When does cms send - Study guides, Class notes & Summaries

Blocks 14-33 on the CMS 1500 Form - *patient condition *provider info What is the symbol 'O' reference used in the current procedural terminology used to do? - indicate a reinstated or recycled code Coinsurance - a percentage of the account balance the patient must pay after services are rendered and the annual deductible is met What should the BCBS first divide the evaluation and management code by? - Place of service What are add-on codes considered? - qualifying circumstances As of...

Which of the following actions is considered under the False Claim Act? Upcoding or unbundling services A health plan sends a request for medical records in order to adjudicate a claim. Does the office have to notify the patient or have them sign a release to send the information? No, since the information is used for payment activities it is not necessary to notify or obtain authorization from the patient The Federal False Claim Act allows for claims to be reviewed for a standard of how many ...

AAPC CPB Final covered entity - correct answer Health plan, clearinghouses, and any entity transmitting health information is considered by the Privacy Rule to be a: healthcare consulting firm - correct answer Which of the following is not a covered entity in the Privacy Rule release reqt to ins co - correct answer A request for medical records is received for a specific date of service from patient's insurance company with regards to a submitted claim. No authorization for release of in...

The security model for Universal Containers in Private for the Case object. When a support case is raised by a user with the Customer Community license, internal users are not able to see those Cases. Internal users in the support role need to work on these Cases. How should internal users see these Cases? Select one or more of the following: A. Use the role hierarchy B. Use a Public Group C. Use a Sharing Set D. Use a Share Group C. Use a Sharing Set Universal Containers needs to mat...

Certified Revenue Cycle Representative (CRCR) Exam Bank Complete Questions and Answers 100% Verified| Latest 2024 Certified Revenue Cycle Representative (CRCR) Exam Bank Complete Questions and Answers 100% Verified| Latest 2024 CRCR EXAM MULTIPLE CHOICE, CRCR Exam Prep, Certified Revenue Cycle Representative - CRCR (2024) What are collection agency fees based on? A percentage of dollars collected Self-funded benefit plans may choose to coordinate benefits using the gender rule or ...

Medical Billing and Coding Certification Blocks 14 through 33 - The patient's condition and the provider's information are shown in what blocks in CMS 1500 form? Coding Compliance Plan - Which of the following includes procedures and best practices for correct coding? Use Arial size 10 font - When completing a CMS 1500 form which of the following is an acceptable action for the billing and coding specialist to take The claim requires an attachment - Which of the following indicates a clai...

Which of the following Medicare policies determines if a particular item or service is covered by Medicare? - National Coverage Determination (NCD) A patient's employer has not submitted a premium payment. Which of the following claim statuses should the provider receive from the third-party payer? - Denied A billing and coding specialist should routinely analyze which of the following to determine the number of outstanding claims? - Aging report Which of the following should a billing...

Health plan, clearinghouses, and any entity transmitting health information is considered by the Privacy Rule to be a: - ANSWERScovered entity Which of the following is not a covered entity in the Privacy Rule - ANSWERShealthcare consulting firm A request for medical records is received for a specific date of service from patient's insurance company with regards to a submitted claim. No authorization for release of information is provided. What action should be taken? - ANSWERSrelease r...

AAPC CPB FinalHealth plan, clearinghouses, and any entity transmitting health information is considered by the Privacy Rule to be a: - correct answer covered entity Which of the following is not a covered entity in the Privacy Rule - correct answer healthcare consulting firm A request for medical records is received for a specific date of service from patient's insurance company with regards to a submitted claim. No authorization for release of information is provided. What action should ...

CLIA Clinical Laboratory Improvement Amendment Level of testing 1. waived testing 2. Moderate complexity 3. High complexity Waived Testing-requirement/criteria Waived tests include test systems cleared by the FDA for home use and those tests approved for waiver under the CLIA criteria. Although CLIA requires that waived tests must be simple and have a low risk for erroneous results, this does not mean that waived tests are completely error-proof. Errors can occur anywhere in t...