Jessica's NCCT Practice Exam Questions and Answers

Jessica's NCCT Practice Exam Questions and Answers The patient owes $25.00 for the visit. The amount collected for the office visit is called what? - Answer-Copayment The insurance carrier rate is 80% the remaining 20% is called what? - Answer- Coinsurance A third party payer made an error when adjudicating a claim which of the following should the specialist do? - 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? - Answer-A clean claim A medicare patient presents to an out patient hospital facility for a hysterectomy. To which medicare plan should be billed? - 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? - Answer- Deductible When there is a professional courtesy awarded to a patient's account the insurance specialist should post the amount under what column? - 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. - 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? - 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? - 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. - Answer-Diagnosis CPT and ICD-10 codes, Physician information, Demographic information Which of the following reports is used to follow up on an outstanding claims to third party payers? - Answer-Aging When following upon a denied claim an insurance specialist should have which of the following information available when speaking with the insurance company? Select 3 correct answers. - Answer-Patient's insurance ID number, Physician's NPI number, and Date of service Developing an insurance claim begins when? - Answer-When the patient calls to schedule an appointment Which of the following must be verified to process a credit card transaction? Choose (3) correct answers. - Answer-Security code, credit card number, and account number The most effective method to manage statements and other financial invoices as well as avoid payment delays is to do what? - Answer-Collect fees at the time of service Based on the CMS 1500 manual system, when updating or maintaining the billing code database which of the following does the R denote? - Answer-Revised An insurance and coding specialist is reviewing a patient's encounter form that is documented in the medical record prior to completing a CMS-1500 form she notices the physician up-coded the encounter form. The specialist has an ethical obligation to first? - Answer-Query the physician HIPPA allows a healthcare provider to communicate with a patient's family, friend, or other person's who are involved in the patient's care regarding their mental health status providing the patient does what? - Answer-Does not object Claims are often rejected because a provider needs to obtain what? - Answer- Preauthourizations When using an Electronic Health Record (EHR) system to enter cpt codes on a CMS- 1500 claim form for electronic submission which of the following should be entered on the claim form first? - Answer-The most resource-intensive procedure or service The Fair and Debt collection Act restricts debt collectors from engaging in conduct that includes what? - Answer-Calling before 8:00am or after 9:00pm, unless given permission Which of the following information is needed to determine a Medicaid sliding fee scale? choose (3) correct answers - Answer-Poverty, salary, and number of depedents The patient presents today for upper gastroinstestinal (GI) endoscopy and a biopsy of the stomach. Which of the cpt codes should be assigned? - Answer-43239 Digestive Esophagogastroduodenoscopy with biopsy