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NCCT Billing And Coding Exam Actual 2025
Questions And Verified Answers |
Verified by Experts Guaranteed Success
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.
,2
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
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
,3
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
, 4
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? - ..(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
NCCT Billing And Coding Exam Actual 2025
Questions And Verified Answers |
Verified by Experts Guaranteed Success
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.
,2
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
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
,3
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
, 4
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? - ..(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
