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Exam Health Professions - Medical Billing Coding Insurance

1
Free
Which of the following is not typically a feature of a practice EHR system that, if used correctly, enhances compliant billing?
2
Free
One type of job reference aid is
3
Free
Medical necessity is based on
4
Free
Which of the following is not fraudulent?
5
Free
All of the following are common billing errors except
6
________ refers to a coding problem in which a procedure code is used that provides a higher reimbursement than the correct code.
7
Which of the following refers to the payer's review and reduction of a procedure code?
8
________ refers to a coding problem in which the age of the patient and the selected code do not match.
9
Medical insurance specialists help ensure maximum appropriate reimbursement for services by
10
Only the codes that ________ should be reported.
11
What does the term assumption coding mean?
12
HIPAA applies to:
13
CCI is an abbreviation for
14
The Medicare allowed charge is $240 and the participating (PAR) provider's usual charge is $600. What amount does the patient pay, if the deductible has already been paid?
15
When regulations seem contradictory or unclear, the OIG issues
16
Which of the following is not a medically necessary procedure?
17
Medical insurance specialists rely on which of the following to stay up to date with payers billing rules?
18
 The ________ lists the types of medical billing and reporting practices that the Office of Inspector General intends to investigate in the coming year.
19
What are the main methods payers use to pay providers?
20
CCI code edits are organized into
21
Under a contracted fee schedule, the allowed amount and the provider's charge are
22
The Medicare conversion factor is set
23
The Medicare allowed charge for a procedure is $150, and a PAR provider's usual charge is $200. What amount must the provider write off?
24
The Medicare allowed charge for a procedure is $80. What amount does the participating provider receive from Medicare, and what amount from the patient, assuming the patient deductible has been met?
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