NCCT Review - Office Financial Management, Billing, Insurance Exam Questions and Answers

NCCT Review - Office Financial Management, Billing, Insurance Exam Questions and Answers Which of the following documents does the provider or facility need to submit in order to receive reimbursement from an insurance company? - Answer-CMS-1500 Which of the following forms is used by the medical office to ensure that insurance payments are made directly to the physician? - Answer-Assignment of benefits Which of the following is the most likely cause of the deposits not agreeing with the credits on the day sheet or the patient ledgers? - Answer-Payment is misplaced When posting an insurance payment via an EOB, the amount that is considered contractual is the - Answer-Insurance allowed amount A list of all account balances and the amounts owed to the medical practice at the end of the day is called an - Answer-Accounts receivable report When following up on a denied claim, a medical office assistant should have which of the following information available when speaking with the insurance company? (Select the three (3) correct answers). - Answer-Patient's claim number, physician's NPI, patient's insurance ID number A medical office assistant's knowledge of a statute of limitations for collecting an overdue account is an example of managing the collections process while complying with - Answer-State and federal guidelines A patient has refused to pay for a medical procedure that was performed six months ago. The medical procedure was not listed under the patient's schedule of benefits, and she is now fully responsible for all costs. Her account has now been turned over to a collection agency. This scenario is most likely an example of failure of the medical office assistant to properly - Answer-Explain the non-coverage billing policies. The medical office assistant receives payments in full from both a primary private insurance company and a 65-year-old patient. At the end of the day she realizes there was an overpayment on the patient's account. Which of the following should the overpayment be refunded to? - Answer-The patient The process of finding out if a service or procedure is covered under a patient's insurance policy is called - Answer-Precertification A patient comes into a provider's office with a diagnosis CHF due to a medical emergency. The provider admits the patient to a local hospital for care. Which Medicare plan will cover the hospital admission? - Answer-Medicare Part A ASCA requires that hospital claims submitted to Medicare Part A and B must be submitted electronically, but will accept non-electronic claims on behalf of providers that - Answer-Employ less than 25 full-time employees A patient presents to the provider's office with a complaint of a migraine. The patient has Medicare and Medicaid. The patient also has a Worker's Compensation claim with a diagnosis of head injury. After the provider assesses the patient, the final diagnosis is a concussion. Where should this claim be submitted first? - Answer-Workers compensation