NCCT Billing and Coding Exam with precise detailed answers || || || || || || || ||
It is important to make the patient aware of the mailing address, interest rates, and
|| || || || || || || || || || || || || || ||
length of agreement when setting up a - correct 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? - correct 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? - correct 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? - correct answer✔✔$80
|| || || || || || || ||
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? - correct 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?
|| || || || || || || || || || || || ||
- correct 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 || || || || || ||
Deductible amount that patient paid: $100 || || || || ||
Accepted fee for service: $250 || || || ||
Insurance payment: $75 - correct 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? - correct 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. || || || || || || || || ||
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? - correct
|| || || || || || || || || || || || || || ||
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? - correct 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 - correct 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? - correct answer✔✔Credit
|| || || || || || ||
Which of the following is used to post patient payments in provider offices,
|| || || || || || || || || || || || ||
electronically or manually? - correct answer✔✔ledgers || || || || ||
The ledger keeps track of all payments and outstanding balances for the patients
|| || || || || || || || || || || ||
A third party payer sent a report to the hospital explaining the payments of multiple
|| || || || || || || || || || || || || || ||
claims submitted for ten patients in the month of November. Which of the following is
|| || || || || || || || || || || || || ||
the title of that document? - correct answer✔✔remittance advice
|| || || || || || || || ||
A remittance advice is used to post payments from insurance carriers. It will explain
|| || || || || || || || || || || || || ||
the reasons for payments or denials, the allowable amounts, copayments, patient
|| || || || || || || || || || ||
balances, etc. A remittance advice is sent monthly and includes all of the patients seen
|| || || || || || || || || || || || || ||
by that practice, with that insurance.
|| || || || || ||
What is the correct process for posting the electronic remittance advice and
|| || || || || || || || || || || ||
Explanation of Benefits to the patient's account? - correct answer✔✔Upload|| || || || || || || || || ||
information from the carrier file, adjust and save || || || || || || ||
It is important to make the patient aware of the mailing address, interest rates, and
|| || || || || || || || || || || || || || ||
length of agreement when setting up a - correct 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? - correct 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? - correct 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? - correct answer✔✔$80
|| || || || || || || ||
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? - correct 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?
|| || || || || || || || || || || || ||
- correct 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 || || || || || ||
Deductible amount that patient paid: $100 || || || || ||
Accepted fee for service: $250 || || || ||
Insurance payment: $75 - correct 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? - correct 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. || || || || || || || || ||
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? - correct
|| || || || || || || || || || || || || || ||
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? - correct 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 - correct 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? - correct answer✔✔Credit
|| || || || || || ||
Which of the following is used to post patient payments in provider offices,
|| || || || || || || || || || || || ||
electronically or manually? - correct answer✔✔ledgers || || || || ||
The ledger keeps track of all payments and outstanding balances for the patients
|| || || || || || || || || || || ||
A third party payer sent a report to the hospital explaining the payments of multiple
|| || || || || || || || || || || || || || ||
claims submitted for ten patients in the month of November. Which of the following is
|| || || || || || || || || || || || || ||
the title of that document? - correct answer✔✔remittance advice
|| || || || || || || || ||
A remittance advice is used to post payments from insurance carriers. It will explain
|| || || || || || || || || || || || || ||
the reasons for payments or denials, the allowable amounts, copayments, patient
|| || || || || || || || || || ||
balances, etc. A remittance advice is sent monthly and includes all of the patients seen
|| || || || || || || || || || || || || ||
by that practice, with that insurance.
|| || || || || ||
What is the correct process for posting the electronic remittance advice and
|| || || || || || || || || || || ||
Explanation of Benefits to the patient's account? - correct answer✔✔Upload|| || || || || || || || || ||
information from the carrier file, adjust and save || || || || || || ||
