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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One of the recent technological advances that makes verification of patient insurance eligibility easier and faster is the:
(Multiple Choice)
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(43)
If the decision is made to go direct to the carrier,there will be multiple _______ that occur when a computer is programmed to automatically connect to another computer.
(Short Answer)
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The intent of HIPAA's Administrative Simplification legislation was to provide consumers with lower healthcare costs.
(True/False)
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The paper claim form approved by the AMA Council on Medical Services,which was subsequently adopted by all government healthcare programs.
(Multiple Choice)
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Small providers that are not computerized can use the paper version of the CMS-1500.
(True/False)
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HIPAA Standards Version ____ addresses many of the limitations in the former version and supports the reporting of national provider identifiers (NPIs)and the new ICD-10 codes.
(Multiple Choice)
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The HIPAA Administrative Simplification Compliance Act (ASCA)prohibits Medicare from paying claims that are not submitted electronically,with certain exceptions.
(True/False)
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A business entity that specializes in consolidating claims received from providers and transmitting them in batches to each respective third-party payer.
(Multiple Choice)
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The _________ may grant a waiver from the mandatory electronic claims submission rule.
(Short Answer)
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The two main sections of the CMS-1500 are ____________ and ____________.
(Short Answer)
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After the paper form has been completed according to the applicable payer guidelines,it should be ____________ to check for errors.
(Multiple Choice)
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According to HIPAA,which of the following code sets is acceptable for the electronic transmission of healthcare data?
(Multiple Choice)
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Complete this statement: "A complete medical record should _______."
(Short Answer)
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Documents needed to generate an insurance claim include all of the following,except a:
(Multiple Choice)
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Additional software may be required to send claims directly to a third-party payer.
(True/False)
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HIPAA's new 5010 transaction standards only impact __________ claim submissions.
(Short Answer)
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If a medical facility has only one employee but is utilizing some type of electronic software,the office must be in compliance with HIPAA's privacy rules and regulations.This is referred to as the ___________ rule.
(Short Answer)
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Direct claim submission is considered the best method if most claims are being sent to a single carrier.
(True/False)
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