Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
insurance chpt 8
chapter 8 test
| Question | Answer |
|---|---|
| how often do you Review clearinghouse/payer transmission confirmation reports? | Daily |
| how often do you audit claims batched and transmitted with confirmation reports ? | Daily |
| how often do you correct rejections and resubmit claims? | Daily |
| how often do you batch, scrub, edit, and transmit claims? | daily or weekly |
| how often do you research unpaid claims? | weekly |
| how often do you make follow-up calls to resolve reasons for rejections, such as incorrect NPI, missing patient ID, incomplete data elements, and wrong format | weekly |
| when do you update practice management system with payer information, such as EIN, and NPI | end of month |
| where do you store confident data? | on a disk rather than only to the computers hard drive. Disk should stored in a locked secure location, preferably one that is fireproof and away from magnetic fields |
| what is a clearinghouse? | an entity that receives the electronic transmission of claims from the health care providers office and translates it into a standard format prescribe in HIPPA |
| what is a batch ? | Group of claims for different Pt. sent at the same time from one facility |
| electronic claims are usually paid in what time frame? | Two weeks or less |
| What is the most important function of a practice management system ? | Accounts receivable |
| employers identification # is assigned by who? | IRS Internal Revenue Service |
| Know what a clearinghouse does | Separate claims by carrier Performs software edits on each claim to check errors Transmit claims electronically to the correct insurance payer |
| Where is insurance claim data gathered from? | before,during, and after service rendered |
| What is carrier-direct | medical practice has own computer system to transmitted electronically directly into payers system |
| If a mds office does not bill medicare & does not submit transactions electronically, directly, or through a third party, the practice is still subject to HIPPA transaction rules | FALSE |
| Medicare claim must include standard code sets, such as CPT & ICD-9 | TRUE |
| practice management systems can be rented from practice management systems over the internet | TRUE |
| Insurance claims submitted electronically must have a signed agreement by the physician with the carrier involved? | TRUE |
| Clearinghouse always charge a flat fee for claim processing? | FALSE |
| what is an insurance billing worksheet | computer print out used to look for errors before an insurance claim is transmitted |
| Back and Forth communication between user an computer that occur during online real time is called? | Interactive transaction |
| When keying in data it is wise to frequently what to save data? | back-up |
| how is a status report of claims received from a third party? | electronically |
| how often do you post payments in practice management system? | Daily |
| how often do you note any problematic claim and resolve outstanding files ? | weekly |
| what are the different names for an encounter form? | charge slip, super bill, eob, |
| what are medical code sets? | data elements used uniformly to document why pt are seen |
Created by:
deefuerte
Popular Medical sets