INTRODUCTION TO MEDICAL BILLING
AND CODING EXAM Q&A
The medical biller receives _______ which explains what services and procedures
the insurance company paid for, analyze them, and then creates bills for patients. -
Answer-explanation of benefits (EOB)
What does EOB stand for? - Answer-explanation of benefits
What is an example of a medical biller's job? - Answer-They take the procedural and
diagnosis codes at the medical coder has translated and creates aclaim from these
using a form or a type of software program. The biller that reviews the patient's
insurance policy determine if the procedures and services performed by the
healthcare provider a covered by that patient's plan. The medical biller needs to
make sure that each code, and less each procedure listed on the claim, is actually
billable, and since the claim to the insurance company. The insurance company then
performs an evaluation known as payer adjudication, which determines the amount
of the bill they will Reimburse the provider for, and then sends this information back
to the provider in the form of an EOB. The EOB explains the amount paid for by the
insurance company, as well as any obligation the patient may have. The biller then
reviews the EOB be for accuracy, as well as ensures that the charges and
reimbursements correspond to the providers agreement with the payer. If there is
any balance owing by the patient, a patient statement will need to be created and
sent out to the patient. The biller also follows up with the patient for payment, and in
a non-pay situation, sends the bill for collections.
How does a medical biller create a patients claim? - Answer-Medical billers job starts
once the medical coder finishes their job. When a patients receives medical services
from a healthcare provider they're typically presents with a bull at the end of their
services. The biller creates this bill by looking at the balance (if any) the patients has.
The biller MUST factor in the patients copay, deductible, and deducting the amount
covered by insurance.
Coders must complete their coding in ___ to ___ days. - Answer-2 to 5 days. 5 days
MAX! Each office has a specific lag time. Things run smoothly if these deadline are
hit.
Why is medical coding needed? - Answer-It's to translate what transpired in any
exchange between a patient and a healthcare provider in a uniform practice,
MAINLY for the purpose of reimbursement for healthcare services.
Every injury, diagnosis, and medical service there is a corresponding code.
True
False - Answer-True
AND CODING EXAM Q&A
The medical biller receives _______ which explains what services and procedures
the insurance company paid for, analyze them, and then creates bills for patients. -
Answer-explanation of benefits (EOB)
What does EOB stand for? - Answer-explanation of benefits
What is an example of a medical biller's job? - Answer-They take the procedural and
diagnosis codes at the medical coder has translated and creates aclaim from these
using a form or a type of software program. The biller that reviews the patient's
insurance policy determine if the procedures and services performed by the
healthcare provider a covered by that patient's plan. The medical biller needs to
make sure that each code, and less each procedure listed on the claim, is actually
billable, and since the claim to the insurance company. The insurance company then
performs an evaluation known as payer adjudication, which determines the amount
of the bill they will Reimburse the provider for, and then sends this information back
to the provider in the form of an EOB. The EOB explains the amount paid for by the
insurance company, as well as any obligation the patient may have. The biller then
reviews the EOB be for accuracy, as well as ensures that the charges and
reimbursements correspond to the providers agreement with the payer. If there is
any balance owing by the patient, a patient statement will need to be created and
sent out to the patient. The biller also follows up with the patient for payment, and in
a non-pay situation, sends the bill for collections.
How does a medical biller create a patients claim? - Answer-Medical billers job starts
once the medical coder finishes their job. When a patients receives medical services
from a healthcare provider they're typically presents with a bull at the end of their
services. The biller creates this bill by looking at the balance (if any) the patients has.
The biller MUST factor in the patients copay, deductible, and deducting the amount
covered by insurance.
Coders must complete their coding in ___ to ___ days. - Answer-2 to 5 days. 5 days
MAX! Each office has a specific lag time. Things run smoothly if these deadline are
hit.
Why is medical coding needed? - Answer-It's to translate what transpired in any
exchange between a patient and a healthcare provider in a uniform practice,
MAINLY for the purpose of reimbursement for healthcare services.
Every injury, diagnosis, and medical service there is a corresponding code.
True
False - Answer-True
