Question 1

When submitting a secondary claim, you must attach a copy of the primary carrier's EOB to the completed CMS-1500 or UB-04.

Accepted Answer

A) True 
 B)False

Question 2

On the CMS-1500 claim form, the abbreviation NPI indicates that:

Accepted Answer

A)   a condition was Not Present or Indicated upon examination.
B)   the National Health Plan Identifier must be entered.
C)   the National Provider Identifier must be entered.
D)   the National Preferred Identifier for clearinghouses must be entered.

Question 3

To avoid denials, always make sure that the ________ codes used are the most recent, up-to-date codes.

Accepted Answer

The answer of To avoid denials, always make sure that...

Question 4

The majority of income in a physician's office comes from:

Accepted Answer

A)   bank loans.
B)   payments from insurance companies.
C)   payments from patients.
D)   private donations.

Question 5

To what does the term healthcare information refer?

Accepted Answer

Information recorded in any form or medium that identifies the patient and relates to the patient's history, diagnosis, treatment, or prognosis is healthcare information, also known as the patient's medical record.

Question 6

The CMS-1500 claim form used by physician offices was developed by:

Accepted Answer

A)   the American Medical Association (AM
A)  .
B)   the Blue Cross/Blue Shield Association.
C)   the CMS.
D)   representatives from all insurance carriers.

Question 7

On the CMS-1500 claim form, the abbreviation DD indicates that:

Accepted Answer

A)   up to two diagnosis codes can be entered.
B)   a doctor of dentistry performed the service.
C)   the day of the month should be entered as two digits.
D)   durable medical equipment (DM
E)   was ordered.

Question 8

If form locator 20 is marked Yes because the physician referred the patient to an outside lab for some type of lab work, form locator 32 must also be completed.

Accepted Answer

A) True 
 B)False

Question 9

What is meant by coordination of benefits (COB)?

Accepted Answer

It is important to find out which carrie...

Question 10

The individual who purchases an insurance policy is known as the:

Accepted Answer

A)   employee.
B)   guarantor.
C)   patient.
D)   policyholder. D

Question 11

A referral or prior authorization number may still be required even if that insurance carrier provides secondary coverage for the patient.

Accepted Answer

A) True 
 B)False

Question 12

Optical character recognition can recognize handwriting and text, which helps staff turn paper records into digital records quickly and efficiently.

Accepted Answer

A) True 
 B)False

Question 13

According to the birthday rule, if both parents cover dependent children under their insurance policies, the primary insurance is the policy:

Accepted Answer

A)   that has been in force the longest.
B)   of the older parent.
C)   of the parent whose date of birth occurs earliest in the year.
D)   that has the highest level of benefits.

Question 14

Match the following
-The person ultimately responsible for paying for medical services

Accepted Answer

A)   release of information form
B)   superbill
C)   CMS-1500
D)   clearinghouse
E)   billing serviceF)  guarantorG)  policyholderH)  assignment of benefitsI)  UB-04J)  patient information form

Question 15

The use of the CMS-1500 claim form is:

Accepted Answer

A)   mandatory for all physician office claims.
B)   mandatory for all Medicare claims but optional for private insurance carriers.
C)   optional for all Medicare claims but mandatory for private insurance carriers.
D)   optional for all physician office claims.

Question 16

The person who purchases an insurance policy is known as the________.

Accepted Answer

The answer of The person who purchases an insurance policy...

Question 17

The form a new patient completes when registering in a physician's office is known as a(n) ________ form.

Accepted Answer

patient information

Question 18

Match the following
-Claim form used by hospitals to report services to insurance carriers

Accepted Answer

A)   release of information form
B)   superbill
C)   CMS-1500
D)   clearinghouse
E)   billing serviceF)  guarantorG)  policyholderH)  assignment of benefitsI)  UB-04J)  patient information form

Question 19

What are some of the advantages of OCR in the processing of paper claims?

Accepted Answer

Scanners read at such a fast s...

Question 20

If a patient has more than one insurance plan, the determination of how much will be paid by each is known as:

Accepted Answer

A)   assignment of benefits.
B)   the birthday rule.
C)   coordination of benefits.
D)   verification of benefits.

Exam 10: Physician Medical Billing

When submitting a secondary claim, you must attach a copy of the primary carrier's EOB to the completed CMS-1500 or UB-04.

Correct AnswerverifiedShow Answer

On the CMS-1500 claim form, the abbreviation NPI indicates that:

Correct AnswerverifiedShow Answer

To avoid denials, always make sure that the ________ codes used are the most recent, up-to-date codes.

Correct AnswerverifiedShow Answer

The majority of income in a physician's office comes from:

Correct AnswerverifiedShow Answer

To what does the term healthcare information refer?

Correct AnswerverifiedInformation recorded in any form or medium that identifies the patient and relates to the patient's history, diagnosis, treatment, or prognosis is healthcare information, also known as the patient's medical record.

The CMS-1500 claim form used by physician offices was developed by:

Correct AnswerverifiedShow Answer

On the CMS-1500 claim form, the abbreviation DD indicates that:

Correct AnswerverifiedShow Answer

If form locator 20 is marked Yes because the physician referred the patient to an outside lab for some type of lab work, form locator 32 must also be completed.

Correct AnswerverifiedShow Answer

What is meant by coordination of benefits (COB)?

Correct AnswerverifiedIt is important to find out which carrie...View AnswerShow Answer

The individual who purchases an insurance policy is known as the:

Correct AnswerverifiedD

A referral or prior authorization number may still be required even if that insurance carrier provides secondary coverage for the patient.

Correct AnswerverifiedShow Answer

Optical character recognition can recognize handwriting and text, which helps staff turn paper records into digital records quickly and efficiently.

Correct AnswerverifiedShow Answer

According to the birthday rule, if both parents cover dependent children under their insurance policies, the primary insurance is the policy:

Correct AnswerverifiedShow Answer

Match the following -The person ultimately responsible for paying for medical services

Correct AnswerverifiedShow Answer

The use of the CMS-1500 claim form is:

Correct AnswerverifiedShow Answer

The person who purchases an insurance policy is known as the________.

Correct AnswerverifiedShow Answer

The form a new patient completes when registering in a physician's office is known as a(n) ________ form.

Correct Answerverifiedpatient information

Match the following -Claim form used by hospitals to report services to insurance carriers

Correct AnswerverifiedShow Answer

What are some of the advantages of OCR in the processing of paper claims?

Correct AnswerverifiedScanners read at such a fast s...View AnswerShow Answer

If a patient has more than one insurance plan, the determination of how much will be paid by each is known as:

Correct AnswerverifiedShow Answer

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Information recorded in any form or medium that identifies the patient and relates to the patient's history, diagnosis, treatment, or prognosis is healthcare information, also known as the patient's medical record.

Correct Answer
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It is important to find out which carrie...
View Answer

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D

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patient information

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Scanners read at such a fast s...
View Answer

Correct Answer
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