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25 Cards in this Set
- Front
- Back
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After a third party payer validates a claim which of the following takes place next? |
Claim adjudication |
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According to the Affordable Care Act (ACA) of 2010, what is the maximum allowable time from the date of service that a claim can be submitted to Medicare? |
12 Months |
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According to the affordable care act (ACA) of 2010, what is the allowable maximum time from the date of service that a claim can be submitted to Medicare? |
12 months |
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According to OSHA, what is the appropriate way to file a complaint with OSHA? |
Submit an online form |
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According to HIPAA standards, which of the following identifies the rendering provider on the CMS–1500 claim form in Block 24? |
National Provider Identifier |
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Accepting assignment on the CMS–1500 claim form indicates which of the following? |
The physician agrees to accept payment under the terms of the payer program |
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Abbreviation for electroencephalogram |
EEG |
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A provider's office receives a subpoena requesting medical documentation from a patient's medical record. After confirming the correct authorization, which of the following actions should the billing and coding specialist take? |
Send the medical information pertaining to the dates of service requested |
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A provider's office receives a remittance advice showing a denial code. The MAA creates a formal written request for review of the rejected claim. The Assistant should use which of the following formats? |
Claim Appeal |
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A provider's office receives a subpoena requesting medical documentation from a patient's medical record. After confirming the correct authorization, which of the following actions should the billing and coding specialist take? |
Send the medical information pertaining to the dates of service requested |
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A Provider surgically punctures through the space between the patient's ribs using an aspirating needle to withdraw fluids from the chest cavity. Which of the following is the name of this procedure? |
Pleurocentesis |
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A patient who has Cohn’s disease should be scheduled with what type of specialist |
gastroenterologist |
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A patient refuses to pay his copayment. What actions should the MAA take? |
Inform the patient that the copayment is due at time of service |
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A patient is an identified smoker in her medical record and is requesting a medical record amendment due to her cessation of smoking 15 years earlier. Which of the sections of the patients’ bill of rights is the patient exercising? |
Confidentiality of health information |
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A patient is diagnosed with matastatic bone neoplasm. The neoplasm will be coded as what? |
Secondary Malignant |
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A MAA should verify a patients CPT code for what process |
A MAA should verify a patients CPT code for what process |
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A MAA should take what actions when documenting a prescription refill? |
Date and initial the prescription refill in the patient’s medical record |
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A MAA receives telephone calls from four patients. Which of the following calls indicates a need for immediate attention? |
A Patients who is reporting difficulty breathing |
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A MAA is asked to schedule a CXR for a patient. The assistant should make an appointment for which of the following? |
An X–Ray of the chest |
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A form that contains charges, DOS, CPT codes, fees, and copayment information is called which of the following? |
Encounter form |
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A patient with a past due balance requests that his records be sent to another provider, which of the following actions should be taken? |
Accommodate the request and send the records |
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A patient who was given instructions to stop taking aspirin 1 week prior to surgery informs the MAA that she forgot to follow instructions. What action does the MAA take? |
Speak with the provider about rescheduling the procedure |
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A patient who has a HMO insurance plan needs to see a specialist for a specific problem. From which of the following should the patient obtain a referral? |
Primary Care Provider |
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A patient wants to update his medical record to include medication sensitivity information that he had failed to provide. Which of the following actions should the MAA take? |
Make a new entry to update the previous information |
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A patient presents to the provider with chest pain and shortness of breath. After an expected ECG result, the provider calls a cardiologist and summarizes the patient's symptoms. What portion of the HIPAA allows the provider to speak to the cardiologist prior to obtaining the patient's consent? |
Title II |
