The 'Module 113 Final Review' quiz assesses understanding of insurance claims processing, including dispute resolution, claim tracking, and compliance with financial standards. It is crucial for professionals managing insurance claims and ensures adherence to legal and procedural guidelines.
Federal insurance commissioner
State insurance commissioner
State insurance federation
Department of public service
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EOB
EOMB
MRA
MPS
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Patient's financial accounting record
Practice's day sheet
Copy of the CMS-1500 form
Patients's insurance contract
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File containing the name and address of all insurance companies
Follow-up report that is sent to the insurance companies
Follow-up procedures for insurance claims
Practice analysis
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Tickler file
Clinical file
Data file
Patient file
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Inquiry
Tracer
Rebill
Both inquiry and tracer
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Ask if there is a backlog of claims at the insurance office
Submit a copy of the original claim
Verify the correct mailing address
All of the above
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Paid
Rejected
Suspended
Denied
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Provide the information
Call the patient and advise the patient to contact the insurance carrier with the requested information
The carrier should contact the other carrier and coordinate benefits
None of the above
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Paid
Rejected
Suspended
Denied
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Rebill with a letter of explanation from the physician
Write off the amount on the patient's ledger
Send the patient a statement with a notation of the response from the insurance company
Appeal the decision with a statement from the physician
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Rebill with a letter of explanation from the physician
Write off the amount on the patient's ledger
Send the patient a statement with a notation of the response from the insurance company
Appeal the decision with a statement from the physician
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Not be affected
Be denied
Be less
Be more
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Advise the physician to write off the amount as a bad debt
Pay the physician within 2 to 3 weeks and honor the assignment even before the company recovers their money from the patient
Pay the physician witin 2 to 3 weeks after recovering the money from the patient
Notify the physician of the error and indicate in a letter that it will never happen again
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Two
Three
Five
Six
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Redetermination
Inquiry
Fair hearing
Appeals council review
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Certified mail with return receipt requested
Certified mail
Standard mail
Overnight mail
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$100
$250
$350
$500
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One
Two
Three
Five
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2 weeks
30 days
60 days
90 days
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$100 or more
$300 or more
$500 or more
$1000 or more
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The amount of money available in the cash drawer
The amount of money taken into the office in a given period of time
The ongoing availability of cash in the medical practice
The amount of money in accounts receivable
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Increased cash flow
Decreased cash flow
Decreased accounts receivable
Decreased copayments
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Number of statements sent
Number of claims processed
Accounts payable
Accounts receivable
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1.5 to 2 times the charges for 1 month of services
2 to 2.5 times the charges for 1 month of services
2.5 to 3 times the charges for 1 month of services
3 to 3.5 times the charges for 1 month of services
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5% to 11% of the total accounts receivable
10% to 15% of the total accounts receivable
15% to 18% of the toal accounts receivable
20% to 25% of the toal accounts receivable
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Send a patient information brochure
Send a confirmation letter
Discuss fees and policies at the time of the initial contact
All of the above
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Before any services are provided
Right after services are provided
At the time of the first statement
In a follow-up telephone call
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Financial accounting record
Medical record
Insurance file
Registration
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Applying a discount (percentage) to the entire fee
Applying a discount after the insurance company has paid its portion
Writing off the balance of an account after the insurance company has paid its portion
Making no charge to anyone, patient or insurance company, for medical care
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Leave the impression that you are a nice person
Collect at least one half the fee
Collect the full amount
Collect as much as possible
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Say, "all right" and bill the patient
State the office policy and ask for the full fee
Indicate that because it is such a small sum, it can be paid later
Ask that the payment be mailed to the office
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Personal check
Credit card
Cash
Debit card
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Send a NSF demand letter
File a claim in small claims court
Call the bank or the patient
Notify the patient that future payments need to be in the form of cash or money orders
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1,4,6, and 8 weeks
30,60,90, and 120 days
1,2,3, and 6 months
30,60,90,120, and 180
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Billing messages
Statement slogans
Dun messages
Payment prompters
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Electronic billing
Manual milling
Computer billing
Insurance balance billing
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Statement of service
Centralized billing
Outsourcing
Cycle billing
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Presented at the time of service
Mailed right after the date of service
Mailed 2 weeks after the date of service
Mailed 30 days after the date of service
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Private-label card
Credit card
Debit card
Verifone card
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Three or more
Four or more
Five or more
Six or more
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Equal Credit Opportunity Act
Fair Credit Reporting Act
Fair Credit Billing Act
Truth in Lending Act
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Equal Credit Opportunity Act
Fair Credit Billing Act
Truth in Lending Act
Fair Debt Collection Practices Act
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After 9 AM and before 9 PM
After 8 AM and before 9 PM
After 8 AM and before 8 PM
After 9 AM and before 8 PM
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30-60 day accounts
60-90 day accounts
90-120 day accounts
Accounts older then 120 days
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Organize the accounts alphabetically and start with the letter A
Organize the accounts by account number and start with number 1
Organize the accounts according to amounts owed and start with the largest amount
Determine what patient you think may be easier to collect from and start with that account
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Flex time
Floating time
Job share
Salary
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Do not try and be friendly; just get to the point
Use a friendly tone and ask why payment has not been made
Do not suggest that the patient has overlooked a previous statement
Do not imply that the patient has good intentions to pay
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Quiz Review Timeline (Updated): Mar 22, 2023 +
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