NCCT Office Financial Management, Billing, Insurance

The main purpose for verifying a patient’s insurance coverage at every visit is to

• prevent claim rejection due to ineligibility or non-active status.

• maintain confidentiality of protected health information.

• expedite the age analysis process of delinquent accounts.

• establish rapport and respectful approach to care.

Which of the following must be filled out by the patient in order to forward payment to the physician's office?

• coordination of benefits

• assignment of benefits

• remittance advice

• explanation of benefits 

Which of the following documents does the provider or facility need to submit in order to receive reimbursement from an insurance company?

• ABN

• CMS-1500

• Medical consent from

• Explanation of benefits

Which of the following forms is used by the medical office to ensure that insurance payments are made directly to the physician? 

• CMS-1500

• Patient consent

• assignment of benefits

• UB-04

When posting an insurance payment via an EOB, the amount that is considered contractual is the

• Insurance allowed amount.

• NON-PAR payment allowable.

• co-insurance

• Patient responsibility

A list of all account balances and the amounts owed to the medical practice at the end of the day is called an

• accounts receivable report.

• aging summary analysis.

• accounts payable report.

• insurance aging report.

A medical office assistant’s knowledge of a statute of limitations for collecting an overdue account is an example of managing the collections process while complying with

• AMA guidelines

• practice management guidelines

• state and federal guidelines

• HIPAA guidelines

The process of finding out if a service or procedure is covered under a patient’s insurance policy is called

• pretermination

• preauthorization

• precertification

• preexisting

The medical office assistant receives payments in full from both a primary private insurance company and a 65-year-old patient. At the end of the day she realizes there was an overpayment on the patient's account. Which of the following should the overpayment be refunded to?

• the patient

• the insurance company

• Medicare

• the physician

ASCA requires that hospital claims submitted to Medicare Part A and B must be submitted electronically, but will accept non-electronic claims on behalf of providers that

• have been in business for less than 90 days

• employ less than 25 full-time employees

• also participate in the Medicaid program

• offer both inpatient and outpatient services