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