NCCT Practice Test Questions and Answers with Complete Solutions

Document Content and Description Below

NCCT Practice Test Questions and Answers with Complete Solutions Which of the following is an appropriate way to open the discussion when explaining practice fees to a patient? a. "Do you have any... questions about the cost of today's visit?" b. We can accept your insurance as payment in full." c. "Do you know what your out of pocket cost is today?" d. "We will bill you for the visit in full." Correct Answer-A. "Do you have any questions about the cost of today's visit?" Which of the following information should be used to capture charges from an encounter form? a. provider participation status b. patient's insurance benefits c. past procedures and scheduled future visits d. services rendered and reason for visit Correct Answer-d. services rendered and reason for visit When posting transactions for electronic claims submission, it is necessary to enter which of the following items onto the claim? a. insurance plan's allowable fee b. physician's office fee c. insurance plan's UCR fee d. physician's contractual fee Correct Answer-b. physician's office fee The patient is sent a statement for an office visit. The total amount of the bill is $100.00 and this amount must be paid before the insurance company will pay on the claim. Which of the following is this called? a. deductible b. premium c. copayment d. coinsurance Correct Answer-a. deductibleWhen posting an insurance payment via an EOB, the amount that is considered contractual is the: a. co-insurance b. NON-PAR payment allowable c. patient responsibility d. insurance allowed amount Correct Answer-d. insurance allowed amount Developing an insurance claim begins a. when the patient calls to schedule an appointment b. once the charges have been entered into the computer c. when the patient arrives for the appointment d. after the medical encounter is completed Correct Answer-a. when the patient calls to schedule an appointment When should a provider have a patient sign an ABN? a. when a service is excluded from coverage under Medicare b. when the items may be denied and prior to performing the service c. when the service is covered under Part B fee schedule d. prior to treating a patient who requires emergency services that might not be covered Correct Answerb. when the items may be denied and prior to performing the service Which of the following regulations prohibits the submission of a fraudulent claim or making a false statement or representation in connection with a claim? a. Stark Law b. Federal Claims Collection Act c. Federal False Claims Act d. Anti-kickback Law Correct Answer-c. Federal False Claims Act The patient's total charges are $300. The allowed amount is $150. Benefits pay 60%. Which of the following will the patient have to pay? a. $60 b. $90 c. $150d. $180 Correct Answer-a. $60 Which of the following process makes a final determination for payment in an appeal board? a. deposition b. peer to peer c. special handing d. arbitration Correct Answer-d. arbitration Which of the following items are mandatory in patient financial policies? (Select the three (3) correct answers.) a. participating insurance companies b. provider fee schedule c. statement that responsibility for payment lies with patient d. collection process e. expectation of payment due at time of service Correct Answer-c. statement that responsibility for payment lies with patient d. collection process e. expectation of payment due at time of service Collections agencies are regulated by the a. Outpatient Prospective Payment System b. Health Care Finance Administration c. Uniform Bill of 2004 d. Fair Debt Collections Practices Act Correct Answer-d. Fair Debt Collections Practices Act In order to have claims paid as quickly as possible, the insurance specialist must be familiar with which of the following? a. Automated claims status requests b. clearinghouse processing procedures c. prompt pay laws d. payer's claim processing procedures Correct Answer-d. payer's claim processing proceduresWhich of the following are violations of the Stark Law? (Select the two (2) correct answers) a. accepting gifts in place of payment from patients b. referring patients to facilities where the provider has a financial interest c. upcoding d. negligent handling of protected health information (PHI) e. billing for services not rendered Correct Answer-a. accepting gifts in place of payment from patients b. referring patients to facilities where the provider has a financial interest HIPAA allows a health care provider to communicate with a patient's family, friends, or other persons who are involved in the patient's care regarding their mental health status providing a. the patient is not incapacitated b. a second physician signs off on the disclosure c. the patient does not object d. psychotherapy notes are used for further treatment Correct Answer-c. the patient does not object The insurance and coding specialist calls a carrier to verify a patient's insurance and the representative states that the patient insurance was canceled three months ago. Which of the following should the insurance and coding specialist do first? a. ask the patient for another form of insurance coverage b. discuss self-pay options with the insurance policy holder. c. ask the patient to reschedule the appointment d. record the information and refer the patient to another provider Correct Answer-a. ask the patient for another form of insurance coverage When using an EHR system to enter CPT codes on a CMS 1500 claim form for electronic submission, which of the following should be entered on the claim form first? a. the most resource-intensive procedure or service b. the first code selected on the electronic superbill c. any HCPCS code d. the least expensive procedure or service Correct Answer-a. the most resource-intensive procedure or serviceWhich of the following is the correct procedure for keeping a Workers' Compensation patient's financial and health records when the same physician is also seeing the patient as a private patient? a. Separate financial and health records must be used. b. the same health record may be used, but a separate financial record must be maintained c. the same financial and health records may be used d. the same financial record may be used, but a separate health record must be maintained Correct Answer-a. separate financial and health records must be used Which of the following protects federal healthcare programs from fraud and abuse by healthcare providers who solicit referrals? a. Federal Claims Collection Act b. Utilization Review Act C. Fraud and Abuse Act d. Anti-Kickback Statute Correct Answer-c. Fraud and Abuse Act A Medicare patient presents to an outpatient hospital facility for a scheduled hysterectomy. To which Medicare plan should the facility submit the claim? a. Part D b. Part B c. Part C d. Part A Correct Answer-B. Part B Which of the following are necessary to complete a CMS 1500 form? (Select the three (3) correct answers.) a. patient SSN b. physician information c. demographic information d. effective date of insurance e. diagnosis and CPT codes Correct Answer-b. physician information c. demographic information e. diagnosis and CPT codesAn established patient is being seen by the physician today. The patient owes $25.00 for the visit. The amount collected for the office visit is called the a. balance b. deductible c. coinsurance d. copayment Correct Answer-d. copayment Which of the following reports is used to follow up on outstanding claims to third party payers? a. accounts payable b. financial c. audit d. aging Correct Answer-d. aging Which of the following financial reports produces a quarterly review of any dollar amount a patient still owes after all insurance carriers claim payments have been received? a. aging b. claims settlement c. patient listing d. rejected claims Correct Answer-a. aging The most effective method to manage patient statements and other financial invoices as well as avoid payment delays is to a. use a bimonthly billing system b. issue periodic reminders c. collect fees at the time of service d. write off overdue balances Correct Answer-c. collect fees at the time of service When reviewing the charges for a patient procedure using computer assisted coding software (CAC), the insurance and coding specialist should first a. discuss with th [Show More]

Last updated: 2 years ago

Preview 1 out of 17 pages