Bcbs new exam - Study guides, Class notes & Summaries

CRCR EXAM 154 Questions and Answers 2023 What do Case Managers do? - CORRECT ANSWERSMonitor high resource cases to ensure effective utilization What is HIM responsible for? - CORRECT ANSWERSall pt medical records: transcribe, coding, release to biling, answer requests for documentation What is utilization management responsible for? - CORRECT ANSWERSmanage cases: services correct, on time What are the three types of utilization review? - CORRECT ANSWERSProspective, Concurrent, Retros...

Mock CPB Exam Question and answers, 100% Accurate. Verified. Court decisions that establish a standard use legal decisions to serve as authoritative rules or patterns in future similar cases. The legal term for standard is ______. a. decision b. example c. precedent d. statute - -precedent Which is established in advance and based on reported health care charges from which a predetermined per diem rate is determined? a. prospective cost-based rate b. retrospective reasonable c...

NHA CBCS Certification Practice Exam A Questions and Answers Graded A+ Which of the following is considered the final determination of the issues involving the settlement of an insurance claim? Adjudication - is the process of putting an insurance claim through a series of edits for final determination. Chapter 4 A form that contains charges, DOS, CPT codes, fees, and copayment information is called which of the following? Encounter form is a form that contains charges, DOS, CPT code,...

1. What are the 4 settings for prescriptive authority? Describe the requirements in each setting for physician supervision, # of NPs, chart review, and any other special requirements in that site. correct answer- 1. Medically Underserved 2. Physician Primary Site 3. Physician Alternate Site 4. Facility Based Practice Site. * General requirements per TBON rule 222.5: regular visits, chart review as determined by APRN & physician, periodic face to face meeting of APRN & physician to discuss pt...

[COMPANY NAME] [Company address] AAPC CPB TEST BANK QUESTIONS WITH COMPLETE SOLUTIONS 2022| GRADED A AAPC CPB Test Bank Questions With Complete Solutions 2022| GRADED A 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 ...

BCBS LMS Training 2018 Exam Questions with Correct Answers What action can an individual request if BlueCross or its Business Associates refuse a request to amend or correct the individual's PHI? - Answer-The individual can request a statement of disagreement. Any potential breach of PHI must be reported to BlueCross within ? - Answer- Three Business Days Who should a Business Associate contact with questions concerning HIPAA compliance? - Answer-BlueCross privacy official Which of...

HMGT 3311 Exam Review Ch 1,13,3,&2. All Questions with accurate answers. Rated A+ What did the Patient Protection and the Affordable Care Act (ACA) do for industry developments? - --Established the "Triple aim" - Political hot-topic, under constant challenge What do the Centers for Medicare and Medicaid Services (CMS) aiming to? - --Get the right care for the right patient, every time - Control costs by moving from a "quantity of care" (" prospective") reimbursement system to a ...

AAPC CPB - CHAPTER 2: QUESTIONS WITH ANSWERS 2023 Why must a provider obtain an NPI number? I. To submit claims II. To prove that he is licensed III. To be HIPAA compliant IV. To guarantee payment by a health plan a. I, II, III b. II, III, IV c. I, II, III, IV d. I, III d. I, III A patient has receipts for her dental cleaning, vision exam, and contact lenses. Her employer has set up special accounts for each employee, there is no limit to the amount the employer can contribute...

BCBS NE 2022 Exam Questions with Correct Answer How many counties are in the Blue Cross Blue Shield of Nebraska HMO and PPO plans service area for 2022? A. 76 B. 68 c. 42 D. 82 - Answer-A What tiers of drugs will your client have to pay a deductible before they are covered under the Part D benefit included with the Blue Cross and Blue Shield of Nebraska's Medicare Advantage plans? A. Tiers 1, 2, B. Tiers 1 & 2 C. Tiers 3 D. None of the above. - Answer-C The nurse line offers? A...

[COMPANY NAME] [Company address] AAPC CPB TEST BANK QUESTIONS WITH COMPLETE SOLUTIONS 2022| GRADED A AAPC CPB Test Bank Questions With Complete Solutions 2022| GRADED A 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 b...