Understanding Health Insurance Chapter 1 Health Insurance Specialist Careers: Review Questions | Questions and Answers(A+ Solution guide)

The documentation submitted to the payer requesting reimbursement is called a(n) - A. Explanation of benefits The Centers for Medicare and Medicaid Services CMS is an administration within the - B. Department of Health and Human Services (DHHS) A health care practitioner is also called a health care - B. Provider Which is the most appropriate response to a patient who calls the office and ask to speak with the physician - B. Explain that the physician is unavailable, and ask if the patient would like to leave a message. The process of assigning diagnosis, procedures, and services using numeric an alpha numeric characters is called - A. Coding If a health insurance plan preauthorization requirements are not met by provider - C. Payment of claim is denied. Which coding system is used to report diagnosis and conditions on claims - C. ICD-10-CM The CPT coding system is published by - D. American Medical Association (AMA), The national codes are associated with - C. HCPCS Level 2 Which reports you sent to the patient by the pair to clarify the results of claims processing - A. Explanation of benefits (EOB)