NCCT STUDY GUIDE (MOA) with
Complete Solutions
The phrase __ was coined to indicate payment of services rendered by someone other
than the patient - ANSWER-Third-party reimbursement
Since 2005, providers have been urged to - ANSWER-Send claims electronically
The CMS-1500 form is accepted by - ANSWER-Medicare and Medicaid
When a third-party payer identifies an error on the claim form, the claim is - ANSWER-
Rejected with a request to resubmit the form with corrections
How many digits are in a National Provider Identifier (NPI) number - ANSWER-10
What is the first step in completing a claim form - ANSWER-Check for a photocopy of
the patients insurance card
Electronically processing claim forms to insurance carriers - ANSWER-Reduces the
amount of preparation time for the claim processor
Which form is also known as the UB-04 form - ANSWER-CMS-1450
Which of the following is not a fee usually charged by a clearinghouse - ANSWER-
customer service fee
Which of the following is not an advantage of using an Electronic Claims Tracking (ECT)
system - ANSWER-All claims are guaranteed to be paid if the forms are filled out
correctly.
Manual claims tracking - ANSWER-Frequently causes payment delays
When following up on a delinquent claim, if the carrier tells you that it is still in process,
you should - ANSWER-request an anticipated date of payment
When applying in insurance adjustment to a patient's account you are not typically
required to post the - ANSWER-Name of secondary insurance company that might be
billed later
Number that identifies or refers to the claim that either the patient or health provider
submitted to the insurance company - ANSWER-Claim number
, Beginning and end dates of the health related service a patient received from a provider
- ANSWER-Date of service
Amount of money that a patient's insurance company did not pay the provider -
ANSWER-Not allowed amount
Amount of money a patient goes as a share of the bill - ANSWER-Coinsurance
copayment amount
Amount of provider billed the patient's insurance company for a service - ANSWER-
Charge
Number assigned to a patient by the insurance company which should match the
number on the patient's insurance card - ANSWER-Insurance ID number
Code and brief description of the health related service a patient received from a
provider - ANSWER-Type of service
Name of the person who received the service - ANSWER-Patient
Bartered goods - ANSWER-Type of payment used for centuries in the past
claim form - ANSWER-Developed to report the health care provided to the source of
payment when third-party reimbursement was created
third party reimbursement - ANSWER-The most Common of these are federal and state
agencies, insurance companies, and workers compensation
CMS-1500 - ANSWER-Standard claim form use for billing in medical offices
CMS-1450 (UB-04) - ANSWER-Paper claim form that may be submitted by an
institutional provider that meet certain requirements
Explanation of Benefits (EOB) - ANSWER-Form or document that may be sent to the
patient by their insurance company after they have had a healthcare service that was
paid by the insurance company may take up to several months to receive
Standard Electronic Data Interchange (EDI) Enrollment form - ANSWER-This must be
completed before submitting electronic media claims to Medicare
remittance advice - ANSWER-Similar to the EOB But is the document provided by the
payer to the provider
Manual insurance log - ANSWER-Use of these allows a medical facility or providers
office to submit transactions faster and be paid sooner
Complete Solutions
The phrase __ was coined to indicate payment of services rendered by someone other
than the patient - ANSWER-Third-party reimbursement
Since 2005, providers have been urged to - ANSWER-Send claims electronically
The CMS-1500 form is accepted by - ANSWER-Medicare and Medicaid
When a third-party payer identifies an error on the claim form, the claim is - ANSWER-
Rejected with a request to resubmit the form with corrections
How many digits are in a National Provider Identifier (NPI) number - ANSWER-10
What is the first step in completing a claim form - ANSWER-Check for a photocopy of
the patients insurance card
Electronically processing claim forms to insurance carriers - ANSWER-Reduces the
amount of preparation time for the claim processor
Which form is also known as the UB-04 form - ANSWER-CMS-1450
Which of the following is not a fee usually charged by a clearinghouse - ANSWER-
customer service fee
Which of the following is not an advantage of using an Electronic Claims Tracking (ECT)
system - ANSWER-All claims are guaranteed to be paid if the forms are filled out
correctly.
Manual claims tracking - ANSWER-Frequently causes payment delays
When following up on a delinquent claim, if the carrier tells you that it is still in process,
you should - ANSWER-request an anticipated date of payment
When applying in insurance adjustment to a patient's account you are not typically
required to post the - ANSWER-Name of secondary insurance company that might be
billed later
Number that identifies or refers to the claim that either the patient or health provider
submitted to the insurance company - ANSWER-Claim number
, Beginning and end dates of the health related service a patient received from a provider
- ANSWER-Date of service
Amount of money that a patient's insurance company did not pay the provider -
ANSWER-Not allowed amount
Amount of money a patient goes as a share of the bill - ANSWER-Coinsurance
copayment amount
Amount of provider billed the patient's insurance company for a service - ANSWER-
Charge
Number assigned to a patient by the insurance company which should match the
number on the patient's insurance card - ANSWER-Insurance ID number
Code and brief description of the health related service a patient received from a
provider - ANSWER-Type of service
Name of the person who received the service - ANSWER-Patient
Bartered goods - ANSWER-Type of payment used for centuries in the past
claim form - ANSWER-Developed to report the health care provided to the source of
payment when third-party reimbursement was created
third party reimbursement - ANSWER-The most Common of these are federal and state
agencies, insurance companies, and workers compensation
CMS-1500 - ANSWER-Standard claim form use for billing in medical offices
CMS-1450 (UB-04) - ANSWER-Paper claim form that may be submitted by an
institutional provider that meet certain requirements
Explanation of Benefits (EOB) - ANSWER-Form or document that may be sent to the
patient by their insurance company after they have had a healthcare service that was
paid by the insurance company may take up to several months to receive
Standard Electronic Data Interchange (EDI) Enrollment form - ANSWER-This must be
completed before submitting electronic media claims to Medicare
remittance advice - ANSWER-Similar to the EOB But is the document provided by the
payer to the provider
Manual insurance log - ANSWER-Use of these allows a medical facility or providers
office to submit transactions faster and be paid sooner
