Medical billing - Study guides, Class notes & Summaries

Abuse - Actions inconsistent with accepted, sound medical business or fiscal practice Accept Assignment - Provider accepts as payment in full whatever is paid on the cliam by the payer (except for any copayment and or coinsurance amounts.) Accounts Receivable - The amount owed to a business for services or goods provided. Accounts Receivable Aging Report - Shows the status (by date) of outstanding claims from each payer, as well as payments due from patients. Accounts Receivable Management -...

Medical billing and coding latest version graded A+ Medical Insurance Financial plan (the payer) that covers the cost of hospital and medical care Policyholder Person who buys an insurance plan; the insured, subscriber, or guarantor Health Plan Individual or group plan that provides or pays for the cost of medical care Benefits What a health plan pays for services covered in an insurance policy; listed in the schedule of benefits. Medical Necessity Reasonable services of prov...

Medical Billing Questions and Answers Already Passed 1. Administrative medical office responsibilities include Claims submissions 2. A claims assistant professional Works for the consumer and helps patients file insurance claims 3. The amount of money an insurance billing specialist earns is dependent on which of the following factors Knowledge,experience, and size of employing institution 4. A billing specialist is entrusted with Holding patient's medical information in confid...

Medical Billing and Coding Practice Test with Complete Solutions Which of the following Medicare policies determines if a particular item or service is covered by Medicare? National Coverage Determination (NCD) Which of the following is considered the final determination of the issues involving settlement of an insurance claim? Adjudication A form that contains charges, DOS, CPT codes, ICD codes, fees and copayment information Encounter Form A patient comes to the hospital for ...

Medical Billing Latest Update Graded A+ AMA American Medical Association cash flow The amount of actual money available to the medical practice ethics Standards of conduct generally accepted as a moral guide for behavior. etiquette customs, rules of conduct, courtesy, and manners of the medical profession HIPAA Health Information Portability and Accountability Act abuse Incidents or practices, not usually considered fraudulent, that are inconsistent with accepted sound medical...

medical billing & coding review latest update graded A+ Three factors of E/M Codes 1. Place of service 2. Type of service 3. Patient status Place of service Explains the sttings in which the services were provided to the patient. Codes vary depending on the place of the service. Service can be a doctors office, hospital, emergency department, nursing home and so on. Type of service Explains the sttings in which the services were provided to the patient. Codes vary depending on...

MEDICAL BILLING & CODING - CERTIFICATION TESTS ALREADY PASSED What symptoms are included in ROS (Review of Systems) for Constitutional Classification - Usual weight. - recent weight changes, - fever, - weakness, - fatigue What symptoms are included in ROS (Review of Systems) for Eyes (Ophthalmologic)Classification - Glasses or contact lenses - last eye examination - visual glaucoma - cataracts - eyestrain - pain - diplopia, - redness - lacrimation - inflammation - b...

MEDICAL BILLING AND CODING LATEST UPDATE GRADED A+ NP New Patient RX Perscription CC Chief Complaint EP Established Patient DX Diagnosis 6 Sections of CPT Medicine Surgery Raidiology Pathology Evaluation Anesthesiology What is a Modifier? Used to further explain service, treatment, diagnosis What does CPT stand for and what do CPT codes represent? Current Procedural Terminology Used to classify service or procedures How many digits does a CPT code contain? ...

Telepsychiatry - a provider administers psychiatric care from a distance through a technological interface -a subset of telehealth -telepsychiatric services • psychiatric interview • psychiatric evaluations • therapy • medication management • consultation • client education The American Psychiatric Association (APA, 2020) supports telemedicine as a legitimate component of a mental health delivery system when telepsychiatry services: - -benefit the client -maintain client...

Medical Billing and Coding Practice Questions with Verified Solutions What type of insurance allows treatment virtually anywhere with a high deductible that policyholder are willing to pay? PPO Veterans with service related disabilities are eligible for care under which of the following programs: CHAMPVA ______________________ is usually sponsored and partially paid by an employer Group Health Insurance ______________________ are used to report encounter for circumstances other t...