When submitting claims - Study guides, Class notes & Summaries

©BRAINBARTER 2024/2025 Nah practice test Exam Questions With Correct Answers Which of the following is considered the final determination of the issues involving settlement of an insurance claim? - answeradjudication : is the process of putting an insurance claim through a series of edits for final determination. a form that contains charges, DOS,CPT codes,ICD codes, fees, and copayment information is called which of the following? - answerencounter form: an encounter form is a form that...

NR511 Midterm Exam (2024) || Questions & Answers (Rated A+) NR511 Midterm Exam (2024) || Questions & Answers (Rated A+) Define diagnostic reasoning - ANSWER - Reflective thinking because the process involves questioning one's thinking to determine if all possible avenues have been explored and if the conclusions that are being drawn are based on evidence. Seen as a kind of critical thinking. What is subjective data? - ANSWER - Anything the patient tells you or complains of regarding t...

CFCI Study Guide Latest Update Already Passed Fraud "Any illegal acts characterized by deceit, concealment, or violation of trust. These acts are not dependent upon the perpetrated by individuals and organizations to obtain money, property, or services; to avoid payment or loss of services; or to secure personal or business ad- vantage." Main types of fraud Internal Fraud and External Fraud Internal Fraud which involves the employees of the company against which the fraud is ...

When the disclosure of an insured's nonpublic information is involved, what is the insurer obligated to do? - ANS Give notice, explain, and allow opting out Under the Telemarketing Sales Rule, telemarketing calls may NOT be received after - ANS 9:00 PM A health plan offered by private insurance companies is - ANS Medicare Supplement Chris has a single major medical contract which covers all medical expenses. His plan is considered to be - ANS comprehensive In accident and he...

North Carolina MPJE Questions and Answers Rated A+ Pure Food and Drug Act of 1906 prohibited the adulteration and misbranding of foods and drugs in interstate commerce Food, Drug, and Cosmetic Act of 1938 Core of today's drug laws. No new drug can be marketed/sold until proven safe and approved by FDA. Labels must contain adequate directions for use and warnings about their habit-forming properties Durham-Humphrey Amendment of 1951 Established two classes of medications: Rx and ...

CPMA Exam Questions and Answers Latest Updated 2023 CMS Fraud Definition Making false statements or misrepresenting facts to obtain an undeserved benefit or payment from a federal healthcare program CMS Abuse Definition An action that results in unnecessary costs to a federal healthcare program, either directly or indirectly CMS Examples of Fraud Billing for services and/or supplies that you know were not furnished or provided, altering claim forms and/or receipts to receive a ...

Midterm Exam: NR511/ NR 511 (Latest 2024/ 2025 Update) Differential Diagnosis & Primary Care Review| Questions and Verified Answers| 100% Correct |Grade A – Chamberlain Q: Your client, a 72-year-old smoker of 50 years, is at the office today for a routine physical. During your inspection of the oral mucosa, you discover a white lesion on the lateral surface of the tongue that you suspect to be cancerous. You document your finding as Answer: A white, painless, firm, ulcerated lesion w...

When the disclosure of an insured's nonpublic information is involved, what is the insurer obligated to do? - ANSWERGive notice, explain, and allow opting out Under the Telemarketing Sales Rule, telemarketing calls may NOT be received after - ANSWER9:00 PM A health plan offered by private insurance companies is - ANSWERMedicare Supplement Chris has a single major medical contract which covers all medical expenses. His plan is considered to be - ANSWERcomprehensive In accident and he...

Medical Billing & Coding as a Career - *Claims assistant professional or claims manager, *Coding Specialist, * Collection Manager, *Electronic Claims Processor, *Insurance Billing Specialist, * Insurance Coordinator, *Insurance Counselor, *Medical Biller, *Medical & Financial Records Manager, * Billing & Coding Specialist What are Medical Ethics? - Standards of conduct based on moral principle. They are generally accepted as a guide for behavior towards pt's, dr's, co-workers, the gov, ...

CBCS Exam 2023/2024 with Question and 100% Correct Answers. Medical Billing & Coding as a Career - Correct answer-*Claims assistant professional or claims manager, *Coding Specialist, * Collection Manager, *Electronic Claims Processor, *Insurance Billing Specialist, * Insurance Coordinator, *Insurance Counselor, *Medical Biller, *Medical & Financial Records Manager, * Billing & Coding Specialist What are Medical Ethics? - Correct answer-Standards of conduct based on moral principle. They a...