Prep questions latest
top score and answers
What are collection agency fees based on? CORRECT ANSWER. A percentage
of dollars collected
Self-funded benefit plans may choose to coordinate benefits using the
gender rule or what other rule? CORRECT ANSWER. Birthday
In what type of payment methodology is a lump sum or bundled payment
negotiated between the payer and some or all providers? CORRECT
ANSWER. Case rates
What customer service improvements might improve the patient accounts
department?
CORRECT ANSWER. Holding staff accountable for customer service during
performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required to
do? CORRECT ANSWER. Inform a Medicare beneficiary that Medicare may not
pay for the order or service
What type of account adjustment results from the patient's unwillingness
to pay for a self-pay balance? CORRECT ANSWER. Bad debt adjustment
What is the initial hospice benefit? CORRECT ANSWER. Two 90-day
periods and an unlimited number of subsequent periods
When does a hospital add ambulance charges to the Medicare inpatient
claim? CORRECT ANSWER. If the patient requires ambulance
transportation to a skilled nursing facility
,How should a provider resolve a late-charge credit posted after an account
is billed? CORRECT ANSWER. Post a late-charge adjustment to the account
an increase in the dollars aged greater than 90 days from date of service
indicate what about accounts CORRECT ANSWER. They are not being processed in
a timely manner
What is an advantage of a preregistration program? CORRECT ANSWER.
It
reduces processing times at the time of service
What are the two statutory exclusions from hospice coverage? CORRECT
ANSWER. Medically unnecessary services and custodial care
What core financial activities are resolved within patient access?
CORRECT ANSWER. Scheduling, insurance verification, discharge
processing, and payment of point-of- service receipts
What statement applies to the scheduled outpatient? CORRECT ANSWER.
The
services do not involve an overnight stay
How is a mis-posted contractual allowance resolved? CORRECT ANSWER.
Comparing
the contract reimbursement rates with the contract on the admittance
advice to identify the correct amount
What type of patient status is used to evaluate the patient's need for
inpatient care? CORRECT ANSWER. Observation
Coverage rules for Medicare beneficiaries receiving skilled nursing care
require that the beneficiary has received what? CORRECT ANSWER.
Medically necessary inpatient
hospital services for at least 3 consecutive days before the skilled nursing
care admission
When is the word "SAME" entered on the CMS 1500 billing form in Field 0$?
CORRECT ANSWER. When the patient is the insured
What are non-emergency patients who come for service without prior
notification to the provider called? CORRECT ANSWER. Unscheduled
patients
If the insurance verification response reports that a subscriber has a single
policy, what is the status of the subscriber's spouse? CORRECT ANSWER.
Neither enrolled not
entitled to benefits
Regulation Z of the Consumer Credit Protection Act, also known as the Truth
in Lending Act, establishes what? CORRECT ANSWER. Disclosure rules for
, consumer credit sales and consumer loans
top score and answers
What are collection agency fees based on? CORRECT ANSWER. A percentage
of dollars collected
Self-funded benefit plans may choose to coordinate benefits using the
gender rule or what other rule? CORRECT ANSWER. Birthday
In what type of payment methodology is a lump sum or bundled payment
negotiated between the payer and some or all providers? CORRECT
ANSWER. Case rates
What customer service improvements might improve the patient accounts
department?
CORRECT ANSWER. Holding staff accountable for customer service during
performance reviews
What is an ABN (Advance Beneficiary Notice of Non-coverage) required to
do? CORRECT ANSWER. Inform a Medicare beneficiary that Medicare may not
pay for the order or service
What type of account adjustment results from the patient's unwillingness
to pay for a self-pay balance? CORRECT ANSWER. Bad debt adjustment
What is the initial hospice benefit? CORRECT ANSWER. Two 90-day
periods and an unlimited number of subsequent periods
When does a hospital add ambulance charges to the Medicare inpatient
claim? CORRECT ANSWER. If the patient requires ambulance
transportation to a skilled nursing facility
,How should a provider resolve a late-charge credit posted after an account
is billed? CORRECT ANSWER. Post a late-charge adjustment to the account
an increase in the dollars aged greater than 90 days from date of service
indicate what about accounts CORRECT ANSWER. They are not being processed in
a timely manner
What is an advantage of a preregistration program? CORRECT ANSWER.
It
reduces processing times at the time of service
What are the two statutory exclusions from hospice coverage? CORRECT
ANSWER. Medically unnecessary services and custodial care
What core financial activities are resolved within patient access?
CORRECT ANSWER. Scheduling, insurance verification, discharge
processing, and payment of point-of- service receipts
What statement applies to the scheduled outpatient? CORRECT ANSWER.
The
services do not involve an overnight stay
How is a mis-posted contractual allowance resolved? CORRECT ANSWER.
Comparing
the contract reimbursement rates with the contract on the admittance
advice to identify the correct amount
What type of patient status is used to evaluate the patient's need for
inpatient care? CORRECT ANSWER. Observation
Coverage rules for Medicare beneficiaries receiving skilled nursing care
require that the beneficiary has received what? CORRECT ANSWER.
Medically necessary inpatient
hospital services for at least 3 consecutive days before the skilled nursing
care admission
When is the word "SAME" entered on the CMS 1500 billing form in Field 0$?
CORRECT ANSWER. When the patient is the insured
What are non-emergency patients who come for service without prior
notification to the provider called? CORRECT ANSWER. Unscheduled
patients
If the insurance verification response reports that a subscriber has a single
policy, what is the status of the subscriber's spouse? CORRECT ANSWER.
Neither enrolled not
entitled to benefits
Regulation Z of the Consumer Credit Protection Act, also known as the Truth
in Lending Act, establishes what? CORRECT ANSWER. Disclosure rules for
, consumer credit sales and consumer loans
