I've got this
A billing service sending a claim is likely to be the:
A. destination payer
B. referring provider
C. billing provider
D. pay-to provider
C. billing provider
Medicare Part D covers durable medical equipment
true or false
false
The coinsurance for Medicare Part B is
A. 80/20
B. $361
C. There is no coinsurance
D. 70/30
A. 80/20
Hospice care is covered under
a. Medicare Part A
b. Medicare Part B
c. Medicare Part C
d. Medicare Part D
a. Medicare Part A
Anyne over age 65 who receives Social Security benefits is automatically
A.enrolled in Medicare Part A and eligible for Medicare Part B.
B. Neither enrolled in Medicare Part A nor eligible for Medicare Part B.
C. enrolled in Medicare Part A.
D. eligible for Medicare Part B
A.enrolled in Medicare Part A and eligible for Medicare Part B.
Which are major sections of the HIPPA claim. (Select all that apply) A. provider section B. subscriber/patient section C. payer section D.all of the above
D.all of the above
Which Medicare Part provides coverage for durable medical equipment?
A. Medicare Part B
B. Medicare Part A
C. Medicare Part C
D. Medicare Part D
A. Medicare Part B
Inpatient Hospital benefits are provided under
A. Medicare Part A
B. Medicare Part D
C. Medicare Part B
D. Medicare Part C
A. Medicare Part A
Which of the following type of plan do employers or employee organizations offer to their employees?
A. group health plan
B. individual health plan
C. FEHB plan
D. URO
A. group health plan
What type of surgery is a procedure that can be scheduled ahead of time, but which may or may not be medically necessary?
A. voluntary surgery
B. elective surgery
C. emergency surgery
D. experimental surgery
B. elective surgery
What is an MBI
A. Medicare Beneficiary Indentifier
B. Medicare Billing Indicator
C. Medicaid Beneficiary Indentifier
D. Medicaid Billing Indicator
A. Medicare Beneficiary Indentifier
Eligible members of a capitated plan are listed on the
A. patient medical record.
B. monthly enrollment list.
C. annual membership list.
D. plan summary grid.
B. monthly enrollment list.
Complete the list of the 7 steps of the revenue cycle that lead to completion of correct private payer claims.
1 ______________
2 Establish financial responsibility for visits
3 _______________
4 Review coding compliance
5 Check billing compliance
6 ____________________
7 Prepare and transmit claims
1 Preregister patients
3 Check in patients
6 Check out patients
Complete the list of 5 major sections of the HIPPA claim.
1. provider section
2. _________________
3. payer section
4. __________________
5. ____________________
2. subscriber/patient section
4. claim information section
5. service line information section
The NPI is used to report the provider identifier on a claim
true or false
true
Claim accepted by a health plan for adjudication is _____________
clean claim
Insurance carrier that is to receive the claim is ________
destination payer
The insurance policyholder or guarantor for the claim___________
subscriber
Paper claim for physician services.
CMS-1500
a tricare for life beneficiary must be at least ___ years old.
65
the departmen of defence's health insurance plan for military personnel and their families.
a. tricare
b. tricare select
c. tricare prime
d. champva
a. tricare
A fee-for-service military health plan
a. tricare
b. tricare select
c. tricare prime
d. champva
b. tricare select
a managed care plan that provides most services at military treatment facilities
a. tricare
b. tricare select
c. tricare prime
d. champva
c. tricare prime
Payer of last resort
A. Medicaid
B. Medicare
C. Anthem
D. GHP
A. MEDICAID
A. Medicare Part C
B. Medicare Part A
C. Medicare Part B
D. Medicare Part D
A. Medicare Part C