NHA CBCS 2022/23 Test Questions & Answers

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NHA CBCS 2022/23 Test Questions & Answers Which of the following describes the reason for a claim rejection because of Medicare ncci edits? - ANS - Improper code combinations A claim is submitted ... with a transposed insurance member ID number and returned to the provider. Which of the following describes the status that should be assigned to the claim by the carrier? - ANS - invalid Medigap coverage is offered to Medicare beneficiaries by which of the following? - ANS - Private third-party payers Which of the following provisions ensures that an insureds benefits from all insurance companies do not exceed 100% of allowable medical expenses? - ANS - coordination of benefits A coroner's autopsy is comprised of what examinations? - ANS - Gross examination Which of the following statements is true regarding the release of patients records? - ANS - Patient access to psychotherapy notes may be restricted Which of the following actions by a billing and coding specialist would be considered fraud? - ANS - billing for services not provided Which of the following components of an explanation of benefits expedites the process of a phone appeal? - ANS - claim control number On the cms-1500 claim form, blocks 14 through 33 contain information about which of the following? - ANS - The patient's condition and the provider's information A billing and coding specialist should understand that the financial records source that is generated by a providers office is called a - ANS - Patient ledger account Which of the following medical terms refers to the sac that causes the heart - ANS - Pericardium Hipaa transaction standards apply to which of the following entities? - ANS - Health care clearinghouses All dependents 10 years of age or older are required to have which of the following for tricare? - ANS - Military identification The standard medical abbreviation ECG refers to a test used to assess which of the following body systems? - ANS - cardiovascular system Which of the following is an example of a violation of an adult patient confidentiality? - ANS - Patient information was disclosed to the patient's parent without consent Claims that are submitted without an NPI number will delay payment to the provider because - ANS - the number is needed to identify the provider Which of the following sections of the medical record is used to determine the correct evaluation and management code used for billing and coding? - ANS - history and physical Which of the following actions should be taken if an insurance company denies a service as not medically necessary? - ANS - Appeal the decision with a provider's report Which of the following is the portion of the account balance the patient must pay after services are rendered in the annual deductible is met? - ANS - coinsurance Which of the following is the function of the respiratory system? - ANS - Oxygenating blood cells Which of the following describes a delinquent claim? - ANS - The claim is overdue for payment Which of the following actions should be billing and coding specialist take if he observes a colleague and on ethical situation? - ANS - Report the incident to a supervisor A participating Blue Cross Blue Shield provider receives an explanation of benefits for a patient account. The charge amount was $100. Blue Cross Blue Shield allowed $80 and applied $40 to the patient's annual deductible. Blue Cross Blue Shield paid the balance at 80%. How much should the patient expect to pay? - ANS - $48 Which of the following statements is correct regarding a deductible? - ANS - The deductible is the patient's responsibility A physician ordered a comprehensive metabolic panel for 70-year-old patient who has Medicare as her primary insurance. Which of the following forms is required so no she may be responsible for payment? - ANS - Advance beneficiary notice Which of the following is the purpose of pre-certification? - ANS - Verification of coverage Which of the following claims is submitted and then optically skin by the insurance carrier and converted to an electronic form? - ANS - Paper claim Which of the following information is required on a patient account record? - ANS - Name and address of guarantor Which of the following includes procedures in best practices for correct coding? - ANS - Coding compliance plan A patient who has a primary malignant neoplasm of the lung should be referred to which of the following specialist? - ANS - Pulmonary oncologist A provider performs an examination of a patient's sore throat during an office visit. Which of the following describes a level of the examination? - ANS - Problem focused examination To be compliant with Hipaa which of the following positions should be assigned in each office? - ANS - privacy officer Which of the following indicates a claim should be submitted on paper instead of electronically? - ANS - The claim requires an attachment Which of the following should the billing and coding specialist include in an authorization to release information? - ANS - the entity to whom t [Show More]

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