UNDERSTANDING Health Insurance | 50 Questions and Answers(A+ Solution guide)

The document submitted to the payer requesting reimbursement is called a - health insurance claim The Centers for Medicare and Medicaid Services (CMS) is an administration within the - Department of Health and Human Services A healthcare practioner is also called a - provider Which is the most appropriate response to a patient who calls the office and asks to speak with the physician? - Explain that the physician is with a patient, and ask if the patient would leave a message The process of assigning diagnoses, procedures and services using numeric and alphanumeric characters is called - coding If a health insurance plan's preauthorization requirements are not met by providers, - payment of the claim is denied Which coding system is used to report diagnoses and conditions on claims? - ICD The CPT coding system is published by the - AMA National codes are associated with - HCPCS Which report is sent to the patient by the payer to clarify the results of claims processing? - Explanation of benefits A remittance advice contains - payment information about a claim