Exam 31: Preparing Insurance Claims and Posting Insurance Payments

Match the following definition of claims tracking to "Manual" or "Electronic." Note: answers may be used more than once. -​A time-consuming process that frequently causes payment delays

Match the following definition of claims tracking to "Manual" or "Electronic." Note: answers may be used more than once. -​Claims can be entered from anywhere with Internet access with real-time response

Manual claims tracking:

​Which of the following is not one of the necessary pieces of information to have before calling to follow up on a delinquent insurance claim?

Since 2005,providers have been urged to:

Match each term with its definition. -Form or document that may be sent to the patient by their insurance company after they have had a health care service that was paid by the insurance company (may take up to several months to receive)

​Match the type of insurance to its description.Note: Answers may be used more than once. -​All of the providers in the network are required to file a claim to get paid

How many digits are in a National Provider Identifier (NPI)number?

Match each term with its definition. -Authorizes benefits to be paid directly from a third-party payer to a provider

The CMS-1500 form is accepted by:

​Match the definition/scenario to differentiate between fraud and abuse relating to Medicare claims.Note: Answers may be used more than once. -​With intent

Match each term with its definition. -Standard claim form used for billing in medical offices

Match each type of information found on an Explanation of Benefits (EOB)form with its definition. -Amount of money that a patient's insurance company did not pay the provider

​Ambulatory payment classifications (APCs)are:

Match the following definition of claims tracking to "Manual" or "Electronic." Note: answers may be used more than once. -​Payment is quicker,claims usually received by a payer within 24 hours

Match each term with its definition. -The most common of these are federal and state agencies,insurance companies,and workers' compensation

​Which of the following is not considered a true statement regarding the history of claims?

Match the following definition of claims tracking to "Manual" or "Electronic." Note: answers may be used more than once. -​Payers typically do not inform providers of the status of their claims

​Match the definition/scenario to differentiate between fraud and abuse relating to Medicare claims.Note: Answers may be used more than once. -​When providers seek Medicare payment they do not deserve but have not knowingly or intentionally done so

​_____________________ means that the doctor,provider,or supplier agrees (or is required by law)to accept the Medicare-approved amount as full payment for covered services.