Question |
Answer |
Which of the following information is necessary to post payments from the RA/EOB? |
1. Billed CPT codes 2. Patient's Name3. Date of service |
A third party payer made an error while adjudicating a claim. Which of the following should the insurance and coding specialist do? |
Resubmit the claim with an attachment explaining the error |
When there is a professional courtesy awarded to a patient's account the insurance and coding specialist should post the amount under the ? |
Adjustment Column |
Collecting statistics on the frequency of copay collection at the time of service is step in the process of |
Managing A/R |
A Medicare patient has an 80/20 plna. The charged amount was $300. The amount allowed was $100. Which of the following is the patient's coinsurance? |
$20 |
When is a referral from a provider required? |
When contained in the individual policy |
Which of the following reports is used to follow up on outstanding claims to third party payers? |
Aging |
When following up on a denied claim, an insurance and coding specialist should have which of the following information available when speaking with the insurance company? |
1. Date of Service2. Physicians' NPI3. Patient's Insurance ID number |
Which of the following financial reports produces a quarterly review of any dollar amount a patient still owes after all insurance carriers claim payments have been received? |
Aging |
When posting transactions for electronic claims submission, it is necessary to enter which of the following items onto the claim? |
Physicians Office Fee |
Applying the birthday rule, a minor child comes in. Both parents have remarried and the child is listed on all policies. Mothers bday is 4/16, stepfather 3/19, father 2/19 stepmom 1/20. |
Father's Plan is primary and mother's plan is secondary. |
When the patient calls to inquire about an account, which of the following does the insurance and coding specialist need to ask before discussing the account? |
1. Patient's date of birth 2. Patient's Name 3. Patient's Insurance ID number |
When a capitation account is applied to the ledger it is also known as a |
Monthly Prepayment Amount |
Which of the following patient information is needed to determine a Medicaid sliding fee scale? |
1. Poverty Level2. Number of dependents3. Salary |
When posting an insurance payment via an EOB the amount that is considered contractual is the |
Insurance Allowed Amount |
When a document is changed in the EHR, the original documentation is |
Hidden |