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Medical Billing and Reimbursement
Terms in this set (15)
Electronic data interchange is:
a) transferring data back and forth between two or more entities
b) sending information to one insurance carrier
c) sending information to one clearinghouse for processing
d) None of the above
a) transferring data back and forth between two or more entities
To examine claims for accuracy and completeness before they are submitted is to _________ the claims.
a) correct
b) audit
c) revise
d) reject
b) audit
How many diagnoses can be reported on the CMS-1500?
a) Two
b) Three
c) Four
d) Six
c) Four
Claims that have errors or omissions that must be corrected and resubmitted to receive reimbursement are called _____________ claims.
a) clean
b) dirty
c) dingy
d) incomplete
b) dirty
Which of the following steps to medical billing should be performed prior to rendering medical services?
a) Verify the patient's eligibility for insurance coverage
b) Collect patient insurance information
c) Code the diagnosis and procedures
Complete the CMS-1500 health insurance claim form
d) Both A and B
d) Both A and B
Which of the following is a fixed amount per visit and is typically paid at the time of medical services?
a) Co-payment
b) Deductible
c) Co-insurance
d) Both A and B
a) Co-payment
A(n) __________ claim has been completed accurately and completely.
clean
A claim that is missing information and is returned to the provider for correction and resubmission is called a(n) __________ claim.
incomplete
The medical assistant should __________ the front and back of the patient's insurance card.
copy
The medical assistant should do everything possible to prevent claim __________.
rejection
Dirty claims cannot be resubmitted.
a) True
b) False
b) false
Only physicians can be providers of medical services.
a) True
b) False
b) false
Electronic claims are submitted via electronic media.
a) True
b) False
a) true
Claims that are done by direct billing first go to a clearinghouse.
a) True
b) False
b) false
The insurance claim should always be proofread.
a) True
b) False
a) true
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