Question 1

Claims that have errors or omissions that must be corrected and resubmitted to receive reimbursement are called _____________ claims.

Accepted Answer

A)   clean
B)   dirty
C)   dingy
D)   incompleteE) A) and B)
F) None of the above

Question 2

The insured's address in block 7 refers to the __________ address.

Accepted Answer

A)   patient's
B)   spouse's
C)   policyholder's
D)   insurance carrier'sE) B) and C)
F) None of the above

Question 3

Dirty claims cannot be resubmitted.

Accepted Answer

A) True 
 B)False

Question 4

Patients sign an __________ of benefits form so that the physician will receive payment for services directly.

Accepted Answer

assignment
Patients sign an as...

Question 5

Which of the following steps to medical billing should be performed prior to rendering medical services?

Accepted Answer

A)   Verify the patient's eligibility for insurance coverage
B)   Collect patient insurance information
C)   Code the diagnosis and procedures
D)   Complete the CMS-1500 health insurance claim form
E)   Both A and BF) None of the above
G) C) and D)

Question 6

Claims submitted to a(n) __________ are forwarded to individual insurance carriers.

Accepted Answer

clearinghouse
Claims...

Question 7

The medical assistant should __________ the front and back of the patient's insurance card.

Accepted Answer

copy
The medical ass...

Question 8

Block 1 of the CMS-1500 contains what information?

Accepted Answer

A)   Patient's name
B)   Insured's name
C)   Type of insurance coverage
D)   Carrier addressE) B) and C)
F) A) and D)

Question 9

Match block 17 with the appropriate content as it relates to completing the CMS-1500 form. (Select all that apply.)

Accepted Answer

A)   National provider identification number
B)   Preauthorization number
C)   Date of current illness, injury, or pregnancy
D)   Diagnosis or nature of illness or injury
E)   Name of referring providerF)  Hospitalization dates related to current servicesG) All of the above
H) E) and F)

Question 10

Electronic claims are submitted via electronic media.

Accepted Answer

A) True 
 B)False

Question 11

The charges for procedures are listed in column __________ of block 24.

Accepted Answer

F
The charges for pr...

Question 12

The patient's name is found in block

Accepted Answer

A)   1.
B)   2.
C)   3.
D)   4.E) B) and C)
F) All of the above

Question 13

Which of the following is typically documented in the estimation of benefits (EOB) ?

Accepted Answer

A)   Patient's deductible
B)   Co-insurance
C)   Co-payment
D)   Both A and B
E)   All of the aboveF) None of the above
G) A) and B)

Question 14

The insured's name is found in block

Accepted Answer

A)   1.
B)   2.
C)   3.
D)   4.E) B) and C)
F) None of the above

Question 15

The medical assistant should always follow office __________ for claim review and signatures.

Accepted Answer

policies
The medical assistant...

Question 16

The insurance claim should always be proofread.

Accepted Answer

A) True 
 B)False

Question 17

Only physicians can be providers of medical services.

Accepted Answer

A) True 
 B)False

Question 18

The physician's signature is located in block

Accepted Answer

A)   12.
B)   13.
C)   31.
D)   33.E) B) and C)
F) C) and D)

Question 19

Match block 21 with the appropriate content as it relates to completing the CMS-1500 form. (Select all that apply.)

Accepted Answer

A)   National provider identification number
B)   Preauthorization number
C)   Date of current illness, injury, or pregnancy
D)   Diagnosis or nature of illness or injury
E)   Name of referring providerF)  Hospitalization dates related to current servicesG) A) and D)
H) B) and D)

Question 20

Preauthorization specifically determines the dollar amount approved for the medical procedure, while precertification gives the provider approval to render the medical service.

Accepted Answer

A)   Both statements are true.
B)   Both statements are false.
C)   The first statement is true; the second is false.
D)   The first statement is false; the second is true.E) All of the above
F) A) and D)

Exam 15: Medical Billing and Reimbursement

Preauthorization specifically determines the dollar amount approved for the medical procedure, while precertification gives the provider approval to render the medical service.

Correct AnswerverifiedShow Answer

Match block 21 with the appropriate content as it relates to completing the CMS-1500 form. (Select all that apply.)

Correct AnswerverifiedShow Answer

The medical assistant should __________ the front and back of the patient's insurance card.

Correct AnswerverifiedcopyThe medical ass...View AnswerShow Answer

The insurance claim should always be proofread.

Correct AnswerverifiedShow Answer

The patient's name is found in block

Correct AnswerverifiedShow Answer

Which of the following is typically documented in the estimation of benefits (EOB) ?

Correct AnswerverifiedShow Answer

Match block 17 with the appropriate content as it relates to completing the CMS-1500 form. (Select all that apply.)

Correct AnswerverifiedShow Answer

Which of the following steps to medical billing should be performed prior to rendering medical services?

Correct AnswerverifiedShow Answer

The charges for procedures are listed in column __________ of block 24.

Correct AnswerverifiedFThe charges for pr...View AnswerShow Answer

The medical assistant should always follow office __________ for claim review and signatures.

Correct AnswerverifiedpoliciesThe medical assistant...View AnswerShow Answer

The insured's address in block 7 refers to the __________ address.

Correct AnswerverifiedShow Answer

The insured's name is found in block

Correct AnswerverifiedShow Answer

The physician's signature is located in block

Correct AnswerverifiedShow Answer

Only physicians can be providers of medical services.

Correct AnswerverifiedShow Answer

Dirty claims cannot be resubmitted.

Correct AnswerverifiedShow Answer

Patients sign an __________ of benefits form so that the physician will receive payment for services directly.

Correct AnswerverifiedassignmentPatients sign an as...View AnswerShow Answer

Electronic claims are submitted via electronic media.

Correct AnswerverifiedShow Answer

Claims that have errors or omissions that must be corrected and resubmitted to receive reimbursement are called _____________ claims.

Correct AnswerverifiedShow Answer

Block 1 of the CMS-1500 contains what information?

Correct AnswerverifiedShow Answer

Claims submitted to a(n) __________ are forwarded to individual insurance carriers.

Correct AnswerverifiedclearinghouseClaims...View AnswerShow Answer

Correct Answer
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The medical ass...
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The charges for pr...
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policies
The medical assistant...
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assignment
Patients sign an as...
View Answer

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clearinghouse
Claims...
View Answer