What is TRICARE Prime Remote (TPR)?
What will be an ideal response?
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Q. 2) The two main methods used by providers to determine their fees are:
capitation-based and resource-based fee structures.
profit-based and charge-based fee structures.
charge-based and resource-based fee structures.
resource-based and usual-and-customary fee structures.
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Q. 3) What are the four components of HIPAA's Administrative Simplification section?
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Q. 4) The statute of limitations for refunds in cases in which no contract language covers refunds is:
2 years.
4 years.
5 years.
7 years.
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Q. 5) The Medicare RBRVS system first implemented in 1992 is the:
relative basis for resource-valued services.
relative-based resource value scale.
resource-based relative value scale.
resource-based relative value services.
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Q. 6) If a claim is denied, what process can be followed to request that the carrier reconsider the decision?
What will be an ideal response?
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Q. 7) When an objective, unbiased group of physicians reviews claims to determine what payment is adequate for the services provided, the process is called__________ .
Fill in the blank with correct word.
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Q. 8) A patient is expected to pay for services excluded from his or her insurance policy at the time the service is rendered.
Indicate whether this statement is true or false.
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Q. 9) Explain how the explanation of benefits (EOB) is used in the coordination of benefits process.
What will be an ideal response?
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Q. 10) Offering, accepting, or soliciting bribes, rebates, or kickbacks is considered fraud.
Indicate whether this statement is true or false.
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