NHA CBCS Final Exam Study Guide Package Deal with Practice Tests, Certification Exams, and Complete Solutions (2023/2024)

What two accreditors state: a hospital may not rely solely on board certification when considering practitioner for medical staff membership? - HFAP, CMS According to JC & HFAP name four approved sources PSV for Medical Education - Medical School, AMA, ECFMG, AOA According to NCQA practitioners ...

A _____________________________ would be the provider who would perform an orchiopexy - UROLOGIST The first section of the CPT manual is the _____________________________________________. - EVALUATION AND MANAGEMENT CODES ____________________________ means the amount of reimbursement an insura...

National Coverage Determination (NCD) - Which of the following Medicare policies determines if a particular item or service is covered by Medicare? Adjudication - Which of the following is considered the final determination of the issues involving settlement of an insurance claim? Encounter Form...

Requires documentation of the patient's informed consent. - urine pregnancy The patient should for a 24-hour urine specimen. - discard the first urine sample prior to collection 20/50 with no errors on the Snellen test means: - The patient can see at 20 feet what the normal eye sees at 50 feet....

Which of the following electronic forms is used to post payments? - Electronic remittance advice (ERA) If a clean claim is received March 1 of this year, which of the following is the allowable last day of payment in order to meet Medicare compliance requirements? - March 30 Threading a cathete...

Which of the following is considered the final determination of the issues involving settlement of an insurance claim? - Adjudication A form that contains charges, DOS, CPT codes, ICD codes, fees and copayment information is called which of the following? - Encounter form A patient comes to the ...

Missing #1 - blank A claim is submitted with a transposed insurance member ID number & returned to the provider. This describes the status that should be assigned to the claim by the carrier? - Invalid. Medigap coverage is offered to Medicare beneficiaries by? - Private Third-party payers This...

what do physicians use to electronically submit claims? - clearinghouse what is one purpose of an internal auditing program in a physician's office? - verifying that the medical records and the billing records match in which department should a patient be seen for psoriasis - dermatology * on a...

1. Missing #1 - BLANK 2. A claim is submitted with a transposed insurance member ID number & returned to the provider. This describes the status that should be assigned to the claim by the carrier? - INVALID 3. Medigap coverage is offered to Medicare beneficiaries by? - PRIVATE THIRDPARTY PAYER ...

Medical Billing & Coding as a Career - *Claims assistant professional or claims manager, *Coding Specialist, * Collection Manager, *Electronic Claims Processor, *Insurance Billing Specialist, * Insurance Coordinator, *Insurance Counselor, *Medical Biller, *Medical & Financial Records Manager, * B...

Medical Billing & Coding as a Career - *Claims assistant professional or claims manager, *Coding Specialist, * Collection Manager, *Electronic Claims Processor, *Insurance Billing Specialist, * Insurance Coordinator, *Insurance Counselor, *Medical Biller, *Medical & Financial Records Manager, * B...

What describes the reason for a claim rejection because of Medicare NCCI edits - Improper code combinations A claim is submitted with a transposed insurance member ID number and returned to the provider. - Invalid Medigap coverage is offered to Medicare beneficiaries by whom - Private thirdparty...

When a billing and coding specialist is completing the CMS-1500 claim form, which of the following information is required to process a medical claim? - CPT, ICD The allowed amount for a patient's office visit is $175. The copayment is $15 and the amount the insurance paid is $85. Which of the ...

A copay is the patient's share of the insurance premium. - False The term reconciliation means? - Determining how much the provider has been reimbursed and how much patient owes EOB (explanation of benefits) - Sent to policyholder RA (remittance advice) - Report from 3rd party payer to provider ...