MEDICAL BILLING AND
REIMBURSEMENT ESSENTIALS
QUESTIONS AND ANSWERS WITH
SOLUTIONS 2024
Medical billing and reimbursement represent the financial lifeline of the healthcare facility. True or false?
- ANSWER True
When does the medical billing process start? - ANSWER When a patient makes an appointment
When does the medical billing process end? - ANSWER When payment has been recieved
What is the first step in medical billing? - ANSWER Collect patient information when they call to schedule
an appointment
What should be reviewed prior to a patient being seen by the provider? - ANSWER Benefits and
exclusions
The form used for coding and billing is the ____. - ANSWER CMS 1500
Why is it important to meet the timely filing requirements of different insurance carriers? - ANSWER
Health insurance companies do not pay claims submitted after the established filing period
Health insurance claims for patient accounts with secondary insurance should be submitted to the
secondary carrier. True or false? - ANSWER True
What should you post to the patient's account? - ANSWER Payments using the EOB
When the patient makes an appointment, what should you ask for? - ANSWER Insurance billing
information
, What is a medical release of information form? - ANSWER Allows medical information to be released to
the insurance company
Should the medical release of information be in a patient's file? - ANSWER Yes
Should the medical release of information form be signed by the patient before or after the billing
process? - ANSWER Before
Precertification is ______. - ANSWER The process of proving to the insurance company that the service is
medically necessary
Does precertification guarantee a payment of services? - ANSWER No
Each insurance company has the same precertification requirements. True or false? - ANSWER False
Below listed is what all health insurance companies accept:
-CMS 1500 forms
-ICD-10-CM for diagnostic coding
-CPT and HCPCS procedural/supply codes
True or false? - ANSWER True
The medical assistant can successfully manage the requirements of the different insurance plans by keep
a ______. - ANSWER Medical billing manual
If the majority of claims are submitted electronically, why is it important to learn the different fields of
the CMS-1500 paper form? - ANSWER The data used to submit electronic claims are the same data used
of the CMS-1500
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Performance. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $12.49. You're not tied to anything after your purchase.