept the allowed amount. The insurance company $80 of a $120 billed amount, and $50 of the deductible has not been met. How much should the physician write off the patient's account?
$40
Which of the following is a requirement of some third-party payers before a procedure is performed?
Preauthorization
A prospective billing account audit prevents fraud by reviewing and comparing a completed claim form with which of the following documents?
a billing worksheet from the patient account
Which of the following documents is required to disclose an adult patient's information?
a signed release from the patient
After reading a provider's notes about a new patient, a coding specialist decides to code for a longer length of time than the actual office visit. Which of the following describes the specialist's action?
fraud
Two providers from the same practice visit a patient in the emergency department using the same CPT code. The claim may be denied due to which of the following reasons?
duplication of services
Which of the following security features is required during transmission of protected health information and medical claims to third-party payers?
encryption
Which of the following billing patterns is a best-practice action?
documenting the patient's chief complaint, history, exam, assessment and plan for care
A provider receives a reimbursement from a third-party payer accompanied by which of the following documents?
explanation of benefits
Which of the following is a correct entry of a charge of $150 in Block 24F of the CMS-1500 claim form?
150 00
A beneficiary of a Medicare/Medicaid crossover claim submitted by a participating provider is responsible for which of the following percentages?
0%
Which of the following coding manuals is used primarily to identify products, supplies, and services?
HCPCS level II manual
A billing and coding specialist needs to know how much Medicare paid on a claim before billing the secondary insurance. To which of the following should the specialist refer?
Remittance advice
Which of the following is allowed when billing procedural codes?
billing using two-digit CPT modifiers to indicate a procedure as performed differs from its usual five-digit code
Which of the following types of health insurance plans best describes a government-sponsored benefit program?
TRICARE Prime [Show Less]