Medical Billing and Coding Study guides, Class notes & Summaries

Medical Billing Test Latest Update Graded A+ NPI unique ten digit identifier assigned to each provider by the national provider system CMS-1500 paper claim for physician services Timely filing Medicare requires claim to be filed no later than within one calendar year after the date of service CCI edits apply to Medicare claims that bill for more than one procedure performed on the same patient; on the same date of service; by the same performing provider. Global period days s...

Medical Billing and Coding Questions and Answers Already Passed Which of the following is an example of health insurance abuse? Performing more tests than are necessary. A durable power of attorney (POA) must be a blood relative of the patient. False Under the HIPAA Privacy Rule, what does "minimum necessary" mean? Disclose only what is necessary for the intended purpose. What's the term for the document that states which medical treatments you want and don't want if you're ...

Medical Billing Terminology Latest Update Graded A+ 72 Hour rule Hospital coding rule for Medicare beneficiaries that allows outpatient services performed within 72 hours of an inpatient admission to be reported on the claim as part of the inpatient stay so long as the services are related to the inpatient stay; also known as the three-day window rule. Accounts Receivable (AR) Accounts Receivable is the total of all balances owed by patients or insurance companies regardless of deli...

Medical Billing and Coding Questions and Answers Already Passed What patient information will you need to obtain to file and insurance claim. Insured's complete name, Insured's current employer, Patient's date of birth. Identify the information included in blocks 1 through 13 of the CMS-1500. Information about the patient and the patient's insurance coverage? Identify the information included in blocks 14 through 33 of the CMS-1500? The diagnoses, procedures, and charges. Inform...

Medical Billing and Coding Final Exam Questions and Answers 100% Pass Which of the following is a reason for why the field of medical billing and coding is in high demand? An aging population will use more healthcare services to manage a multitude of chronic diseases. What is the process of reporting diagnoses and procedures/services as numeric and alphanumeric characters on the insurance claim? Medical coding What is the two-way, real time video visit between the patient and the ph...

Medical Billing Questions and Answers Already Passed 1. Administrative medical office responsibilities include Claims submissions 2. A claims assistant professional Works for the consumer and helps patients file insurance claims 3. The amount of money an insurance billing specialist earns is dependent on which of the following factors Knowledge,experience, and size of employing institution 4. A billing specialist is entrusted with Holding patient's medical information in confid...

Medical Billing and Coding Test 1 with Complete Solutions ICD-10-CM is mandated code set for diagnosis under the HIPPA: transaction and code sets A code in ICD-10-CM has up to how many characters? Seven An ICD-10-CM category code has how many characters? Three A subcategory code in ICD-10-CM has how many characters? Four An example of subcategory code: S81.2 The correct code set to be used is according to the CMS is based on what? Date of service The first step to begin c...

Medical Billing and Coding Chapter 1 Latest Update 100% Correct Manged Care a system in which healthcare is monitored. Health care provider contract with a health insurance company. What percentage does physicians and nurses make up? 40% of all healthcare providers Solo/private facilities The receptionist and medical biller are often cross-trained. Staff may consist of nurse, receptionist and a medical biller and/or office manger. small group practice four or five general practiti...

Medical Billing and Coding Practice Test with Complete Solutions Which of the following Medicare policies determines if a particular item or service is covered by Medicare? National Coverage Determination (NCD) Which of the following is considered the final determination of the issues involving settlement of an insurance claim? Adjudication A form that contains charges, DOS, CPT codes, ICD codes, fees and copayment information Encounter Form A patient comes to the hospital for ...

Medical Billing and Coding Chapter 7 Latest 2024 Graded A+ CMS 100 - paper claim submitted to TPP for reinbursement ( paper claim ) HIPPA x12 837 - electronic form used to send a claim ( HIPPA 837 P claim (electronic) HIPPA requires electronic transmission of claims by all providers with _________ employees. 10 or more National Uniform Claim Commitee (NUCC) - organization responsible for claim content CMS - 1500 (02/12) -revised- current paper claim approved by the NUCC 501...