NHA CBCS Final Exam Study Guide Package Deal with Practice Tests, Certification Exams, and Complete Solutions (2023/2024)
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Are limitations of the clinical privileges of a psychiatrist for more than 30 days reportable to the NPDB? - Yes According to The Joint Commission, who may amend medical staff bylaws? - Medical Staff Failure to meet the established qualifications and criteria for appointment should be reported ...
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In winkelwagenAre limitations of the clinical privileges of a psychiatrist for more than 30 days reportable to the NPDB? - Yes According to The Joint Commission, who may amend medical staff bylaws? - Medical Staff Failure to meet the established qualifications and criteria for appointment should be reported ...
What two accreditors state: a hospital may not rely solely on board certification when considering practitioner for medical staff membership? - HFAP, CMS According to JC & HFAP name four approved sources PSV for Medical Education - Medical School, AMA, ECFMG, AOA According to NCQA practitioners ...
Voorbeeld 3 van de 25 pagina's
In winkelwagenWhat two accreditors state: a hospital may not rely solely on board certification when considering practitioner for medical staff membership? - HFAP, CMS According to JC & HFAP name four approved sources PSV for Medical Education - Medical School, AMA, ECFMG, AOA According to NCQA practitioners ...
A _____________________________ would be the provider who would perform an orchiopexy - UROLOGIST The first section of the CPT manual is the _____________________________________________. - EVALUATION AND MANAGEMENT CODES ____________________________ means the amount of reimbursement an insura...
Voorbeeld 2 van de 12 pagina's
In winkelwagenA _____________________________ would be the provider who would perform an orchiopexy - UROLOGIST The first section of the CPT manual is the _____________________________________________. - EVALUATION AND MANAGEMENT CODES ____________________________ means the amount of reimbursement an insura...
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National Coverage Determination (NCD) - Which of the following Medicare policies determines if a particular item or service is covered by Medicare? Adjudication - Which of the following is considered the final determination of the issues involving settlement of an insurance claim? Encounter Form...
Voorbeeld 3 van de 21 pagina's
In winkelwagenNational Coverage Determination (NCD) - Which of the following Medicare policies determines if a particular item or service is covered by Medicare? Adjudication - Which of the following is considered the final determination of the issues involving settlement of an insurance claim? Encounter Form...
Requires documentation of the patient's informed consent. - urine pregnancy The patient should for a 24-hour urine specimen. - discard the first urine sample prior to collection 20/50 with no errors on the Snellen test means: - The patient can see at 20 feet what the normal eye sees at 50 feet....
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In winkelwagenRequires documentation of the patient's informed consent. - urine pregnancy The patient should for a 24-hour urine specimen. - discard the first urine sample prior to collection 20/50 with no errors on the Snellen test means: - The patient can see at 20 feet what the normal eye sees at 50 feet....
Which of the following electronic forms is used to post payments? - Electronic remittance advice (ERA) If a clean claim is received March 1 of this year, which of the following is the allowable last day of payment in order to meet Medicare compliance requirements? - March 30 Threading a cathete...
Voorbeeld 2 van de 9 pagina's
In winkelwagenWhich of the following electronic forms is used to post payments? - Electronic remittance advice (ERA) If a clean claim is received March 1 of this year, which of the following is the allowable last day of payment in order to meet Medicare compliance requirements? - March 30 Threading a cathete...
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 is called which of the following? - Encounter form A patient comes to the ...
Voorbeeld 3 van de 18 pagina's
In winkelwagenWhich 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 is called which of the following? - Encounter form A patient comes to the ...
Missing #1 - blank A claim is submitted with a transposed insurance member ID number & returned to the provider. This describes the status that should be assigned to the claim by the carrier? - Invalid. Medigap coverage is offered to Medicare beneficiaries by? - Private Third-party payers This...
Voorbeeld 2 van de 8 pagina's
In winkelwagenMissing #1 - blank A claim is submitted with a transposed insurance member ID number & returned to the provider. This describes the status that should be assigned to the claim by the carrier? - Invalid. Medigap coverage is offered to Medicare beneficiaries by? - Private Third-party payers This...
what do physicians use to electronically submit claims? - clearinghouse what is one purpose of an internal auditing program in a physician's office? - verifying that the medical records and the billing records match in which department should a patient be seen for psoriasis - dermatology * on a...
Voorbeeld 2 van de 10 pagina's
In winkelwagenwhat do physicians use to electronically submit claims? - clearinghouse what is one purpose of an internal auditing program in a physician's office? - verifying that the medical records and the billing records match in which department should a patient be seen for psoriasis - dermatology * on a...
1. Missing #1 - BLANK 2. A claim is submitted with a transposed insurance member ID number & returned to the provider. This describes the status that should be assigned to the claim by the carrier? - INVALID 3. Medigap coverage is offered to Medicare beneficiaries by? - PRIVATE THIRDPARTY PAYER ...
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In winkelwagen1. Missing #1 - BLANK 2. A claim is submitted with a transposed insurance member ID number & returned to the provider. This describes the status that should be assigned to the claim by the carrier? - INVALID 3. Medigap coverage is offered to Medicare beneficiaries by? - PRIVATE THIRDPARTY PAYER ...
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, * B...
Voorbeeld 4 van de 38 pagina's
In winkelwagenMedical 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, * B...
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, * B...
Voorbeeld 4 van de 39 pagina's
In winkelwagenMedical 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, * B...
What describes the reason for a claim rejection because of Medicare NCCI edits - Improper code combinations A claim is submitted with a transposed insurance member ID number and returned to the provider. - Invalid Medigap coverage is offered to Medicare beneficiaries by whom - Private thirdparty...
Voorbeeld 3 van de 16 pagina's
In winkelwagenWhat describes the reason for a claim rejection because of Medicare NCCI edits - Improper code combinations A claim is submitted with a transposed insurance member ID number and returned to the provider. - Invalid Medigap coverage is offered to Medicare beneficiaries by whom - Private thirdparty...
When a billing and coding specialist is completing the CMS-1500 claim form, which of the following information is required to process a medical claim? - CPT, ICD The allowed amount for a patient's office visit is $175. The copayment is $15 and the amount the insurance paid is $85. Which of the ...
Voorbeeld 2 van de 11 pagina's
In winkelwagenWhen a billing and coding specialist is completing the CMS-1500 claim form, which of the following information is required to process a medical claim? - CPT, ICD The allowed amount for a patient's office visit is $175. The copayment is $15 and the amount the insurance paid is $85. Which of the ...
A copay is the patient's share of the insurance premium. - False The term reconciliation means? - Determining how much the provider has been reimbursed and how much patient owes EOB (explanation of benefits) - Sent to policyholder RA (remittance advice) - Report from 3rd party payer to provider ...
Voorbeeld 2 van de 11 pagina's
In winkelwagenA copay is the patient's share of the insurance premium. - False The term reconciliation means? - Determining how much the provider has been reimbursed and how much patient owes EOB (explanation of benefits) - Sent to policyholder RA (remittance advice) - Report from 3rd party payer to provider ...
A patient presents to the provider with chest pain and shortness of breath. After an unexpected ECG result, the provider calls a cardiologist and summarizes the patient's symptoms. What portion of HIPAA allows the provider to speak to the cardiologist prior to obtaining the patient's consent? -...
Voorbeeld 2 van de 9 pagina's
In winkelwagenA patient presents to the provider with chest pain and shortness of breath. After an unexpected ECG result, the provider calls a cardiologist and summarizes the patient's symptoms. What portion of HIPAA allows the provider to speak to the cardiologist prior to obtaining the patient's consent? -...
NHA CBCS Exam Study Guide with Rationales 2023 -Combo with "scenarios for CPT coding, ICD-9-CM coding" and 21 others
Voorbeeld 4 van de 125 pagina's
In winkelwagenNHA CBCS Exam Study Guide with Rationales 2023 -Combo with "scenarios for CPT coding, ICD-9-CM coding" and 21 others
What describes the reason for a claim rejection because of Medicare NCCI edits - Improper code combinations A claim is submitted with a transposed insurance member ID number and returned to the provider. - Invalid Medigap coverage is offered to Medicare beneficiaries by whom - Private thirdparty...
Voorbeeld 3 van de 16 pagina's
In winkelwagenWhat describes the reason for a claim rejection because of Medicare NCCI edits - Improper code combinations A claim is submitted with a transposed insurance member ID number and returned to the provider. - Invalid Medigap coverage is offered to Medicare beneficiaries by whom - Private thirdparty...
The symbol "O" in the Current Procedural Terminology reference is used to indicate what? - Reinstated or recycled code In the anesthesia section of the CPT manual, what are considered qualifying circumstances? - Add-on codes As of April 1, 2014 what is the maximum number of diagnoses that can ...
Voorbeeld 2 van de 13 pagina's
In winkelwagenThe symbol "O" in the Current Procedural Terminology reference is used to indicate what? - Reinstated or recycled code In the anesthesia section of the CPT manual, what are considered qualifying circumstances? - Add-on codes As of April 1, 2014 what is the maximum number of diagnoses that can ...
Blocks 14-33 on the CMS 1500 Form - *patient condition *provider info What is the symbol 'O' reference used in the current procedural terminology used to do? - indicate a reinstated or recycled code Coinsurance - a percentage of the account balance the patient must pay after services are rend...
Voorbeeld 3 van de 16 pagina's
In winkelwagenBlocks 14-33 on the CMS 1500 Form - *patient condition *provider info What is the symbol 'O' reference used in the current procedural terminology used to do? - indicate a reinstated or recycled code Coinsurance - a percentage of the account balance the patient must pay after services are rend...
When is the principle diagnosis applicable? - Inpatient Hospital coding The term "encounter records" means: - claim What is the name of the act designed to address the collection practices of thirdparty debt collectors and attorneys who regularly collect debts for others? - Fair debt collection...
Voorbeeld 3 van de 26 pagina's
In winkelwagenWhen is the principle diagnosis applicable? - Inpatient Hospital coding The term "encounter records" means: - claim What is the name of the act designed to address the collection practices of thirdparty debt collectors and attorneys who regularly collect debts for others? - Fair debt collection...
A nurse is reviewing a patients lab results prior to discharge and discovers an elevated glucose level. Which of the following health care providers should be altered before the nurse can proceed with discharge planning? - The attending physician On the CMS-1500 Claims for, blocks 14 through 33 ...
Voorbeeld 3 van de 20 pagina's
In winkelwagenA nurse is reviewing a patients lab results prior to discharge and discovers an elevated glucose level. Which of the following health care providers should be altered before the nurse can proceed with discharge planning? - The attending physician On the CMS-1500 Claims for, blocks 14 through 33 ...
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