MEDICAL BILLING AND
REIMBURSEMENT ESSENTIALS
QUESTIONS AND ANSWERS WITH
SOLUTIONS 2024
Medical billing and reimbursement represent the financial lifeline of the healthcare facility. True or false?
- ANSWER True
When does the medical billing process start? - ANSWER When a patient makes an appointment
When does the medical billing process end? - ANSWER When payment has been recieved
What is the first step in medical billing? - ANSWER Collect patient information when they call to schedule
an appointment
What should be reviewed prior to a patient being seen by the provider? - ANSWER Benefits and
exclusions
The form used for coding and billing is the ____. - ANSWER CMS 1500
Why is it important to meet the timely filing requirements of different insurance carriers? - ANSWER
Health insurance companies do not pay claims submitted after the established filing period
Health insurance claims for patient accounts with secondary insurance should be submitted to the
secondary carrier. True or false? - ANSWER True
What should you post to the patient's account? - ANSWER Payments using the EOB
When the patient makes an appointment, what should you ask for? - ANSWER Insurance billing
information
, What is a medical release of information form? - ANSWER Allows medical information to be released to
the insurance company
Should the medical release of information be in a patient's file? - ANSWER Yes
Should the medical release of information form be signed by the patient before or after the billing
process? - ANSWER Before
Precertification is ______. - ANSWER The process of proving to the insurance company that the service is
medically necessary
Does precertification guarantee a payment of services? - ANSWER No
Each insurance company has the same precertification requirements. True or false? - ANSWER False
Below listed is what all health insurance companies accept:
-CMS 1500 forms
-ICD-10-CM for diagnostic coding
-CPT and HCPCS procedural/supply codes
True or false? - ANSWER True
The medical assistant can successfully manage the requirements of the different insurance plans by keep
a ______. - ANSWER Medical billing manual
If the majority of claims are submitted electronically, why is it important to learn the different fields of
the CMS-1500 paper form? - ANSWER The data used to submit electronic claims are the same data used
of the CMS-1500
REIMBURSEMENT ESSENTIALS
QUESTIONS AND ANSWERS WITH
SOLUTIONS 2024
Medical billing and reimbursement represent the financial lifeline of the healthcare facility. True or false?
- ANSWER True
When does the medical billing process start? - ANSWER When a patient makes an appointment
When does the medical billing process end? - ANSWER When payment has been recieved
What is the first step in medical billing? - ANSWER Collect patient information when they call to schedule
an appointment
What should be reviewed prior to a patient being seen by the provider? - ANSWER Benefits and
exclusions
The form used for coding and billing is the ____. - ANSWER CMS 1500
Why is it important to meet the timely filing requirements of different insurance carriers? - ANSWER
Health insurance companies do not pay claims submitted after the established filing period
Health insurance claims for patient accounts with secondary insurance should be submitted to the
secondary carrier. True or false? - ANSWER True
What should you post to the patient's account? - ANSWER Payments using the EOB
When the patient makes an appointment, what should you ask for? - ANSWER Insurance billing
information
, What is a medical release of information form? - ANSWER Allows medical information to be released to
the insurance company
Should the medical release of information be in a patient's file? - ANSWER Yes
Should the medical release of information form be signed by the patient before or after the billing
process? - ANSWER Before
Precertification is ______. - ANSWER The process of proving to the insurance company that the service is
medically necessary
Does precertification guarantee a payment of services? - ANSWER No
Each insurance company has the same precertification requirements. True or false? - ANSWER False
Below listed is what all health insurance companies accept:
-CMS 1500 forms
-ICD-10-CM for diagnostic coding
-CPT and HCPCS procedural/supply codes
True or false? - ANSWER True
The medical assistant can successfully manage the requirements of the different insurance plans by keep
a ______. - ANSWER Medical billing manual
If the majority of claims are submitted electronically, why is it important to learn the different fields of
the CMS-1500 paper form? - ANSWER The data used to submit electronic claims are the same data used
of the CMS-1500
