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Which of the following is an appropriate way to open the discussion when explaining practice fees to a patient? a. "Do you have any questions about the cost of today's visit?" b. We can accept your insurance as payment in full." c. "Do you know what your out of pocket cost is today?" d. "We will bill you for the visit in full." Correct Answer-A. "Do you have any questions about the cost of today's visit?" Which of the following information should be used to capture charges from an encounter form? a. provider participation status b. patient's insurance benefits c. past procedures and scheduled future visits d. services rendered and reason for visit Correct Answer-d. services rendered and reason for visit When posting transactions for electronic claims submission, it is necessary to enter which of the following items onto the claim? a. insurance plan's allowable fee b. physician's office fee c. insurance plan's UCR fee d. physician's contr fee Correct Answer-b. physician's office fee The patient is sent a statement for an office visit. The total amount of the bill is $100.00 and this amount must be paid before the insurance company will pay on the claim. Which of the following is this called? a. deductible b. premium c. copayment d. coinsurance Correct Answer-a. deductible When posting an insurance payment via an EOB, the amount that is considered contr is the: a. co-insurance b. NON-PAR payment allowable c. patient responsibility d. insurance allowed amount Correct Answer-d. insurance allowed amount Developing an insurance claim begins a. when the patient calls to schedule an appointment b. once the charges have been entered into the computer c. when the patient arrives for the appointment d. after the medical encounter is completed Correct Answer-a. when the patient calls to schedule an appointment When should a provider have a patient sign an ABN? a. when a service is excluded from coverage under Medicare b. when the items may be denied and prior to performing the service c. when the service is covered under Part B fee schedule d. prior to treating a patient who requires emergency services that might not be covered Correct Answerb. when the items may be denied and prior to performing the service Which of the following regulations prohibits the submission of a fraudulent claim or making a false statement or representation in connection with a claim? a. Stark Law b. Federal Claims Collection Act c. Federal False Claims Act d. Anti-kickback Law Correct Answer-c. Federal False Claims Act The patient's total charges are $300. The allowed amount is $150. Benefits pay 60%. Which of the following will the patient have to pay? a. $60 b. $90 c. $150 d. $180 Correct Answer-a. $60 Which of the following process makes a final determination for payment in an appeal board? a. deposition b. peer to peer c. special handing d. arbitration Correct Answer-d. arbitration
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