NCCT PRACTICE 125 questions with complete solutions

If the insurance and coding specialist suspects Medicare fraud, she should contact the A. DOJ. B. AMA. C. FDA. D. OIG. Correct Answer: D. OIG Collecting statistics on the frequency of copay collection at time of service is a step in the process of A. a recovery audit. B. managing A/R. C. claims management. D. performance reviews. Correct Answer: B. managing A/R When the patient has signed the assignment of benefits form, the payment for services should be sent to the provider unless the provider is A. in-network. B. out of network. C. the primary care provider. D. a referred specialist. Correct Answer: B. out of network. When speaking with an insurance company representative to follow up on a denied claim, an insurance and coding specialist should have which of the following information available? (Select the three (3) correct answers). A. date of service B. physician's NPI C. patient's mailing address D. patient's insurance ID number E. date the claim was denied Correct Answer: A. date of service D. patient's insurance ID number E. date the claim was denied Which of the following defines the maximum time that a debt can be collected from the time it was incurred or became due? A. benchmark B. practice management payment policy C. statute of limitations D. Stark Law Correct Answer: C. statute of limitations A physician performed a bilateral L4/L5 Laminectomy on a patient in an ambulatory surgical center. Which of the following place of service codes should be used on the CMS 1500? A. 24 B. 22 C. 21 D. 11 Correct Answer: A. 24