NCCT Billing And Coding Exam With 100% Correct Answers 2024

NCCT Billing And Coding Exam With 100% Correct Answers 2024 It is important to make the patient aware of the mailing address, interest rates, and length of agreement when setting up a -answer payment arrangement. What is the correct term for a doctor who enters into an agreement with a third party payer on charges, discounts, and services rendered to their policyholders within the network? -answer PAR (participating provider) a physician who enters into an agreement with a payer to offer discounts on charges rendered to their policy holders. What should a practice's financial policy always explain? -answer what is required from the patient and when payment is due A patient had a procedure which was billed at $200.00. The allowed amount was $150.00 and he has $50.00 left to meet of his deductible. His co-insurance is 20%. How much does the patient owe? -answer $80 The patient in this question is responsible for 20%. $150 allowed amount. 20% of $150 allowed is $30. Patient still owes $50 deductible. Patient would owe $80 total. The physician charges $100 for a visit. The insurer allowable amount is $80. The patient has a $200 deductible, which has not been met. Which of the following will happen? -answer The patient will be billed $80. The allowed amount is now the cost of the service, so since the deductible is not met, the patient will be responsible for the entire $80. Which of the following documents from the insurance carrier should the payment poster read and post the payments or contractual adjustments to the patient account? -answer remittance advice. A remittance advice is used to post payments from insurance carriers. The insurance and coding specialist received an EOB and is posting the payments to the patient accounts. According to the following information below, how much does the patient still owe for this service? Non-participating provider Copay: $20, paid at time of service Deductible amount that patient paid: $100 Accepted fee for service: $250 Insurance payment: $75 -answer $55 Total charges are $250.00 of which the patient has paid $20.00 and $100.00. This now leaves a balance of $130.00, of which the insurance company paid $75.00. This now leaves a balance due from the patient of $55.00. Which of the following are the steps to posting a Medicare payment to the patient's account? - answer Review the EOB., Adjust any contractual agreements., Send the billing statement if there is a balance. First the EOB should be reviewed to make sure all the information is correct and the correct patient is credited. Any payments are posted and all the adjustments are made. Once these tasks are finished, the system will generate a statement of any balances due to send to the patient. There is no need to check the copay since the system will automatically have this information on the statement to the patient. Which of the following does a thorough understanding of the Explanation of Benefits (EOB) supplied by the payer allow the insurance and coding specialist to do? -answer Apply write- offs., Bill patients correctly., Resolve payment issues. Which of the following information will the insurance and coding specialist need to apply the payment correctly when in receipt of an insurance EOB and check for payment? -answer account number, date of service, patient name The difference between the billed amount and the allowed amount for services from a participating provider is -answer adjusted by the provider. When a patient sees a participating provider, he receives a discount. This discounted amount is called the allowed amount. The difference between the billed amount and the allowed amount cannot be charged to the patient when seeing a participating provider. The patient makes a co-payment of $50. To which section of the patient's account should the payment be applied? -answer Credit Which of the following is used to post patient payments in provider offices, electronically or manually? -answer ledgers The ledger keeps track of all payments and outstanding balances for the patients A third party payer sent a report to the hospital explaining the payments of multiple claims submitted for ten patients in the month of November. Which of the following is the title of that document? -answer remittance advi