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A ______ indicates the location or type of service provided for an inpatient and is reported with
_______.
a. Revenue code; four-digit code
b. Revenue code; three-digit code
c. CPT code; five-digit code
d. MSDRG code; three-digit code - Answer - a. Revenue code; four-digit code
Which of the following documentation is NOT needed for an audit?
a. Encounter form
b. Medical record
c. Explanation of Benefits
d. CMS-1500 claim form - Answer - c. Explanation of Benefits
A clearinghouse is an entity that provides which of the following services?
a. Converts nonstandard data received from payers to standard transaction data to meet HIPAA
requirements.
b. Pursues payments of debts owed by individuals or businesses.
c. Assists providers in the collection of appropriate reimbursement for services rendered.
d. Explains insurance benefits, policy requirements, and filing rules to patients. - Answer - a. Converts
nonstandard data received from payers to standard transaction data to meet HIPAA requirements.
Which is a TRUE statement about daily deposits?
, a. Keeping the checks and cash in the office for more than a day opens the practice up to liability for the
cash and checks.
b. Daily deposits should be made for the mail receipts and personal payment receipts.
c. Daily deposits of the mail receipts and personal payment receipts should be balanced each day.
d. All the statements are true. - Answer - d. All the statements are true.
Mrs. Fryer takes her son to the ED for an injured arm. Her son is covered by both parents. Mr. Fryer's
birthday is 10/14/1984 and Mrs. Fryer's birthday is 6/10/1986. Under the birthday rule whose insurance
plan will be primary?
a. Mrs. Fryer
b. Mr. Fryer
c. Either one can be primary
d. The parent's birthday closest to the child's birthday - Answer - a. Mrs. Fryer
When a batch of claims is submitted electronically to a clearinghouse a report is sent to the provider.
Which feedback does this report from the clearinghouse identify?
a. Shows improper Medicare payments paid to the provider.
b. Patient claims that will be sent to collections.
c. All claims sent to the payer and all rejected claims.
d. Patient claims that have not been paid within a certain time frame. - Answer - c. All claims sent to the
payer and all rejected claims.
What is a clean claim?
a. A blank claim form
b. A claim that meets medical necessity
c. A claim that has all of the information required to be processed
d. A claim that is paid on time - Answer - c. A claim that has all of the information required to be
processed