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123kduncan 123kduncan
wrote...
6 years ago
A(n) __________ is an examination and verification of claims and supporting documentation submitted by a physician or medical facility to a carrier.
 
  Fill in the blank with correct word.



(Q. 2) Monies owed to a provider by insurance carriers or patients makes up the__________ .
 
  Fill in the blank with correct word.



(Q. 3) Why is documentation important?
 
  What will be an ideal response?



(Q. 4) Software that is used to calculate the Diagnosis Related Group (DRG) payment group is called a(n):
 
  claims processing system.
 
  grouper.
 
  accounts receivable system.
 
  database.



(Q. 5) Due to confidentiality regulations, TRICARE claims examiners do NOT provide information to parents or guardians of minors in regard to healthcare services that are related to:
 
  abortion.
 
  alcoholism or drug abuse.
 
  sexually transmitted disease.
 
  all of the above.



(Q. 6) The TRICARE Standard annual catastrophic cap (maximum amount beneficiaries are required to pay within 1 year) for active-duty families is:
 
  1,000 per beneficiary.
 
  1,000 per family.
 
  7,500 per beneficiary.
 
  7,500 per family.



(Q. 7) The only state that allows private employers to choose whether or not to provide workers' compensation is:
 
  Maryland.
 
  New York.
 
  Texas.
 
  Wisconsin.



(Q. 8) A copayment may NOT be collected from a Medicaid patient for:
 
  hospital services.
 
  family planning services.
 
  physician office visits.
 
  preventive care services.



(Q. 9) The program that provides states with grants to be spent on time-limited cash assistance to low-income families is called __________ .
 
  Fill in the blank with correct word.



(Q. 10) A medical records audaA medical records audit conducted by a representative of a private or government payer is a(n)it conducted by a representative of a private or government payer is a(n) __________ audit.
 
  Fill in the blank with correct word.
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THOTLESLEYTHOTLESLEY
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6 years ago
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