Exam 5: Claim Submission Methods
Exam 1: The Origins of Health Insurance45 Questions
Exam 2: Tools of the Trade: A Career as a Health (Medical)Insurance Professional40 Questions
Exam 3: The Legal and Ethical Side of Medical Insurance67 Questions
Exam 4: Types and Sources of Health Insurance48 Questions
Exam 5: Claim Submission Methods70 Questions
Exam 6: Traditional Fee For Service/Private Plans74 Questions
Exam 7: Unraveling the Mysteries of Managed Care50 Questions
Exam 8: Understanding Medicaid87 Questions
Exam 9: Conquering Medicare’s Challenges105 Questions
Exam 10: Military Carriers80 Questions
Exam 11: Miscellaneous Carriers: Workers’ Compensation and Disability Insurance55 Questions
Exam 12: Diagnostic Coding132 Questions
Exam 13: Procedural, Evaluation and Management, and HCPCS Coding122 Questions
Exam 14: The Patient74 Questions
Exam 15: Keys to Successful Claims Management60 Questions
Exam 16: The Role of Computers in Health Insurance65 Questions
Exam 17: Reimbursement Procedures: Getting Paid72 Questions
Exam 18: Hospital Billing and the UB-0489 Questions
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What information can the health insurance professional typically find on a patient's insurance ID card?
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(Essay)
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Correct Answer:
Name of insurance carrier
Patient/insured’s name
Insurance ID number
Plan code
Group number
Carrier’s customer service toll-free telephone number
Copay amounts
Examples of technological advancements in enrollee verification include all,except the following:
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(Multiple Choice)
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Correct Answer:
B
The new HIPAA Standards version addresses many of the deficiencies in the former version and accommodates the reporting of:
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(Multiple Choice)
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Correct Answer:
D
What is the most important task the health insurance professional is responsible for?
(Essay)
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Covered entities were required by law to conform to Version 5010,which replaced the HIPAA ASC X12 4010/4010A1 EDI transaction standard,as of
(Multiple Choice)
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The federal government mandates the use of a "universal" encounter form for all providers.
(True/False)
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One way to track submitted claims is through the use of an insurance claims tracking form or "log."
(True/False)
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A claim that has no errors or omissions and can be processed without delays is called a _____ claim.
(Multiple Choice)
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The AMA developed the first CMS-1500 claim form for military use.
(True/False)
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After January 2012,a new version of the HIPAA Standards was implemented called:
(Multiple Choice)
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The two basic methods for submitting claims electronically are _____________ and ___________________.
(Short Answer)
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Supplemental documents that provide additional information to the claims processor that normally cannot be included within the electronic claim format are called:
(Multiple Choice)
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Explain how claim attachments can be sent electronically using such software as FastAttach™.
(Essay)
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Failure to confirm a patient's insurance coverage can create a delay in payment or result in no payment at all.
(True/False)
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Submitting insurance claims straight to a third-party payer is called:
(Multiple Choice)
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Practice management software allows users to enter patient demographic information,schedule appointments,maintain lists of insurance payers,perform billing tasks,and generate reports.
(True/False)
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The primary objective of a health insurance professional is to:
(Multiple Choice)
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Guidelines for claim attachments are the same if the medical facility uses electronic claim submission.
(True/False)
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