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When filling out an electronic insurance claim, the insurance and coding specialist processes which forms? CMS-1500
Which of the following are violations of the Stark Law? Accepting gifts in place of payment from patients; referring patients to facilities where provider has financial interest
When a capitation account is applied to the ledger it is also known as a Monthly prepayment amount
3rd party payer made an error when adjudicating a claim, the specialist should do what? Resubmit the claim with an attachment explaining the error
What information is needed to determine a medical sliding fee scale Poverty level; Number of dependents; Salary
Collecting statistics on the frequency of copay collection at time of a service is a step in the process of Managing A/R
Financial Record Patient Ledger
HIPAA allows physician to communicate with pt's family who are involved in pt's care regarding their mental state providing The patient does not object
When a document is changed in an EHR the original documentation is Hidden
A lady got a new job her new benefits kick in in 90 days, what is correct regarding her health ins. She will be able to keep her current medical insurance from her previous job trough COBRA
What produces a quarterly review of any dollar amount a patient still owes after all ins. carriers claim payments have been received Aging Process
What information is needed before discussing a patient account with the patient when calling in Patients DOB; Patients name; Patients Insurance ID number
When following up on a denied claim the specialist should have what info available when speaking to ins. company Date of service; Physicians NPI; Patients insurance ID number
The provider is paid the same rate per pt. whether or not they provide services and no matter which services are being provided Capitation
In order to have claims paid as quickly as possible the specialist must be familiar with Payer's claim processing procedure
Which of the following reports is used to follow up on outstanding claims to 3rd party payers Aging
When is a referral from a provider required When contained in the individual policy
Which of the following are necessary to complete a CMS 1500 Diagnosis and CPT codes; Physician information; Demographic Information
When using the EHR to schedule a patient visit which screen should be used to complete the scheduling process Patient Search

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