Billing and Coding Final Exam 127 Questions Rated 100% Correct!!

A claims assistance professional (CAP) acts as an informal representative of patients and helps patients interpret insurance contracts. - False Which level of education is generally required for one who seeks employment as an insurance coder? - c) Completion of an accredited program for coding certification The amount of money an insurance billing specialist earns is dependent on which factors? - d) All of the above: knowledge, experience, size of employing institution Medical etiquette refers to... - a) consideration for others A billing specialist is entrusted with.... - d) All of the above: holding patients' medical information in confidence, collecting monies, being a reliable resource for coworkers Standards of conduct by which an insurance billing specialist determines the propriety of his or her behavior in a relationship are know as medical _____. - ethics It is _____ to report incorrect information to private insurance carriers because this can possible damage the individual and the integrity of the database. - unethical The Office of Civil Right enforces... - privacy and security rules. Privileged information is related to the treatment and progress of patients. - True The focus on the health care practice setting and reducing administrative costs and burdens are the goals of... - HIPAA Title II Administrative SimplificationWhich 3 measures should be taken by a coder who has knowledge of fraud or abuse? - Notify the provider verbally and in writing; document the false statement or representation; don't discuss the problem with anyone who is not involved The contract is a worker's comp case exists between the... - physician and insurance company In health insurance, the insured is also known as - subscriber, or member, or policyholder, or recipient. If a child has health insurance coverage from 2 parents, according to the birthday law... - the health plan of the person whose birthday (month and day, not year) falls earlier in the calendar year pays first. If same b-day, person whose policy has been in effect longest.