Death benefits compensate the family of a deceased employee for the loss of income which the employee would have provided to the family.
Indicate whether this statement is true or false.
(
Q. 2) Assume these patients are covered under Medicare A & B. Use the following physician notes to indicate diagnosis and procedure codes that would be used in billing for these patients. The bill is for the physician services or physician office services only. Assume the office has a CLIA waived testing lab on site.
Patient: Drew Carrigan, 68-year-old male
Physician Note:
S: Drew is an established patient presenting with ringing in the ears. Drew states that it started quite a while ago, but it is now interfering with his ability to hear normal conversations. Drew cannot identify any triggers or treatments that have helped; he reports it is a constant ringing and has had no trauma or sinus issues.
O: Ht: 58 inches, Wt 200 lbs; BP 120/80; Respirations 12; Temp 97.6F; Pulse ox 100 on room air; Pulse 63. Ears have no signs of infection or injury. Hearing screening test, pure tone, air only shows hearing is within normal limits.
A: R/O Tinnitus, consider CT scan/MRI after audiology consult.
P: Referral to audiology.
Diagnosis codes:
Procedure codes:
What will be an ideal response?
(
Q. 3) Tips for creating these audits or reviews include involvement of:
a. The patient making the original claim
b. Interdepartmental committees that review claims for fraud
c. State Medicare employees
d. Interdepartmental committees that review claims for errors
(
Q. 4) Which of the following are reasons to check the eligibility roster?
a. To determine the likely date of coverage termination
b. To determine what contract they are covered under
c. To determine their history of filing for second opinions
d. To determine their RAC
(
Q. 5) The Medicare Remittance Advice is used to convey payments to providers who accept assignment for Medicare claims.
Indicate whether this statement is true or false.
(
Q. 6) What is a progress report?
What will be an ideal response?
(
Q. 7) The percentage of all healthcare providers who are allied health professionals is:
a. 25.
b. 40.
c. 50.
d. 60.
(
Q. 8) Which of the following is one of the two arms of an IPO?
a. The physicians' group arm
b. The PCP arm
c. The medical group arm
d. The HMP arm
(
Q. 9) Zone Program Integrity Contractor (ZPIC) is the latest auditing program designed to look at billing trends and patterns of Medicare billing.
Indicate whether this statement is true or false.
(
Q. 10) Reasonable charges are the amounts approved by the Medicare carrier based on what is considered reasonable for the geographic area in which the doctor practices.
Indicate whether this statement is true or false.