Primary payer - Study guides, Class notes & Summaries

NC Medicare Supplement & Long Term Care Insurance Licensing Final Exam 100% Verified Medicare - CORRECT ANSWER-Health insurance for those over age 65, people under 65 with certain disabilities & those with ESRD (end stage renal disease - permanent kidney failure requiring dialysis or kidney transplant) CMS - CORRECT ANSWER-Centers for Medicare and Medicaid Services administers the Medicare program. Social Security Administration handles most of the enrollment & plays a role in clai...

AAPC CPB Practice Exam (500 Questions, All Answered Correctly) Updated 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 bef...

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...

NCCT: Interactive Review: Medical Insurance Exam Questions and Answers Eligibility for Medicaid may change as quickly as - Answer-monthly. Which of the following processes requires checking and confirming that the patient is a member of the insurance plan and that the member identification number is correct? - Answer-verification The patient is a 3-year-old. Both parents have private insurance coverage on the patient, and the mother has a Healthcare Savings Account. The primary insurance ...

RHIA Domain 4 Exam Questions with Correct Answers Which government-sponsored program provides coverage for active-duty service members of the armed forces (ADSM)? - Answer-TRICARE Dr. McGee is a primary care physician. Several of Dr. McGee's patients are insured by Super Payer. Super Payer reimburses Dr. McGee for each service she provides during a clinic visit. Which reimbursement methodology does Super Payer use to reimburse Dr. McGee? - Answer-Fee schedule Dayna is analyst at Communit...

NHA,CBCS Exam (Latest 2024/ 2025 Update) | Questions and Verified Answers| 100% Correct| Grade A Q: Which of the following would most likely result in a denial on a Medicare claim? Answer: An experimental chemotherapy medication for a patient who has stage III renal cancer Q: Which of the following pieces of guarantor information is required when establishing a patient's financial record? Answer: Phone number Q: A provider surgically punctures through the space betw...

NC Medicare Supplement & Long Term Care Insurance Licensing Latest Update Graded A+ Medicare Health insurance for those over age 65, people under 65 with certain disabilities & those with ESRD (end stage renal disease - permanent kidney failure requiring dialysis or kidney transplant) CMS Centers for Medicare and Medicaid Services administers the Medicare program. Social Security Administration handles most of the enrollment & plays a role in claims appeal process. MAC Medicare A...

Which of the following sections of the medical record is used to determine the correct evaluation and management code used for billing and coding? - history and physical A billing and coding specialist is reviewing a CMS-1500 claim form. The "assignment of benefits" box has been checked "yes." The checked box indicates which of the following? - The provider receives payment directly from the payer Which of the following do physicians use to electronically submit a claim? - Clearinghouse W...

Accurate reimbursement begins with accurate coding and rules that vary by payer The CPT codebook contains instructions, coding guidelines, parenthetical notes, and symbols to provide guidance for proper coding. Not all payers follow CPT coding guidelines. An auditor must be able to apply payer variations to the CPT guidelines during an audit, and must communicate the differences in a way that will make sense to the provider. Add-on codes Master01 | September, 2024/2025 | Latest u...

________ is when the provider has limited access to payer and patient data elements on their patients only. - Extranet An extranet is a private computer network allowing controlled access to the payer's system. The provider has limited access to payer and patient data elements on their patients only. 1992 US federal government implemented a standardized physician payment schedule utilizing resourcebased relative value scale - RBRVS A batch of claims is submitted to the clearinghouse for pr...