Insurance Billing And Coding

21 cards

Medical billing and insurance coding. These are my questions and answers for the theory test we have every 5th day of the week in my medical billing class


 
  
Created May 8, 2012
by
hoops1

 

 
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  Side A   Side B
1
What is the name of the federal health insurance program ?
 
Medicare
2
Fiscal Intermediaries handles what?
 
handles claims from hospitals and other facilities; NF's..LTCF's..home health agencies
3
What part of Medicare covers hospice care?
 
Part A
4
Part A is run by?
 
CMS- Centers for Medicare and Medicaid Services
5
What is a crossover claim?
 
Medicare transmits a Medigap claim electronically to the Medigap carrier
6
Level II codes are also called what:?
 
HCPCS- national alphanumeric codes
7
Who can act on a Medicare beneficiary's behalf?
 
CAPS- Claim assistant professionals
8
What % does Medicare pay on?
 
80% of approved charges
9
Under what system are hospitals reimbursed according to preestablished rates for each type...
 
PPS- Prospective payment systems
10
What's it called when a Medicare beneficiary also has insurance through their employer?
 
Medicare Secondary Payer-MSP
11
What is the process when a RA is received by MCR (Medicae)?
 
post the patients name and the amount of the payment on the day sheet and the patients ledger
12
What part covers diagnostic test?
 
Part B
13
What process reviews claims for medical necessity and monitors numbers of times procedures...
 
Medicare Prepayment Screen
14
What is an explanation of Medicare Benefits referred as?
 
Medicare remittance advice document
15
Medicare payments to hospitals are based on what type of codes?
 
DRG's
16
When a patient signs an ABN , what modifier must be added to the procedure code?
 
- GA
17
What are the functions of the digestive system ?
 
Digestion , Absorption , Elimination
18
What is the largest grandular organ in the body?
 
Liver
19
What are the teeth with sharp cutting edges called?
 
Incisors
20
What is the part of the tooth seen above the gum line called?
 
crown
21
What is the first portion of the small intestine called?
 
Duodenum

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