4 Written Questions
3 Multiple Choice Questions
- A business entity that receives claims from serveral medical facilities and consolidates these claims so that one transmission containing multiple claims can be sent to each insurance carrier. Serves as an intermediary between medical practices and the insurance companies, facilitating the electronic exchange of information between the facilities.
- The electronic transfer of information in a standard format between two entities. Allows business entities to exchange information and trasact business in a rapid and cost-effective way.
- The transmission of claim information over phone lines using a computer and a modem. The most common form of electronic claim transmission.
3 True/False Questions
Billing services → Companies that offer services to healthcare facilities that include billing processes and claims filing. Many billing services take on the responsibility of keeping up with rapidly changing Medicare and other healthcare-related laws.
Code sets → The numbers used in the administration of health care to distinguish individual healthcare providers, health plans, employers, and patients. They are intended to simplify the administrative processes such as referrals and billing, improve the accuracy of date and reduce costs.
Direct data entry claims → Claims that are submitted directly to an insurance carrier.