Question 1

Match each term with its definition.
-These give you immediate access to the status of a claim or group of claims

Accepted Answer

A)  bartered goods
B)  claim form
C)  third-party reimbursers
D)  CMS-1500
E)  CMS-1450F) Explanation of Benefits (EO
B)   formG) Standard Electronic Data Interchange (EDI)  Enrollment formH) Remittance Advice formI) manual insurance logJ) signature on fileK) assignment of benefits clauseL) Electronic Data Interchange (EDI)  transactionsM) Administrative Simplification Compliance Act (ASC
A)  N) clearinghouseO) Electronic Claims Tracking (ECT)  systemsP) credit balanceQ) secondary insuranceR) E) and K)
S) G) and K)

Question 2

Match each type of information found on an Explanation of Benefits (EOB)  form with its definition.
-Amount of money a patient owes as a share of the bill

Accepted Answer

A)  patient
B)  insured ID number
C)  claim number
D)  type of service
E)  date of serviceF) chargeG) not covered amountH) total patient costI) B) and C)
J) A) and H)

Question 3

Which carriers will accept physicians' typed name and credentials as an indication of their signature?

Accepted Answer

A)   Medicare and Medicaid
B)   private health insurers
C)   no carriers
D)   all carriersE) None of the above
F) A) and B)

Question 4

Match each term with its definition.
-In many instances, this will pay most, if not all, of the balance left over from the primary insurance to your physician and will leave little out-of-pocket expenses for the patient

Accepted Answer

A)  bartered goods
B)  claim form
C)  third-party reimbursers
D)  CMS-1500
E)  CMS-1450F) Explanation of Benefits (EO
B)   formG) Standard Electronic Data Interchange (EDI)  Enrollment formH) Remittance Advice formI) manual insurance logJ) signature on fileK) assignment of benefits clauseL) Electronic Data Interchange (EDI)  transactionsM) Administrative Simplification Compliance Act (ASC
A)  N) clearinghouseO) Electronic Claims Tracking (ECT)  systemsP) credit balanceQ) secondary insuranceR) E) and G)
S) B) and J)

Question 5

Match each type of information found on an Explanation of Benefits (EOB)  form with its definition.
-Beginning and end dates of the health-related service a patient received from a provider

Accepted Answer

A)  patient
B)  insured ID number
C)  claim number
D)  type of service
E)  date of serviceF) chargeG) not covered amountH) total patient costI) B) and H)
J) A) and H)

Question 6

Match each term with its definition.
-Private or public company that often serves as the middleman between providers and billing groups, payers, and other health care partners for the transmission and translation of electronic claims information into the specific format required by payers

Accepted Answer

A)  bartered goods
B)  claim form
C)  third-party reimbursers
D)  CMS-1500
E)  CMS-1450F) Explanation of Benefits (EO
B)   formG) Standard Electronic Data Interchange (EDI)  Enrollment formH) Remittance Advice formI) manual insurance logJ) signature on fileK) assignment of benefits clauseL) Electronic Data Interchange (EDI)  transactionsM) Administrative Simplification Compliance Act (ASC
A)  N) clearinghouseO) Electronic Claims Tracking (ECT)  systemsP) credit balanceQ) secondary insuranceR) F) and G)
S) H) and O)

Question 7

Match each term with its definition.
-This must be completed before submitting electronic media claims to Medicare

Accepted Answer

A)  bartered goods
B)  claim form
C)  third-party reimbursers
D)  CMS-1500
E)  CMS-1450F) Explanation of Benefits (EO
B)   formG) Standard Electronic Data Interchange (EDI)  Enrollment formH) Remittance Advice formI) manual insurance logJ) signature on fileK) assignment of benefits clauseL) Electronic Data Interchange (EDI)  transactionsM) Administrative Simplification Compliance Act (ASC
A)  N) clearinghouseO) Electronic Claims Tracking (ECT)  systemsP) credit balanceQ) secondary insuranceR) M) and Q)
S) G) and P)

Question 8

The phrase _____ was coined to indicate payment of services rendered by someone other than the patient.

Accepted Answer

A)   health care provider
B)   health maintenance organization
C)   third-party reimbursement
D)   two-party systemE) A) and B)
F) B) and D)

Question 9

Match each term with its definition.
-The most common of these are federal and state agencies, insurance companies, and workers' compensation

Accepted Answer

A)  bartered goods
B)  claim form
C)  third-party reimbursers
D)  CMS-1500
E)  CMS-1450F) Explanation of Benefits (EO
B)   formG) Standard Electronic Data Interchange (EDI)  Enrollment formH) Remittance Advice formI) manual insurance logJ) signature on fileK) assignment of benefits clauseL) Electronic Data Interchange (EDI)  transactionsM) Administrative Simplification Compliance Act (ASC
A)  N) clearinghouseO) Electronic Claims Tracking (ECT)  systemsP) credit balanceQ) secondary insuranceR) K) and Q)
S) A) and F)

Question 10

Match each term with its definition.
-Book in which a list of insurance claims is kept

Accepted Answer

A)  bartered goods
B)  claim form
C)  third-party reimbursers
D)  CMS-1500
E)  CMS-1450F) Explanation of Benefits (EO
B)   formG) Standard Electronic Data Interchange (EDI)  Enrollment formH) Remittance Advice formI) manual insurance logJ) signature on fileK) assignment of benefits clauseL) Electronic Data Interchange (EDI)  transactionsM) Administrative Simplification Compliance Act (ASC
A)  N) clearinghouseO) Electronic Claims Tracking (ECT)  systemsP) credit balanceQ) secondary insuranceR) E) and M)
S) L) and Q)

Question 11

The Remittance Advice form is used when payment is being made from:

Accepted Answer

A)   American Medical Association (AM
A)  
B)   American Heart Association (AH
A)  
C)   Medicare
D)   Blue Cross Blue ShielfE) None of the above
F) A) and C)

Question 12

Match each type of information found on an Explanation of Benefits (EOB)  form with its definition.
-Amount of money that a patient's insurance company did not pay the provider

Accepted Answer

A)  patient
B)  insured ID number
C)  claim number
D)  type of service
E)  date of serviceF) chargeG) not covered amountH) total patient costI) A) and H)
J) A) and G)

Question 13

Match each term with its definition.
-Authorizes benefits to be paid directly from a third-party payer to a provider

Accepted Answer

A)  bartered goods
B)  claim form
C)  third-party reimbursers
D)  CMS-1500
E)  CMS-1450F) Explanation of Benefits (EO
B)   formG) Standard Electronic Data Interchange (EDI)  Enrollment formH) Remittance Advice formI) manual insurance logJ) signature on fileK) assignment of benefits clauseL) Electronic Data Interchange (EDI)  transactionsM) Administrative Simplification Compliance Act (ASC
A)  N) clearinghouseO) Electronic Claims Tracking (ECT)  systemsP) credit balanceQ) secondary insuranceR) E) and O)
S) F) and M)

Question 14

Match each type of information found on an Explanation of Benefits (EOB)  form with its definition.
-Code and brief description of the health-related service a patient received from a provider

Accepted Answer

A)  patient
B)  insured ID number
C)  claim number
D)  type of service
E)  date of serviceF) chargeG) not covered amountH) total patient costI) A) and B)
J) A) and C)

Question 15

Which form is also known as the UB-40 form?

Accepted Answer

A)   CMS-1450
B)   CMS-1500
C)   Explanation of Benefits (EO
B)   form
D)   FCC Form 159-CE) B) and C)
F) A) and D)

Question 16

Since 2005, providers have been urged to:

Accepted Answer

A)   require patients to pay the full balance before leaving the office
B)   bill patients directly, requiring them to seek reimbursement on their own
C)   send claims manually
D)   send claims electronicallyE) B) and D)
F) B) and C)

Question 17

When a third-party payer identifies an error on the claim form, the claim is:

Accepted Answer

A)   rejected with a request to resubmit the form with corrections
B)   rejected and barred from resubmission
C)   paid, with a penalty fee subtracted for the error
D)   held indefinitely until the medical office calls to inquire about its statusE) None of the above
F) C) and D)

Question 18

Match each term with its definition.
-Type of payment used for centuries in the past

Accepted Answer

A)  bartered goods
B)  claim form
C)  third-party reimbursers
D)  CMS-1500
E)  CMS-1450F) Explanation of Benefits (EO
B)   formG) Standard Electronic Data Interchange (EDI)  Enrollment formH) Remittance Advice formI) manual insurance logJ) signature on fileK) assignment of benefits clauseL) Electronic Data Interchange (EDI)  transactionsM) Administrative Simplification Compliance Act (ASC
A)  N) clearinghouseO) Electronic Claims Tracking (ECT)  systemsP) credit balanceQ) secondary insuranceR) C) and P)
S) D) and H)

Question 19

Match each term with its definition.
-Sets forth the very specific requirements a provider must meet in order to submit paper claim forms and receive CMS payment

Accepted Answer

A)  bartered goods
B)  claim form
C)  third-party reimbursers
D)  CMS-1500
E)  CMS-1450F) Explanation of Benefits (EO
B)   formG) Standard Electronic Data Interchange (EDI)  Enrollment formH) Remittance Advice formI) manual insurance logJ) signature on fileK) assignment of benefits clauseL) Electronic Data Interchange (EDI)  transactionsM) Administrative Simplification Compliance Act (ASC
A)  N) clearinghouseO) Electronic Claims Tracking (ECT)  systemsP) credit balanceQ) secondary insuranceR) O) and Q)
S) G) and O)

Question 20

Match each type of information found on an Explanation of Benefits (EOB)  form with its definition.
-Name of the person who received the service

Accepted Answer

A)  patient
B)  insured ID number
C)  claim number
D)  type of service
E)  date of serviceF) chargeG) not covered amountH) total patient costI) A) and C)
J) C) and D)

Exam 17: The Immune System

Match each type of information found on an Explanation of Benefits (EOB) form with its definition. -Amount of money a patient owes as a share of the bill

Correct AnswerverifiedShow Answer

Match each term with its definition. -Authorizes benefits to be paid directly from a third-party payer to a provider

Correct AnswerverifiedShow Answer

Match each term with its definition. -The most common of these are federal and state agencies, insurance companies, and workers' compensation

Correct AnswerverifiedShow Answer

Match each term with its definition. -Type of payment used for centuries in the past

Correct AnswerverifiedShow Answer

Which carriers will accept physicians' typed name and credentials as an indication of their signature?

Correct AnswerverifiedShow Answer

Match each term with its definition. -Book in which a list of insurance claims is kept

Correct AnswerverifiedShow Answer

Which form is also known as the UB-40 form?

Correct AnswerverifiedShow Answer

The phrase _____ was coined to indicate payment of services rendered by someone other than the patient.

Correct AnswerverifiedShow Answer

Match each type of information found on an Explanation of Benefits (EOB) form with its definition. -Beginning and end dates of the health-related service a patient received from a provider

Correct AnswerverifiedShow Answer

Match each term with its definition. -In many instances, this will pay most, if not all, of the balance left over from the primary insurance to your physician and will leave little out-of-pocket expenses for the patient

Correct AnswerverifiedShow Answer

Match each type of information found on an Explanation of Benefits (EOB) form with its definition. -Code and brief description of the health-related service a patient received from a provider

Correct AnswerverifiedShow Answer

Match each term with its definition. -These give you immediate access to the status of a claim or group of claims

Correct AnswerverifiedShow Answer

When a third-party payer identifies an error on the claim form, the claim is:

Correct AnswerverifiedShow Answer

Match each type of information found on an Explanation of Benefits (EOB) form with its definition. -Name of the person who received the service

Correct AnswerverifiedShow Answer

Match each term with its definition. -Private or public company that often serves as the middleman between providers and billing groups, payers, and other health care partners for the transmission and translation of electronic claims information into the specific format required by payers

Correct AnswerverifiedShow Answer

Match each term with its definition. -This must be completed before submitting electronic media claims to Medicare

Correct AnswerverifiedShow Answer

Since 2005, providers have been urged to:

Correct AnswerverifiedShow Answer

Match each term with its definition. -Sets forth the very specific requirements a provider must meet in order to submit paper claim forms and receive CMS payment

Correct AnswerverifiedShow Answer

Match each type of information found on an Explanation of Benefits (EOB) form with its definition. -Amount of money that a patient's insurance company did not pay the provider

Correct AnswerverifiedShow Answer

The Remittance Advice form is used when payment is being made from:

Correct AnswerverifiedShow Answer

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified

Correct Answer
verified