NCCT Insurance & Coding Practice Exam questions with complete solutions

The patient owes $25.00 for the visit. The amount collected for the office visit is called what? Correct Answer: Copayment The insurance carrier rate is 80% the remaining 20% is called what? Correct Answer: Coinsurance A third party payer made an error when adjudicating a claim which of the following should the specialist do? Correct Answer: resubmit the claim with an attachment explaining the error A claim submitted with all the necessary and accurate information so that it can be processed and paid is called? Correct Answer: A clean claim A medicare patient presents to an out patient hospital facility for a hysterectomy. To which medicare plan should be billed? Correct Answer: Part B The amount of the bill is $100 and this amount must be paid before the insurance company will pay on the claim. Which of the following is this called? Correct Answer: Deductible When there is a professional courtesy awarded to a patient's account the insurance specialist should post the amount under what column? Correct Answer: Adjustment column When the patient calls to inquire about an account which of the following does the insurance and coding specialist need to ask for before discussing the account? Choose 3 correct answers. Correct Answer: patient's insurance Id number, patient's date of birth, patient's name When a capitation account is applied to a ledger it is also know as what? Correct Answer: Monthly Prepayment amount The insurance and coding specialist calls a carrier to verify a patient's insurance an the representative states that the patient's insurance was cancelled three months ago. Which of the following should the insurance specialist do first? Correct Answer: Ask the patient for another form of insurance coverage Which are the following are necessary to complete a CMS-1500 form (Choose 3) correct answers. Correct Answer: Diagnosis CPT and ICD-10 codes, Physician information, Demographic information