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NHA CBCS Certification Test Study Guide Questions and Answers $13.99   Add to cart

Exam (elaborations)

NHA CBCS Certification Test Study Guide Questions and Answers

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NHA CBCS Certification Test Study Guide Questions and Answers

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  • October 7, 2024
  • 12
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • NHA CBCS
  • NHA CBCS
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NHA CBCS Certification Study Guide




abstracting - Answer -the extraction of specific data from a medical record, often for use in an external
database, such as a cancer registry



abuse - Answer -practices that directly or indirectly result in unnecessary costs to the Medicare program



account number - Answer -number that identifies specific episode of care, date of service, or patient



accounts receivable department - Answer -Department that keeps track of what third-party payers the
provider is waiting to hear from and what patients are due to make a payment.



activity/status date - Answer -Indicates the most recent activity of an item.



actual charge - Answer -the amount the provider charges for the health care service



Administration Simplification Compliance Act (ASCA) - Answer -specifically prohibits any payment by
Medicare for services or medically necessary supplies that are not submitted electronically



administrative services only (ASO) contract - Answer -Contract between employers and private insurers
under which employers fund the plans themselves, and the private insurers administer the plans for the
employers.

, Advance Beneficiary Notice of Noncoverage (ABN) - Answer -Form provided if a provider believes that a
service may be declined because Medicare might consider it unnecessary.



aging report - Answer -Measures the outstanding balances in each account.



allowable charge - Answer -The amount an insurer will accept as full payment, minus applicable cost
sharing.



APC grouper - Answer -Helps coders determine the appropriate ambulatory payment classification (APC)
for an outpatient encounter.



assignment of benefits - Answer -Contract in which the provider directly bills the payer and accepts the
allowable charge.



auditing - Answer -review of claims for accuracy and completeness



authorization - Answer -Permission granted by the patient or the patient's representative to release
information for reasons other than treatment, payment, or health care operations.



balance billing - Answer -Billing patients for charges in excess of the Medicare fee schedule.



batch - Answer -a group of submitted claims



Blue Cross and Blue Shield plan - Answer -The first prepaid plan in the U.S. that offers health insurance
to individuals, small businesses, seniors, and large employer groups.



business associate (BA) - Answer -Individuals, groups, or organizations, who are not members of a
covered entity's workforce, that perform functions or activities on behalf of or for a covered entity.



capitation - Answer -the fixed amount a provider receives

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