Copay - Study guides, Class notes & Summaries

The term for the set payment that the member pays to the healthcare provider on the day of service is the: a. office visit fee. b. co-insurance. c. copay. d. co-signer. - ANSWERSc. copay. Response Feedback: A copayment or copay is the set amount the insured member pays the healthcare provider on the day of service. Blue Cross/Blue Shield identifies the individual or employee who pays for healthcare insurance coverage as the: a. Member b. Group c. Subscriber d. Payer - ANSWER...

SOUTH CAROLINA LIFE AND HEALTH EXAM 2024 WITH 100% CORRECT ANSWERS A closed network plan offers a primary physician copay of $25. If a subscriber chooses a primary care physician outside of the network, the subscriber will likely pay - correct answer 100% of the billed amount What does Coordination of Benefits allow? - correct answer Allows the secondary payor to reduce their benefit payments so no more than 100% of the claim is paid A waiver of premium rider allows an insured to waive ...

Joe and Mary are a married couple and both carry insurance from their employers. Joe was born on February 23, 1977 and Mary was born on April 4, 1974. Using the birthday rule, who carries the primary insurance for their children for billing? A. Joe, because he is the male head of the household. B. Mary, because her date of birth is the 4th and Joe's date of birth is the 23rd. C. Mary, because her birth year is before Joe's birth year. D. Joe, because his birth month and day are before...

Place of Service Correct Answer: Billing and coding specialists should first divide the E & M Code by Privacy Officer Correct Answer: Compliant with HIPPA the following position should be assigned in each office Principal Diagnosis Correct Answer: Coding on the UB-04 Form, must sequence the diagnosis code. Which is the first listed diagnosis? Urethratresia Correct Answer: Obstruction of the urethra is UB04 Forms Correct Answer: Ambulatory surgery centers, home health center, and hos...

A liability policy that pays claims even after the policy is no longer active is termed: a) Claims-made policy b) Tail coverage c) Liability protection d) "all-protect" Answer B A patient you are caring for in your clinic has Medicare Part B. What does this mean? a) The federal government will pay for his visit to your clinic today b) His Medicare benefit covers outpatient services c) He will have to pay a copay for his visit today d) His prescriptions will be partly paid for toda...

Test Bank for Medical-Surgical Nursing 5E Holly Stromberg Chapter 01: Caring for Medical-Surgical Patients Stromberg: Medical-Surgical Nursing: Concepts and Practice, 5th Edition MULTIPLE CHOICE 1. Which statement accurately describes the primary purpose of the state nurse practice act (NPA)? a. To test and license LPN/LVNs b. To define the scope of LPN/LVN practice c. To improve the quality of care provided by the LPN/LVN d. To limit the LPN/LVN employment placement ANS: B While improv...

AAPC CPB - Chapter 3 Practical Application QUESTIONS 2024. Use the CPB Chapter 3_Case to answer questions 1 & 2. 1. Susan smith arrives at her in-network primary care physician's office for her annual preventive visit. What is her copay? a. $15.00 b. $50.00 c. $75.00 d. The patient does not have a copay for preventive visits. - correct answer d. The patient does not have a copay for preventive visits. Response Feedback: On the insurance card, under the copay column for In-net...

A liability policy that pays claims even after the policy is no longer active is termed: a) Claims-made policy b) Tail coverage c) Liability protection d) "all-protect" - B A patient you are caring for in your clinic has Medicare Part B. What does this mean? a) The federal government will pay for his visit to your clinic today b) His Medicare benefit covers outpatient services c) He will have to pay a copay for his visit today d) His prescriptions will be partly paid for today - B Ce...

CRPC 2024 Practice Questions with Correct Answers Which of the following generally are considered potential sources for the funds to cover the cost of long-term custodial care? - Answer-Medicaid, Medicare, group long-term care insurance offered through employers Medicaid and long-term care (ltc) insurance provide - Answer-recipients with benefits such as nursing home care. Medicare provides - Answer-only 20 days of skilled nursing care at full cost and 80 days thereafter with a substant...

AHIP FWA 2024 REAL EXAM WITH 150 QUESTIONS AND CORRECT ANSWERS (100% CORRECT VERIFIED ANSWERS) 2024 AHIP FRAUD, WASTE AND ABUSE EXAM BRAND NEW!! Mrs. Shields is covered by Original Medicare. She sustained a hip fracture and is being successfully treated for that condition. However, she and her physicians feel that after her lengthy hospital stay she will need a month or two of nursing and rehabilitative care. What should you tell them about Original Medicare's coverage of care in a...