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It is important to make the patient aware of the mailing address, interest
rates, and length of agreement when setting up a - 🧠 ANSWER
✔✔payment arrangement.
What is the correct term for a doctor who enters into an agreement with a
third party payer on charges, discounts, and services rendered to their
policyholders within the network? - 🧠 ANSWER ✔✔PAR (participating
provider) a physician who enters into an agreement with a payer to offer
discounts on charges rendered to their policy holders.
What should a practice's financial policy always explain? - 🧠 ANSWER
✔✔what is required from the patient and when payment is due
A patient had a procedure which was billed at $200.00. The allowed
amount was $150.00 and he has $50.00 left to meet of his deductible. His
co-insurance is 20%. How much does the patient owe? - 🧠 ANSWER
✔✔$80
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,The patient in this question is responsible for 20%. $150 allowed amount.
20% of $150 allowed is $30. Patient still owes $50 deductible. Patient
would owe $80 total.
The physician charges $100 for a visit. The insurer allowable amount is
$80. The patient has a $200 deductible, which has not been met. Which of
the following will happen? - 🧠 ANSWER ✔✔The patient will be billed $80.
The allowed amount is now the cost of the service, so since the deductible
is not met, the patient will be responsible for the entire $80.
Which of the following documents from the insurance carrier should the
payment poster read and post the payments or contractual adjustments to
the patient account? - 🧠 ANSWER ✔✔remittance advice.
A remittance advice is used to post payments from insurance carriers.
The insurance and coding specialist received an EOB and is posting the
payments to the patient accounts. According to the following information
below, how much does the patient still owe for this service?
Non-participating provider
Copay: $20, paid at time of service
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PRIVACY STATEMENT. ALL RIGHTS RESERVED
,Deductible amount that patient paid: $100
Accepted fee for service: $250
Insurance payment: $75 - 🧠 ANSWER ✔✔$55
Total charges are $250.00 of which the patient has paid $20.00 and
$100.00. This now leaves a balance of $130.00, of which the insurance
company paid $75.00. This now leaves a balance due from the patient of
$55.00.
Which of the following are the steps to posting a Medicare payment to the
patient's account? - 🧠 ANSWER ✔✔Review the EOB., Adjust any
contractual agreements., Send the billing statement if there is a balance.
First the EOB should be reviewed to make sure all the information is
correct and the correct patient is credited. Any payments are posted and all
the adjustments are made. Once these tasks are finished, the system will
generate a statement of any balances due to send to the patient. There is
no need to check the copay since the system will automatically have this
information on the statement to the patient.
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COPYRIGHT©PROFFKERRYMARTIN 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE.
PRIVACY STATEMENT. ALL RIGHTS RESERVED
, Which of the following does a thorough understanding of the Explanation of
Benefits (EOB) supplied by the payer allow the insurance and coding
specialist to do? - 🧠 ANSWER ✔✔Apply write-offs., Bill patients correctly.,
Resolve payment issues.
Which of the following information will the insurance and coding specialist
need to apply the payment correctly when in receipt of an insurance EOB
and check for payment? - 🧠 ANSWER ✔✔account number, date of service,
patient name
The difference between the billed amount and the allowed amount for
services from a participating provider is - 🧠 ANSWER ✔✔adjusted by the
provider.
When a patient sees a participating provider, he receives a discount. This
discounted amount is called the allowed amount. The difference between
the billed amount and the allowed amount cannot be charged to the patient
when seeing a participating provider.
The patient makes a co-payment of $50. To which section of the patient's
account should the payment be applied? - 🧠 ANSWER ✔✔Credit
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COPYRIGHT©PROFFKERRYMARTIN 2025/2026. YEAR PUBLISHED 2025. COMPANY REGISTRATION NUMBER: 619652435. TERMS OF USE.
PRIVACY STATEMENT. ALL RIGHTS RESERVED