CORRECT ANSWERS
2025
Whatvarevcollectionvagencyvfeesvbasedvon?v-vvcorrectvanswersvAvpercentagevofvdollarsvcollected
Self-
fundedvbenefitvplansvmayvchoosevtovcoordinatevbenefitsvusingvthevgendervrulevorvwhatvothervrule
?v-vvcorrectvanswersvBirthday
Invwhatvtypevofvpaymentvmethodologyvisvavlumpvsumvorvbundledvpaymentvnegotiatedvbetweenvth
evpayervandvsomevorvallvproviders?v-vvcorrectvanswersvCasevrates
Whatvcustomervservicevimprovementsvmightvimprovevthevpatientvaccountsvdepartment?v-
vvcorrectvanswersvHoldingvstaffvaccountablevforvcustomervservicevduringvperformancevreviews
,WhatvisvanvABNv(AdvancevBeneficiaryvNoticevofvNon-coverage)vrequiredvtovdo?v-
vvcorrectvanswersvInformvavMedicarevbeneficiaryvthatvMedicarevmayvnotvpayvforvthevordervorvservic
e
Whatvtypevofvaccountvadjustmentvresultsvfromvthevpatient'svunwillingnessvtovpayvforvavself-
payvbalance?v-vvcorrectvanswersvBadvdebtvadjustment
Whatvisvthevinitialvhospicevbenefit?v-vvcorrectvanswersvTwov90-
dayvperiodsvandvanvunlimitedvnumbervofvsubsequentvperiods
WhenvdoesvavhospitalvaddvambulancevchargesvtovthevMedicarevinpatientvclaim?v-
vvcorrectvanswersvIfvthevpatientvrequiresvambulancevtransportation vtovavskilledvnursingvfacility
Howvshouldvavprovidervresolvevavlate-chargevcreditvpostedvaftervanvaccountvisvbilled?v-
vvcorrectvanswersvPostvavlate-chargevadjustmentvtovthevaccount
anvincreasevinvthevdollarsvagedvgreatervthanv90vdaysvfromvdatevofvservicevindicatevwhatvaboutvacco
untsv-vvcorrectvanswersvTheyvarevnotvbeingvprocessedvinvavtimelyvmanner
Whatvisvanvadvantagevofvavpreregistrationvprogram?v-
vvcorrectvanswersvItvreducesvprocessingvtimesvatvthevtimevofvservice
Whatvarevthevtwovstatutoryvexclusionsvfromvhospicevcoverage?v-
vvcorrectvanswersvMedicallyvunnecessaryvservicesvandvcustodialvcare
Whatvcorevfinancialvactivitiesvarevresolvedvwithinvpatientvaccess?v-
vvcorrectvanswersvScheduling,vinsurancevverification,vdischargevprocessing,vandvpaymentvofvpoint-
of-servicevreceipts
,Whatvstatementvappliesvtovthevscheduledvoutpatient?v-
vvcorrectvanswersvThevservicesvdovnotvinvolvevanvovernightvstay
Howvisvavmis-postedvcontractualvallowancevresolved?v-
vvcorrectvanswersvComparingvthevcontractvreimbursementvratesvwithvthevcontractvonvthevadmittan
cevadvicevtovidentifyvthevcorrectvamount
Whatvtypevofvpatientvstatusvisvusedvtovevaluatevthevpatient'svneedvforvinpatientvcare?v-
vvcorrectvanswersvObservation
CoveragevrulesvforvMedicarevbeneficiariesvreceivingvskilledvnursingvcarevrequirevthatvthevbeneficia
ryvhasvreceivedvwhat?v-
vvcorrectvanswersvMedicallyvnecessaryvinpatientvhospitalvservicesvforvatvleastv3vconsecutivevdaysvb
eforevthevskilledvnursingvcarevadmission
Whenvisvthevwordv"SAME"venteredvonvthevCMSv1500vbillingvformvinvFieldv0$?v-
vvcorrectvanswersvWhenvthevpatientvisvthevinsured
Whatvarevnon-
emergencyvpatientsvwhovcomevforvservicevwithoutvpriorvnotificationvtovthevprovidervcalled?v-
vvcorrectvanswersvUnscheduledvpatients
Ifvthevinsurancevverificationvresponsevreportsvthatvavsubscribervhasvavsinglevpolicy,vwhatvisvthevstat
usvofvthevsubscriber'svspouse?v-vvcorrectvanswersvNeithervenrolledvnotventitledvtovbenefits
RegulationvZvofvthevConsumervCreditvProtectionvAct,valsovknownvasvthevTruthvinvLendingvAct,vestab
lishesvwhat?v-vvcorrectvanswersvDisclosurevrulesvforvconsumervcreditvsalesvandvconsumervloans
Whatvisvavprincipalvdiagnosis?v-vvcorrectvanswersvPrimaryvreasonvforvthevpatient'svadmission
, Collectingvpatientvliabilityvdollarsvaftervservicevleadsvtovwhat?v-
vvcorrectvanswersvLowervaccountsvreceivablevlevels
Whatvisvthevdailyvout-of-pocketvamountvforveachvlifetimevreservevdayvused?v-
vvcorrectvanswersv50%vofvthevcurrentvdeductiblevamount
WhatvservicevprovidedvtovavMedicarevbeneficiaryvinvavruralvhealthvclinicv(RHC)visvnotvbillablevasvanv
RHCvservices?v-vvcorrectvanswersvInpatientvcare
Whatvcodevindicatesvthevdispositionvofvthevpatientvatvthevconclusionvofvservice?v-
vvcorrectvanswersvPatientvdischargevstatusvcode
WhatvarevhospitalsvrequiredvtovdovforvMedicarevcreditvbalancevaccounts?v-
vvcorrectvanswersvTheyvresultvinvlostvreimbursementvandvadditionalvcostvtovcollect
Whenvanvunduevdelayvofvpaymentvresultsvfromvavdisputevbetweenvthevpatientvandvthevthirdvpartyv
payer,vwhovisvresponsiblevforvpayment?v-vvcorrectvanswersvPatient
MedicarevguidelinesvrequirevthatvwhenvavtestvisvorderedvforvavLCDvorvNCDvexists,vthevinformationvp
rovidedvonvthevordervmustvinclude:v-vvcorrectvanswersvAvvalidvCPTvorvHCPCSvcode
Withvadvancesvinvinternetvsecurityvandvencryption,vrevenue-
cyclevprocessesvarevexpandingvtovallowvpatientsvtovdovwhat?v-
vvcorrectvanswersvAccessvtheirvinformationvandvperformvfunctionsvon-line
WhatvdatevisvrequiredvonvallvCMSv1500vclaimvforms?v-
vvcorrectvanswersvonsetvdatevofvcurrentvillness