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Insurance Chapter 4: Prossessing An Insurance Claim

25 Questions  I  By Phliproc
Insurance Quizzes & Trivia

  
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1.  Which means that the paitent and or insured has authorized the payer to reimburse the provider directly?
A.
B.
C.
D.
2.  Providers who o not accept assignment of Medicare benefits do not receive information included in the ______, which is sent to the patient.
A.
B.
C.
D.
3.  The transmissions of claims data to payers or clearinghouses is called claims...
A.
B.
C.
D.
4.  Which facilitates processing of nonstandard claims data elements into standard data elements?
A.
B.
C.
D.
5.  A series of fixed length records submitted to payers to build for health care services is an electronic
A.
B.
C.
D.
6.  Which is considered a covered entity?
A.
B.
C.
D.
7.  A claim that is rejected because of an error or an omission is considered an  
A.
B.
C.
D.
8.  An electronic claim is submitted by using _________ as its transmission media.
A.
B.
C.
D.
9.  Which supporting documentation is associated with submission of an insurance claim?
A.
B.
C.
D.
10.  Which is a group health insurance policy provision that prevents multiple payers from reimbursing benefits by other policies?
A.
B.
C.
D.
11.  The sorting of claims upon submission to collect and verify information about the patient and provider is called claims
A.
B.
C.
D.
12.  Which of the following steps would occur first?
A.
B.
C.
D.
13.  Comparing the claim to payer edits and the patients health plan benefits is part of claims...
A.
B.
C.
D.
14.  Which describes any procedure or service reported on a claim that is not included
A.
B.
C.
D.
15.  Which is an abstract of all recent claims filed on each patient, used by the payer to determine whether the patient is receiving concurrent care for the same condition by more than one provider?
A.
B.
C.
D.
16.  Which is the fixed amount patients receive each time they receive health care services?
A.
B.
C.
D.
17.  Which of the following steps would occur first?
A.
B.
C.
D.
18.  Which must accept whatever a payer reimburses for procedures or services performed?
A.
B.
C.
D.
19.  Which is an interpretation of the birthday rule regarding two group health insurance policies when the parents of a child covered on both policies are married to each other and live in the same household?
A.
B.
C.
D.
20.  Which is the financial record source document usually generated by a hospital? 
A.
B.
C.
D.
21.  (Refer to figure 4-20 of chapter 4) Which payers claim should be followed up first to obtain reimbursement?
A.
B.
C.
D.
22.  Which protects information collected by consumer reporting agencies?
A.
B.
C.
D.
23.  Which protects information collected by consumer reporting agencies?
A.
B.
C.
D.
24.  Which is the best way to prevent delinquent claims?
A.
B.
C.
D.
25.  Which is a characteristic  of delinquent commercial claims awaiting payer reimbursement?
A.
B.
C.
D.
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