Exam 4 MBC116
Questions and answeres to exam 4
does clearinghouse always charge a flat fee?
Practice management system can be rented...
a signed agreement by the physician is involved in order to transmit claims electronicly
even though dr's office does not bill medicare or transmit claims electronicly direct or by third party are they still subject to HIPPA standerds?
A medicare claim must include a standard code set ( CPT< ICD9)
group of ins. claims sent @ same time from one facility
what is a clearinghouse?
entety that receives claims , performf edits before transmitting to ins. carriers
Where should backup copies of office records be kept?
away from office
ins. claims transmitted electronicly are usually paid......
with in 2 weeks
Ins. claim forms are gethared ?
before durring and after services are rendered
A clearing house is?
an entity that receives claim perfomes edits before transmitting to ins. carriers
Who assigns the employers ID number?
What is the most important function of a practice management system?
AR/ Accounts receivable
What is a carrier direct?
A med. Practice has it's own computer and transmits claims electronocly to the ins. carrier
What is an ins. billing worksheet?
A computer printout that is used to look for errors befor transmission of claims
What is an interactve transaction?
back and forth communication between user and computer durring online real time
When keying in data it is wise to.....
bakp up frequently
A status report of claims is usually received.....
Post payments in practice management systems.....
Research unpaid claims....
Update practice management system with payer info......
end of the month
Correct rejections and submit claims....
Revew clearinghouse/payer reports
Make followup calls to resolve reason for rejection
Audit claims Batched and transmitted with confirmation reports
Review all claims rejection reports....
end of month
Batch, scrub, edit, and transmit claims...
daily or weekly
Note any problrmatic claims and resolve outstanding files
3 other names for encounter form
charge, transaction or routing slip
what are medical codes
data elemnet used uniformly to document as to why the p/t is being seen
bone marrow transplant
Auscultation and percution
breast self exam
bilateral salpingo -oophorectomy