NCCT Billing and Coding Exam Questions
And Answers. Verified and Updated
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
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
EXAM STUDY MATERIALS July 24, 2024 1:33:58 PM
,Copay: $20, paid at time of service
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.
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
Which of the following is used to post patient payments in provider offices, electronically or
manually? - answer✔✔ledgers
The ledger keeps track of all payments and outstanding balances for the patients
EXAM STUDY MATERIALS July 24, 2024 1:33:58 PM
, 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? - 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? - answer✔✔Upload information from the carrier file, adjust
and save
The payer provided the following information on a patient's account:
Charge - $189.00
Discounted Amount - $74.59
Patient Responsibility - $30.00
Amount Paid to Provider - $84.41
What is the payer allowed amount for this claim? - answer✔✔$114.41
The allowed amount in this scenario can be found using one of two methods. The first is to take
the charge amount ($189) and subtract the discounted amount ($74.59), which would be $189-
$74.59 = $114.41. The second is to take the patient's responsibility ($30) and add it to the
amount paid to the provider ($84.41), which would be $30 + $84.41 = $114.41.
Which of the following managed care payer denials indicates front end user error? -
answer✔✔incorrect insurance information
When dealing with a Medicare denied claim, it is appropriate to write off the amount denied
when the claim was submitted - answer✔✔for experimental procedures.
What will help prevent a denied claim? - answer✔✔verifying frequency limitations, determining
the need for prior approval, verifying coverage of a chosen diagnosis
A claim which has not been adjudicated due to errors is - answer✔✔rejected.
A rejected claim is one that has not been processed (adjudicated) because there are errors.
Which of the following is the correct term for an insurance claim submitted with errors? -
answer✔✔dirty.
EXAM STUDY MATERIALS July 24, 2024 1:33:58 PM
And Answers. Verified and Updated
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
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
EXAM STUDY MATERIALS July 24, 2024 1:33:58 PM
,Copay: $20, paid at time of service
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.
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
Which of the following is used to post patient payments in provider offices, electronically or
manually? - answer✔✔ledgers
The ledger keeps track of all payments and outstanding balances for the patients
EXAM STUDY MATERIALS July 24, 2024 1:33:58 PM
, 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? - 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? - answer✔✔Upload information from the carrier file, adjust
and save
The payer provided the following information on a patient's account:
Charge - $189.00
Discounted Amount - $74.59
Patient Responsibility - $30.00
Amount Paid to Provider - $84.41
What is the payer allowed amount for this claim? - answer✔✔$114.41
The allowed amount in this scenario can be found using one of two methods. The first is to take
the charge amount ($189) and subtract the discounted amount ($74.59), which would be $189-
$74.59 = $114.41. The second is to take the patient's responsibility ($30) and add it to the
amount paid to the provider ($84.41), which would be $30 + $84.41 = $114.41.
Which of the following managed care payer denials indicates front end user error? -
answer✔✔incorrect insurance information
When dealing with a Medicare denied claim, it is appropriate to write off the amount denied
when the claim was submitted - answer✔✔for experimental procedures.
What will help prevent a denied claim? - answer✔✔verifying frequency limitations, determining
the need for prior approval, verifying coverage of a chosen diagnosis
A claim which has not been adjudicated due to errors is - answer✔✔rejected.
A rejected claim is one that has not been processed (adjudicated) because there are errors.
Which of the following is the correct term for an insurance claim submitted with errors? -
answer✔✔dirty.
EXAM STUDY MATERIALS July 24, 2024 1:33:58 PM
