Third party payer - Study guides, Class notes & Summaries
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NHA CBCS study guide Questions and Answers (2024 / 2025) (Verified Answers)
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NHA CBCS study guide Questions and Answers (2024 / 2025) (Verified Answers) 
When submitting claims, which of the following is the outcome if Block 13 is left blank? 
The third-party payer reimburses the patient, and the patient is responsible for reimbursing the provider 
 
 
Which of the following do physicians use to electronically submit claims? 
clearinghouse 
 
 
When billing a secondary insurance company, which block should the billing and coding specialist fill out on the CMS-1500 claim ...
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PTCB PRACTICE EXAM 2024 WITH 100% CORRECT ANSWERS
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Knowing which of the following can best assist a technician in the prevention of data entry errors? 
 
A. Names of medications 
B. Insurance co-payments 
C. Pharmacokinetics 
D. Physician contact informationAnswer - A. Names of medications 
 
Which of the following injectable drugs would be stored in refrigerator? 
 
A. Clindamycin 
B. Ciprofloxacin 
C. Cyanocobalamin 
D. Calcitonin-salmonAnswer - D. Calcitonin-salmon 
 
The requirement that a non-formulary medication be covered only if approv...
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CMAA EXAM STUDY GUIDE QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS 100% VERIFIED
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CMAA EXAM STUDY GUIDE QUESTIONS 
AND ANSWERS WITH COMPLETE 
SOLUTIONS 100% VERIFIED 
when should an MA assistant schedule a return appointment for a pt when pt checks out 
proper protocol when following up on nonpayment and of claims from third party payers 
notify the pt of the claim; contact third party payer
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NHA CEHRS FINAL PRACTICE TEST REVIEW QUESTIONS ONLY EXAM REV| latest 2024/25 exams updates |IEW QUESTIONS AND ANSWERS, VERIFIED/
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NHA CEHRS FINAL PRACTICE TEST REVIEW QUESTIONS 
ONLY EXAM REVIEW QUESTIONS AND ANSWERS, 
VERIFIED/ 
how does the registration process begin in an outpatient setting? - -when a new patient calls the 
office for an appointment to see a provider. 
what does a front staff member do once they obtain information from a new patient? - -they create 
an account that includes the patient's identity, medical condition, and insurance/payment info. 
what does a front staff member do once they obtain info...
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NHA CBCS exam review 2024/2025 (questions and answers verified)
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NHA CBCS exam review 2024/2025 
(questions and answers verified) 
Which of the following Medicare policies determines if a particular item or service is 
covered by Medicare? - C ORRECT ANSWER-National Coverage Determination (NCD) 
A patient's employer has not submitted a premium payment. Which of the following 
claim statuses should the provider receive from the third-party payer? - C ORRECT 
ANSWER-Denied 
A billing and coding specialist should routinely analyze which of the following to ...
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ICD-10-CM Exam |Questions Solved 100% Correct
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ICD-10-CM Exam |Questions Solved 100% Correct 
What edition of the Federal Register would hospital facilities be especially interested in? 
A. July 
B. November or December 
C. October 
D. January - C. October 
What edition of the Federal Register would outpatient facilities be especially interested in? 
A. November or December 
B. October 
C. January 
D. July - A. November or December 
What is the largest third-party payer? 
A. American government 
B. Department of Health and Human Services 
C....
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NHA CCMA Exam (2022/2023) with Certified Solutions
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Advance Beneficiary Notice (ABN) A form provided to the patient when the provider 
believes Medicare will probably not pay for services received 
Allowed Amount The maximum amount a third-party payer will pay for a particular 
procedure or service 
Copayment a small fixed fee paid by the patient at the time of an office visit 
Coinsurance a provision under which both the insured and the insurer share the covered 
losses, typically 80:20 
deductible specific amount of money a patient must pay out...
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CPAR Exam Questions and Correct Answers
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(ABN)Advanced beneficiary notice 
Ans: advanced notice that the patient may have to pay for lab testing that 
medicare will not cover. 
Insurance 
Ans: a way of reducing a person's exposure to risk of loss because another party 
(insurance company) assumes the risk. 
Reimbursement 
Ans: the compensation or repayment for healthcare services. 
First party 
Ans: the patient or the person responsible for the healthcare bill 
Second party 
Ans: the physician, hospital, clinic, nursing home, or oth...
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Test Bank - Olds' Maternal-Newborn Nursing & Women's Health Across the Lifespan, 11th Edition (Davidson, 2020), Chapter 1-36
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The nurse is speaking to students about changes in maternal-newborn care. One change is 
that self-care has gained wide acceptance with clients and the healthcare community due 
to research findings that suggest that it has which effect? 
A) Shortens newborn length of stay 
B) Decreases use of home health agencies 
C) Decreases healthcare costs 
D) Decreases the number of emergency department visits 
Answer: C 
Explanation: 
A) Length of stay is often determined by third-party payer (insurance c...
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Pharmacy Management Final Exam (Non-Cumulative) || Already Graded A+.
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Third-party payers that interact directly with retail pharmacies include: correct answers - Pharmacy benefit managers 
- Medicare prescription drug plans 
- Medicare advantage plans with prescription drug benefits 
- Medicaid 
 
Which are mechanisms used by third-party payers to control prescription costs and control utilization? correct answers - Prior authorization 
- Step therapy 
- Generic substitution 
- Quantity limits 
- Formularies 
 
Define formulary correct answers List of medications ...
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