FREE MEDICAL AND STUDY GAMES ABOUT HIT 1121 FINAL

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FREE MEDICAL AND STUDY GAMES ABOUT HIT 1121 FINAL

EXAM QUESTIONS

Qs and Ans Expert- Explanation

This Exam contains:

-Guarantee passing score -211 Questions and Answers -format set of multiple-choice -Expert- Explanation Question 1: A participating physician with the Medicare plan agrees to accept...

Answer:

80% of the Medicare approved charge.

Question 2: How many levels of review exist for TRICARE appeal procedures?

Answer:

Three.Question 3: Which organization published diagnostic & procedure coding competencies for outpatient services and diagnostic coding and reporting requirements for physician billing?

Answer:

American Health Information Management Association (AHIMA).Question 4: Who is the individual who is designated to help a provider remain in compliance by setting policies & procedures in place, train staff regarding HIPAA, & act as the contact person for questions and complaints?

Answer:

Privacy officer/privacy official.

Question 5: A follow up effort made to an insurance company to locate the status of an insurance claim is called a/an...

Answer:

inquiry and tracer.Question 6: When an employee with a preexisting condition is injured at work and the injury produces a disability greater than what would have been caused by the second injury alone, the benefits are derived from a/an

Answer:

second injury fund.Question 7: How many installments (excluding a down payment) must a payment plan have to require full written disclosure?

Answer:

Four or more.

Question 8: OCR is the acronym for...

Answer:

optical character recognition.

Question 9: Who can treat an industrial injury?

Answer:

any physician.Question 10: A proceeding during which an attorney questions a witness who answers under oath but not in open court is called a/an...

Answer:

deposition.Question 11: What is the name of the act designed to address the collection practices of third-party debt collectors and attorneys who regularly collect debts for others?

Answer:

Fair Debt Collection Practices Act.

Question 12: What is the protocol to follow on receiving an attending physician's statement from an insurance company on a patient who has applied for health insurance?

Answer:

Request a fee from the insurance company before sending the attending physician's statement.

Question 13: Who pays the workers' compensation insurance premiums?

Answer:

employer Question 14: Who is an individual who is hired by a medical practice to process claims to a third-party payer?

Answer:

Business associate.

Question 15: A program that contracts with CMS to review medial necessity and

appropriateness of inpatient medical care is known as a...

Answer:

QIO.Question 16: The total number of levels of re-determination that exist in the Medicare program is...

Answer:

five.Question 17: Explain Non-disability claims:

Answer:

involves minor injury where patient seen by a doctor, but able to continue working.Question 18: True or false: Usually, there are no deductibles for managed care plans.

Answer:

True.Question 19: When a physician treats an industrial injury, he/she must complete a First Treatment Medical Report or Doctor's First Report of Occupational Injury or Illness and send it

to the following:

Answer:

insurance carrier, employer, and state workers' compensation office.

Question 20: In a TRICARE case, a request for an independent hearing may be pursued if the amount in question is...

Answer:

$300 or more.Question 21: When a Medicare beneficiary has employer supplemental coverage, Medicare refers to these plans as...

Answer:

MSP.Question 22: State five methods used for funding workers' compensation:

Answer:

State fund, territorial fund, self-insurers, competitive state fund and private insurance company.

Question 23: To conform to CMS 1500 OCR guidelines,...

Answer:

do not fold insurance claim forms when mailing, do not use symbols with data on insurance claim forms, and do not strike over errors when making a correction on an insurance claim form.Question 24: Are family/friends covered under workers' compensation insurance if they are injured at the employee's job?

Answer:

No, only the employee would be covered.Question 25: The correct method to send documents for a Medicare reconsideration (Level 2) is by...

Answer:

certified mail with return receipt requested.Question 26: True or false: Managed care plans never require a CMS-1500 claim form to be completed and submitted.

Answer:

False.