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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