Bluecross blueshield - Study guides, Class notes & Summaries

Ch. 13 BlueCross BlueShield Review Questions and Answers | 100% Pass

Medical Insurance Chapter 13th BlueCross BlueShield Exam Study Guide with Complete Solutions One of the requirements that a participating provider must comply with is to - Answer️️ -make fee adjustments for the difference between amounts charged to patients for services provided and payer-approved fees. Which is a program that requires providers to adhere to managed care provisions? - Answer️️ -preferred provider network (PPN) One of the expectations that a nonparticipating provi...

Revenue Cycle Management Ch.13 BlueCross BlueShield Exam Questions With Correct Answers. One of the requirements that a participating provider must comply with is to a. purchase billing manuals and newsletters published by the payer and pay registration fees to attend payer training sessions. b. make fee adjustments for the difference between amounts charged to patients for services provided and payer-approved fees. c. maintain a provider representative department to assist with billing ...

Chapter 13 BlueCross BlueShield Vocabulary and Additional Terms Away From Home Care Program - answerprovides continous BCBS health care coverage for subscribers who will be out of their service area for more than 90 consecutive days BCBS Basic Coverage - answerBlueCross BlueShield (BCBS) coverage for the following services: hospitalization, diagnostic laboratory services, x-rays, surgical fees, assistant surgeon fees, obstetric care, intensive care, newborn care, and chemotherapy for cance...

A ________ is health plan that is sponsored by employer or employee organization to provide health care to the employees, former employees and their families. Group health plan Who manages the group health care plan benefits, negotiating with payers and selecting a number of plans for the employer and employees? Human resources Brainpower Read More Previous Play Next Rewind 10 seconds Move forward 10 seconds Unmute 0:00 / 0:00 Full screen What is a document modifyin...

Physician submit _____ service/procedure codes to payers. 1) ICD-10-CM 2) HCPCS level III 3) DSM-5 4) CPT/HCPCS level II - CPT/HCPCS level II The reverse of the CMS-1500 claim contains special instructions for 1) BlueCross and BlueShield. 2) Private commercial insurance. 3) Government programs. 4) Workers' compensation. - Government programs. Electronic claims must meet requirements adopted as the national standard under 1) CLIA. 2) ARRA. 3) HIPAA. 4) MMA. - HIPAA. When one charg...

Chapter 13- Bluecross Blueshield insurance Exam Questions With Correct Answers. 1929 - answerBluecross began in what year? Baylor University Hospital in Dallas, Texas - answerWhere did Bluecross begin? 21 days of hospitalization per year for subscribers and their dependents - answerHow much hospitalization did bluecross originally cover? $6 annual premium - answerHow much did Bluecross originally cost? Bluecross plan - answerThe forerunner is known as what today? the House of Delegates a...

BCBS Study Questions with All Correct Answers In what year was the BlueCross BlueShield Association (BCBSA) created - Answer1986 BCBS would like the office to ask patients to sign a ROI form - Answer-yearly ROI - Answer-Release of Information When filling out claim forms - Answer-ALL CAPS No Punctuation

BCBS Study Questions with All Correct Answers In what year was the BlueCross BlueShield Association (BCBSA) created - Answer-1986 BCBS would like the office to ask patients to sign a ROI form - Answer-yearly ROI - Answer-Release of Information When filling out claim forms - Answer-ALL CAPS No Punctuation The National Provider Identifier (NPI) - Answer-10 digit number issued to providers and healthcare organizations RA - Answer-remittance advice blue cross (pre paid ) hospital ...

The attending physician - A nurse is reviewing a patients lab results prior to discharge and discovers an elevated glucose level. Which of the following health care providers should be altered before the nurse can proceed with discharge planning? The patients condition and the providers information - On the CMS-1500 Claims for, blocks 14 through 33 contain information about which of the following? Problem focused examination - A provider performs an examination of a patient's throat duri...