NHA CBCS study guide Questions And Answers

NHA CBCS study guide Questions And Answers When submitting claims, which of the following is the outcome if Block 13 is left blank? - ANS The third-party payer reimburses the patient, and the patient is responsible for reimbursing the provider Which of the following do physicians use to electronically submit claims? - ANS clearinghouse When billing a secondary insurance company, which block should the billing and coding specialist fill out on the CMS-1500 claim form? - ANS Block 9a A physician is contracted with an insurance company to accept the allowed amount. The insurance company $80 of a $120 billed amount, and $50 of the deductible has not been met. How much should the physician write off the patient's account? - ANS $40 Which of the following is a requirement of some third-party payers before a procedure is performed? - ANS Preauthorization A prospective billing account audit prevents fraud by reviewing and comparing a completed claim form with which of the following documents? - ANS a billing worksheet from the patient account Which of the following documents is required to disclose an adult patient's information? - ANS a signed release from the patient After reading a provider's notes about a new patient, a coding specialist decides to code for a longer length of time than the actual office visit. Which of the following describes the specialist's action? - ANS fraud Two providers from the same practice visit a patient in the emergency department using the same CPT code. The claim may be denied due to which of the following reasons? - ANS duplication of services Which of the following security features is required during transmission of protected health information and medical claims to third-party payers? - ANS encryption Which of the following billing patterns is a best-practice action? - ANS documenting the patient's chief complaint, history, exam, assessment and plan for care A provider receives a reimbursement from a third-party payer accompanied by which of the following documents? - ANS explanation of benefits Which of the following is a correct entry of a charge of $150 in Block 24F of the CMS-1500 claim form? - ANS 150 00 A beneficiary of a Medicare/Medicaid crossover claim submitted by a participating provider is responsible for which of the following percentages? - ANS 0% Which of the following coding manuals is used primarily to identify products, supplies, and services? - ANS HCPCS level II manual A billing and coding specialist needs to know how much Medicare paid on a claim before billing the secondary insurance. To which of the following should the specialist refer? - ANS Remittance advice Which of the following is allowed when billing procedural codes? - ANS billing using two-digit CPT modifiers to indicate a procedure as performed differs from its usual five-digit code Which of the following types of health insurance plans best describes a government-sponsored benefit program? - ANS TRICARE Prime Which of the following is the correct term for an amount that has been determined to be uncollectable? - ANS bad debt Which of the following is a type of claim that will be denied by the third-party payers? - ANS incomplete claim If a patient has osteomyelitis, he has problems with which of the following areas? - ANS bones and bone marrow Block 17b on the CMS-1500 claim form should list which of the following information? - ANS referring physician's national provider identifier (NPI) number Which of the following actions should the billing and coding specialist take to effectively manage accounts receivable? - ANS collect copayment from the patient at the time of service Which of the following acts applies to the Administrative Simplification guidelines? - ANS Health Insurance Portability and Accountability Act (HIPAA)