NCCT Billing and Coding 218 questions with complete solutions

It is important to make the patient aware of the mailing address, interest rates, and length of agreement when setting up a Correct Answer: payment arrangement. What is the correct term for a doctor who enters into an agreement with a third party payer on charges, discounts, and services rendered to their policyholders within the network? Correct Answer: PAR (participating provider) a physician who enters into an agreement with a payer to offer discounts on charges rendered to their policy holders. What should a practice's financial policy always explain? Correct Answer: what is required from the patient and when payment is due A patient had a procedure which was billed at $200.00. The allowed amount was $150.00 and he has $50.00 left to meet of his deductible. His co-insurance is 20%. How much does the patient owe? Correct Answer: $80 The patient in this question is responsible for 20%. $150 allowed amount. 20% of $150 allowed is $30. Patient still owes $50 deductible. Patient would owe $80 total. The physician charges $100 for a visit. The insurer allowable amount is $80. The patient has a $200 deductible, which has not been met. Which of the following will happen? Correct Answer: The patient will be billed $80. The allowed amount is now the cost of the service, so since the deductible is not met, the patient will be responsible for the entire $80. Which of the following documents from the insurance carrier should the payment poster read and post the payments or contractual adjustments to the patient account? Correct Answer: remittance advice. A remittance advice is used to post payments from insurance carriers. The insurance and coding specialist received an EOB and is posting the payments to the patient accounts. According to the following information below, how much does the patient still owe for this service? Non-participating provider Copay: $20, paid at time of service Deductible amount that patient paid: $100 Accepted fee for service: $250 Insurance payment: $75 Correct Answer: $55 Total charges are $250.00 of which the patient has paid $20.00 and $100.00. This now leaves a balance of $130.00, of which the insurance company paid $75.00. This now leaves a balance due from the patient of $55.00.