Questions Flashcards
Which of the following is a HIPAA compliance guideline affecting electronic health records?
A. The privacy requirements cover facilities’ health information, whether paper or electronic
B. Electronic health records should be sent to the third-party payer on a claim form
C. The electronic transmission and code set standards require every provider to use the health care transactions, code sets, and identifiers
The electronic transmission and code set standards require every provider to use the health care transactions, code sets, and identifiers
A billing and coding specialist is preparing to create patient statements and has been asked to collect finance charges on any late payments. According to the Truth in Lending Act (TILA), which of the following is the way the finance charges must be disclosed on the statement?
A. As an assigned dollar amount
B. As a multiple of the outstanding balance
C. As an annual percentage rate
D. As an amount no higher than the outstanding balance
As an annual percentage rate
Which of the following introduced documentation guidelines to Medicare carriers to ensure that services paid for have been provided and were medically necessary?
A. HIPAA
B. OIG
C. CMS
D. AMA
CMS
A billing and coding specialist is reviewing an operative report for a patient who had a graft. The specialist should consult the CPT® coding
guidelines to determine that which of the following is a tissue transplanted from one individual to another of the same species but different genotype?
A. Autograft
B. Allograft
C. Alloplastic graft
D. Xenograft
Allograft
Which of the following is the filing limit for claim submission for an outpatient service with TRICARE?
A. Within 1 year from the date of service
B. Within 90 days from the date of service
C. Within 60 days from the date of service
D. Within 2 years from the date of service
Within 1 year from the date of service
A patient’s employer has not submitted a premium payment for the company’s commercial insurance plan. Which of the following is the claim status the provider will receive for any claims sent to the third-party payer?
A. Invalid
B. Suspended
C. Denied
D. Incomplete
Denied
