Billing / Coding 3 Flashcards
The practice’s rules for payment for medical services are found in their
financial policy.
Which of these documents will the patient not complete?
encounter form
Identify the person/entity that must authorize providers to release a patient’s PHI for TPO purposes.
none of these; they do not need authorization
You are working at a practice and have been asked to document some payer communications. Determine where the communications should be recorded.
financial record
Determine by which of the following means a practice may receive a “self-refer.”
the patient comes for specialty care without a referral number when one is required
What provision explains how insurance policies will pay if more than one policy applies?
coordination of benefits
Determine what you should ask the patient to do upon arrival.
Complete all required forms before their first encounter with the provider.
Another term for prior authorization number is
certification number.
What type of number is assigned to a HIPAA 270 electronic transaction?
trace number
Sometimes the use of a third payer is necessary after two health plans have made payments on a claim. This type of insurance is known as
tertiary insurance.
What type of provider is required to have patients sign an acknowledgment?
direct provider
Which HIPAA transaction is used to send information from a primary payer to a secondary payer?
Coordination of Benefits
You are working at a practice and need to get prior approval from a payer. Which of the following HIPAA transactions would you use to do so?
Referral Certification and Authorization
Identify the best time during which to begin collecting patient information.
preregistration process
The initial step in establishing financial responsibility is to
Verify the patient’s eligibility for insurance benefits.
