Third party payer Study guides, Class notes & Summaries

Management functions correct answers key functions of a manager including planning, organizing, staffing, directing & controlling Management connective processes correct answers mgmt functions that connect elements of the healthcare org. including communicating, coordinating and decision making Joint Commission correct answers primary accrediting organization for healthcare orgs. Healthcare Financial Mgmt Association (HFMA) correct answers Association of healthcare financial managers; c...

NR 509 Final Exam (Latest Practice Questions) Question: The function of the auditory ossicles is to:  transmit the light reflex to the light cone.  transform sound vibrations into mechanical waves for the inner ear.  to capture sound waves from the external ear for transmission into the middle ear.  to separate the inner ear from the middle ear. Question 1: A primary care NP is developing a clinical practice guideline for management of a patient population in a midsized subu...

NHA,CBCS Exam (New 2024/ 2025 Update) |Questions and Verified Answers| 100% Correct| A Grade QUESTION Which of the following formats are used to submit electronic claims to a third-party payer? Answer: 837 QUESTION Urine moved from the kidneys to the bladder through which of the following parts of the body? Answer: Ureters QUESTION As of April 1, 2014, what is the maximum number of diagnoses that can be reported on the CMS-1500 claim form before a further...

Knowing which of the following can best assist a technician in the prevention of data entry errors? A. Names of medications B. Insurance co-payments C. Pharmacokinetics D. Physician contact informationAnswer - A. Names of medications Which of the following injectable drugs would be stored in refrigerator? A. Clindamycin B. Ciprofloxacin C. Cyanocobalamin D. Calcitonin-salmonAnswer - D. Calcitonin-salmon The requirement that a non-formulary medication be covered only if approv...

In health care payment systems, ________ is a more recent method of paying an organization, in which the third party payer establishes the amount of money that will be paid for the delivery of a particular service before offering the services to the client a. Retrospective reimbursement b. Prospective reimbursement c. Health Maintenance Organization (HMO) d. Preferred Provider Organization (PPO) Correct Answer-b. Prospective reimbursement Which statements are true? Select all that apply C...

NHA CBCS EXAM REVIEW ANSWERED (FALL 2022)/ Which of the following Medicare policies determines if a particular item or service is covered by Medicare? [Answer- National Coverage Determination (NCD) A patient's employer has not submitted a premium payment. Which of the following claim statuses should the provider receive from the third-party payer? []Answer- Denied A billing and coding specialist should routinely analyze which of the following to determine the number of outstanding cla...

NHA CBCS study guide Questions and Answers (2024 / 2025) (Verified Answers) When submitting claims, which of the following is the outcome if Block 13 is left blank? The third-party payer reimburses the patient, and the patient is responsible for reimbursing the provider Which of the following do physicians use to electronically submit claims? clearinghouse When billing a secondary insurance company, which block should the billing and coding specialist fill out on the CMS-1500 claim ...

NHA CEHRS FINAL PRACTICE TEST REVIEW QUESTIONS ONLY EXAM REVIEW QUESTIONS AND ANSWERS, VERIFIED/ how does the registration process begin in an outpatient setting? - -when a new patient calls the office for an appointment to see a provider. what does a front staff member do once they obtain information from a new patient? - -they create an account that includes the patient's identity, medical condition, and insurance/payment info. what does a front staff member do once they obtain info...

The nurse is speaking to students about changes in maternal-newborn care. One change is that self-care has gained wide acceptance with clients and the healthcare community due to research findings that suggest that it has which effect? A) Shortens newborn length of stay B) Decreases use of home health agencies C) Decreases healthcare costs D) Decreases the number of emergency department visits Answer: C Explanation: A) Length of stay is often determined by third-party payer (insurance c...

NCCT NCMA Practice Test - Part 3 Questions and Answers a - Answer-A bed patient in a hospital is called a(n) __________. a. inpatient b. outpatient c. third party payer d. provider b - Answer-A person who represents either party of an insurance claim is the ___________. a. doctor b. adjuster c. provider d. subscriber b - Answer-A request for payment under an insurance contractor bond is called a(n) _____________________. a. insurance application b. claim c. dual choice request ...