Employers can obtain workers' compensation insurance policies through all of the following EXCEPT:
federal programs.
state workers' compensation funds.
private insurance carriers.
self-funded plans.
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Q. 2) The TRICARE regional healthcare finder (HCF) provides preventive services and care for routine illnesses or injuries.
Indicate whether this statement is true or false.
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Q. 3) Items that are NOT covered by Medicare Part A or Part B include:
long-term care, such as custodial care in a nursing home.
care in a skilled nursing facility (SNF) after a 3-day hospital stay.
care provided by a rural health clinic.
home healthcare.
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Q. 4) What is a Medicare benefit period?
What will be an ideal response?
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Q. 5) The benefit payment information on an explanation of benefits (EOB) indicates who was paid, how much, and when.
Indicate whether this statement is true or false.
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Q. 6) If a claim is denied due to services NOT being covered under the insurance policy, the patient cannot be billed for the services.
Indicate whether this statement is true or false.
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Q. 7) If a claim is denied because additional information is needed to prove medical necessity, the medical office specialist should:
bill the patient.
write off the entire amount.
ask the patient to write a letter explaining the situation.
submit the required information and follow up with the carrier.
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Q. 8) Routinely waiving coinsurance and/or deductibles for Medicare patients when the patient has the ability to pay is considered abuse.
Indicate whether this statement is true or false.
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Q. 9) Approximately 50 of all claims are overturned on the first or second appeal.
Indicate whether this statement is true or false.
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Q. 10) If a claim is denied because services were provided before insurance coverage was in effect, the medical office specialist should:
bill the patient.
write off the entire amount.
wait until the effective date of the coverage, then bill the insurance carrier.
change the date of service and resubmit the claim.
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