EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED. FIRST PUBLISH OCTOBER 2024.
NCCT STUDY GUIDE (MOA) WITH
COMPLETE SOLUTIONS
The phrase __ was coined to indicate payment of services rendered by someone other than the patient -
Answer✔✔-Third-party reimbursement
Since 2005, providers have been urged to - Answer✔✔-Send claims electronically
The CMS-1500 form is accepted by - Answer✔✔-Medicare and Medicaid
When a third-party payer identifies an error on the claim form, the claim is - Answer✔✔-Rejected with a
request to resubmit the form with corrections
How many digits are in a National Provider Identifier (NPI) number - Answer✔✔-10
What is the first step in completing a claim form - Answer✔✔-Check for a photocopy of the patients
insurance card
Electronically processing claim forms to insurance carriers - Answer✔✔-Reduces the amount of
preparation time for the claim processor
Which form is also known as the UB-04 form - Answer✔✔-CMS-1450
Which of the following is not a fee usually charged by a clearinghouse - Answer✔✔-customer service fee
Which of the following is not an advantage of using an Electronic Claims Tracking (ECT) system -
Answer✔✔-All claims are guaranteed to be paid if the forms are filled out correctly.
Manual claims tracking - Answer✔✔-Frequently causes payment delays
Page 1/16
,EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED. FIRST PUBLISH OCTOBER 2024.
When following up on a delinquent claim, if the carrier tells you that it is still in process, you should -
Answer✔✔-request an anticipated date of payment
When applying in insurance adjustment to a patient's account you are not typically required to post the -
Answer✔✔-Name of secondary insurance company that might be billed later
Number that identifies or refers to the claim that either the patient or health provider submitted to the
insurance company - Answer✔✔-Claim number
Beginning and end dates of the health related service a patient received from a provider - Answer✔✔-
Date of service
Amount of money that a patient's insurance company did not pay the provider - Answer✔✔-Not allowed
amount
Amount of money a patient goes as a share of the bill - Answer✔✔-Coinsurance copayment amount
Amount of provider billed the patient's insurance company for a service - Answer✔✔-Charge
Number assigned to a patient by the insurance company which should match the number on the
patient's insurance card - Answer✔✔-Insurance ID number
Code and brief description of the health related service a patient received from a provider - Answer✔✔-
Type of service
Name of the person who received the service - Answer✔✔-Patient
Bartered goods - Answer✔✔-Type of payment used for centuries in the past
claim form - Answer✔✔-Developed to report the health care provided to the source of payment when
third-party reimbursement was created
Page 2/16
, EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED. FIRST PUBLISH OCTOBER 2024.
third party reimbursement - Answer✔✔-The most Common of these are federal and state agencies,
insurance companies, and workers compensation
CMS-1500 - Answer✔✔-Standard claim form use for billing in medical offices
CMS-1450 (UB-04) - Answer✔✔-Paper claim form that may be submitted by an institutional provider
that meet certain requirements
Explanation of Benefits (EOB) - Answer✔✔-Form or document that may be sent to the patient by their
insurance company after they have had a healthcare service that was paid by the insurance company
may take up to several months to receive
Standard Electronic Data Interchange (EDI) Enrollment form - Answer✔✔-This must be completed before
submitting electronic media claims to Medicare
remittance advice - Answer✔✔-Similar to the EOB But is the document provided by the payer to the
provider
Manual insurance log - Answer✔✔-Use of these allows a medical facility or providers office to submit
transactions faster and be paid sooner
Signature on File (SOF) - Answer✔✔-Patient signature on a form that permits the release of his or her
information allowing the claim to be filed on his or her behalf
Assignment of benefits clause - Answer✔✔-Authorizes benefits to be paid directly from a third party
payer to a provider
Electronic Data Interchange (EDI) transactions - Answer✔✔-Book in which a list of insurance claims is
kept
Page 3/16
NCCT STUDY GUIDE (MOA) WITH
COMPLETE SOLUTIONS
The phrase __ was coined to indicate payment of services rendered by someone other than the patient -
Answer✔✔-Third-party reimbursement
Since 2005, providers have been urged to - Answer✔✔-Send claims electronically
The CMS-1500 form is accepted by - Answer✔✔-Medicare and Medicaid
When a third-party payer identifies an error on the claim form, the claim is - Answer✔✔-Rejected with a
request to resubmit the form with corrections
How many digits are in a National Provider Identifier (NPI) number - Answer✔✔-10
What is the first step in completing a claim form - Answer✔✔-Check for a photocopy of the patients
insurance card
Electronically processing claim forms to insurance carriers - Answer✔✔-Reduces the amount of
preparation time for the claim processor
Which form is also known as the UB-04 form - Answer✔✔-CMS-1450
Which of the following is not a fee usually charged by a clearinghouse - Answer✔✔-customer service fee
Which of the following is not an advantage of using an Electronic Claims Tracking (ECT) system -
Answer✔✔-All claims are guaranteed to be paid if the forms are filled out correctly.
Manual claims tracking - Answer✔✔-Frequently causes payment delays
Page 1/16
,EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED. FIRST PUBLISH OCTOBER 2024.
When following up on a delinquent claim, if the carrier tells you that it is still in process, you should -
Answer✔✔-request an anticipated date of payment
When applying in insurance adjustment to a patient's account you are not typically required to post the -
Answer✔✔-Name of secondary insurance company that might be billed later
Number that identifies or refers to the claim that either the patient or health provider submitted to the
insurance company - Answer✔✔-Claim number
Beginning and end dates of the health related service a patient received from a provider - Answer✔✔-
Date of service
Amount of money that a patient's insurance company did not pay the provider - Answer✔✔-Not allowed
amount
Amount of money a patient goes as a share of the bill - Answer✔✔-Coinsurance copayment amount
Amount of provider billed the patient's insurance company for a service - Answer✔✔-Charge
Number assigned to a patient by the insurance company which should match the number on the
patient's insurance card - Answer✔✔-Insurance ID number
Code and brief description of the health related service a patient received from a provider - Answer✔✔-
Type of service
Name of the person who received the service - Answer✔✔-Patient
Bartered goods - Answer✔✔-Type of payment used for centuries in the past
claim form - Answer✔✔-Developed to report the health care provided to the source of payment when
third-party reimbursement was created
Page 2/16
, EMILLECT 2024/2025 ACADEMIC YEAR ©2024 EMILLECT. ALL RIGHTS RESERVED. FIRST PUBLISH OCTOBER 2024.
third party reimbursement - Answer✔✔-The most Common of these are federal and state agencies,
insurance companies, and workers compensation
CMS-1500 - Answer✔✔-Standard claim form use for billing in medical offices
CMS-1450 (UB-04) - Answer✔✔-Paper claim form that may be submitted by an institutional provider
that meet certain requirements
Explanation of Benefits (EOB) - Answer✔✔-Form or document that may be sent to the patient by their
insurance company after they have had a healthcare service that was paid by the insurance company
may take up to several months to receive
Standard Electronic Data Interchange (EDI) Enrollment form - Answer✔✔-This must be completed before
submitting electronic media claims to Medicare
remittance advice - Answer✔✔-Similar to the EOB But is the document provided by the payer to the
provider
Manual insurance log - Answer✔✔-Use of these allows a medical facility or providers office to submit
transactions faster and be paid sooner
Signature on File (SOF) - Answer✔✔-Patient signature on a form that permits the release of his or her
information allowing the claim to be filed on his or her behalf
Assignment of benefits clause - Answer✔✔-Authorizes benefits to be paid directly from a third party
payer to a provider
Electronic Data Interchange (EDI) transactions - Answer✔✔-Book in which a list of insurance claims is
kept
Page 3/16
