Biology Forums - Study Force

Biology-Related Homework Help Medical Administration Topic started by: lemalcolm on Feb 22, 2018



Title: If an insured patient signs an Assignment of Benefits form, the insurance carrier will send payment ...
Post by: lemalcolm on Feb 22, 2018
If an insured patient signs an Assignment of Benefits form, the insurance carrier will send payment directly to the:
 
  bank.
 
  guarantor.
 
  patient.
 
  physician.



(Q. 2) Services covered under the Ambulatory Payment Classification (APC) system include all of the following EXCEPT:
 
  outpatient surgical procedures.
 
  inpatient surgical procedures.
 
  emergency department visits.
 
  diagnostic services.



(Q. 3) The CMS-1500 claim form is mandatory for all Medicare claims.
 
  Indicate whether this statement is true or false.



(Q. 4) The type of care that provides palliative services for terminally ill patients is known as:
 
  hospice care.
 
  home health care.
 
  critical care.
 
  terminal care.



(Q. 5) If an individual is covered under Plan A through her employment and is covered under Plan B through her spouse's employment:
 
  Plan A is primary, and Plan B is secondary.
 
  Plan B is primary, and Plan A is secondary.
 
  only Plan A will pay for her benefits.
 
  Plan B will pay all of the benefits.



(Q. 6) A company that receives claims from providers, audits them, and forwards them on to insurance carriers is a(n):
 
  billing service.
 
  independent auditing firm.
 
  clearinghouse.
 
  third-party administrator.



(Q. 7) The computerized comprehensive list of codes for all services and items provided to hospital patients is known as the __________ .
 
  Fill in the blank with correct word.



(Q. 8) The method of reimbursement that establishes the rate of payment to a hospital before services are rendered is:
 
  capitation.
 
  fee for service.
 
  per diem.
 
  prospective payment system.



(Q. 9) The CMS-1500 claim form used by physician offices was developed by:
 
  the American Medical Association (AMA).
 
  the Blue Cross/Blue Shield Association.
 
  the Centers for Medicare and Medicaid Services (CMS).
 
  representatives from all insurance carriers.



(Q. 10) Audits performed on a regular basis will confirm that documentation and coding were appropriate for the level of service provided or will identify problems.
 
  Indicate whether this statement is true or false.


Title: If an insured patient signs an Assignment of Benefits form, the insurance carrier will send payment ...
Post by: amyarango11 on Feb 22, 2018
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Title: If an insured patient signs an Assignment of Benefits form, the insurance carrier will send payment ...
Post by: lemalcolm on Feb 22, 2018
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