NCCT Insurance & Coding Practice Exam with precise
|| || || || || || || ||
detailed answers ||
The patient owes $25.00 for the visit. The amount collected for the office visit is called
|| || || || || || || || || || || || || || ||
what? - ✔✔Copayment
|| || ||
The insurance carrier rate is 80% the remaining 20% is called what? - ✔✔Coinsurance
|| || || || || || || || || || || || ||
A third party payer made an error when adjudicating a claim which of the following
|| || || || || || || || || || || || || || ||
should the specialist do? - ✔✔resubmit the claim with an attachment explaining the
|| || || || || || || || || || || || ||
error
A claim submitted with all the necessary and accurate information so that it can be
|| || || || || || || || || || || || || || ||
processed and paid is called? - ✔✔A clean claim
|| || || || || || || ||
A medicare patient presents to an out patient hospital facility for a hysterectomy. To
|| || || || || || || || || || || || || ||
which medicare plan should be billed? - ✔✔Part B
|| || || || || || || ||
The amount of the bill is $100 and this amount must be paid before the insurance
|| || || || || || || || || || || || || || || ||
company will pay on the claim. Which of the following is this called? - ✔✔Deductible
|| || || || || || || || || || || || || ||
When there is a professional courtesy awarded to a patient's account the insurance
|| || || || || || || || || || || || ||
specialist should post the amount under what column? - ✔✔Adjustment column
|| || || || || || || || || ||
When the patient calls to inquire about an account which of the following does the
|| || || || || || || || || || || || || || ||
insurance and coding specialist need to ask for before discussing the account? Choose
|| || || || || || || || || || || || ||
3 correct answers. - ✔✔patient's insurance Id number, patient's date of birth, patient's
|| || || || || || || || || || || ||
name
||
,When a capitation account is applied to a ledger it is also know as what? -
|| || || || || || || || || || || || || || || ||
✔✔Monthly Prepayment amount || ||
The insurance and coding specialist calls a carrier to verify a patient's insurance an the
|| || || || || || || || || || || || || ||
representative states that the patient's insurance was cancelled three months ago.
|| || || || || || || || || || || ||
Which of the following should the insurance specialist do first? - ✔✔Ask the patient
|| || || || || || || || || || || || || ||
for another form of insurance coverage
|| || || || ||
Which are the following are necessary to complete a CMS-1500 form (Choose 3)
|| || || || || || || || || || || || ||
correct answers. - ✔✔Diagnosis CPT and ICD-10 codes, Physician information,
|| || || || || || || || || ||
Demographic information ||
Which of the following reports is used to follow up on an outstanding claims to third
|| || || || || || || || || || || || || || || ||
party payers? - ✔✔Aging || || ||
When following upon a denied claim an insurance specialist should have which of the
|| || || || || || || || || || || || || ||
following information available when speaking with the insurance company? Select 3
|| || || || || || || || || || ||
correct answers. - ✔✔Patient's insurance ID number, Physician's NPI number, and
|| || || || || || || || || || ||
Date of service || ||
Developing an insurance claim begins when? - ✔✔When the patient calls to schedule
|| || || || || || || || || || || || ||
an appointment
||
Which of the following must be verified to process a credit card transaction? Choose
|| || || || || || || || || || || || || ||
(3) correct answers. - ✔✔Security code, credit card number, and account number
|| || || || || || || || || || ||
The most effective method to manage statements and other financial invoices as well
|| || || || || || || || || || || || ||
as avoid payment delays is to do what? - ✔✔Collect fees at the time of service
|| || || || || || || || || || || || || || ||
, Based on the CMS 1500 manual system, when updating or maintaining the billing
|| || || || || || || || || || || || ||
code database which of the following does the R denote? - ✔✔Revised
|| || || || || || || || || || ||
An insurance and coding specialist is reviewing a patient's encounter form that is
|| || || || || || || || || || || || ||
documented in the medical record prior to completing a CMS-1500 form she notices
|| || || || || || || || || || || || ||
the physician up-coded the encounter form. The specialist has an ethical obligation to
|| || || || || || || || || || || || ||
first? - ✔✔Query the physician
|| || || ||
HIPPA allows a healthcare provider to communicate with a patient's family, friend, or
|| || || || || || || || || || || || ||
other person's who are involved in the patient's care regarding their mental health
|| || || || || || || || || || || || ||
status providing the patient does what? - ✔✔Does not object
|| || || || || || || || ||
Claims are often rejected because a provider needs to obtain what? -
|| || || || || || || || || || || ||
✔✔Preauthourizations
When using an Electronic Health Record (EHR) system to enter cpt codes on a CMS-
|| || || || || || || || || || || || || ||
1500 claim form for electronic submission which of the following should be entered on
|| || || || || || || || || || || || ||
the claim form first? - ✔✔The most resource-intensive procedure or service
|| || || || || || || || || || ||
The Fair and Debt collection Act restricts debt collectors from engaging in conduct
|| || || || || || || || || || || || ||
that includes what? - ✔✔Calling before 8:00am or after 9:00pm, unless given
|| || || || || || || || || || || ||
permission
Which of the following information is needed to determine a Medicaid sliding fee
|| || || || || || || || || || || || ||
scale? choose (3) correct answers - ✔✔Poverty, salary, and number of depedents
|| || || || || || || || || || ||
The patient presents today for upper gastroinstestinal (GI) endoscopy and a biopsy of
|| || || || || || || || || || || || ||
the stomach. Which of the cpt codes should be assigned? - ✔✔43239 Digestive
|| || || || || || || || || || || || ||
Esophagogastroduodenoscopy with biopsy || ||
|| || || || || || || ||
detailed answers ||
The patient owes $25.00 for the visit. The amount collected for the office visit is called
|| || || || || || || || || || || || || || ||
what? - ✔✔Copayment
|| || ||
The insurance carrier rate is 80% the remaining 20% is called what? - ✔✔Coinsurance
|| || || || || || || || || || || || ||
A third party payer made an error when adjudicating a claim which of the following
|| || || || || || || || || || || || || || ||
should the specialist do? - ✔✔resubmit the claim with an attachment explaining the
|| || || || || || || || || || || || ||
error
A claim submitted with all the necessary and accurate information so that it can be
|| || || || || || || || || || || || || || ||
processed and paid is called? - ✔✔A clean claim
|| || || || || || || ||
A medicare patient presents to an out patient hospital facility for a hysterectomy. To
|| || || || || || || || || || || || || ||
which medicare plan should be billed? - ✔✔Part B
|| || || || || || || ||
The amount of the bill is $100 and this amount must be paid before the insurance
|| || || || || || || || || || || || || || || ||
company will pay on the claim. Which of the following is this called? - ✔✔Deductible
|| || || || || || || || || || || || || ||
When there is a professional courtesy awarded to a patient's account the insurance
|| || || || || || || || || || || || ||
specialist should post the amount under what column? - ✔✔Adjustment column
|| || || || || || || || || ||
When the patient calls to inquire about an account which of the following does the
|| || || || || || || || || || || || || || ||
insurance and coding specialist need to ask for before discussing the account? Choose
|| || || || || || || || || || || || ||
3 correct answers. - ✔✔patient's insurance Id number, patient's date of birth, patient's
|| || || || || || || || || || || ||
name
||
,When a capitation account is applied to a ledger it is also know as what? -
|| || || || || || || || || || || || || || || ||
✔✔Monthly Prepayment amount || ||
The insurance and coding specialist calls a carrier to verify a patient's insurance an the
|| || || || || || || || || || || || || ||
representative states that the patient's insurance was cancelled three months ago.
|| || || || || || || || || || || ||
Which of the following should the insurance specialist do first? - ✔✔Ask the patient
|| || || || || || || || || || || || || ||
for another form of insurance coverage
|| || || || ||
Which are the following are necessary to complete a CMS-1500 form (Choose 3)
|| || || || || || || || || || || || ||
correct answers. - ✔✔Diagnosis CPT and ICD-10 codes, Physician information,
|| || || || || || || || || ||
Demographic information ||
Which of the following reports is used to follow up on an outstanding claims to third
|| || || || || || || || || || || || || || || ||
party payers? - ✔✔Aging || || ||
When following upon a denied claim an insurance specialist should have which of the
|| || || || || || || || || || || || || ||
following information available when speaking with the insurance company? Select 3
|| || || || || || || || || || ||
correct answers. - ✔✔Patient's insurance ID number, Physician's NPI number, and
|| || || || || || || || || || ||
Date of service || ||
Developing an insurance claim begins when? - ✔✔When the patient calls to schedule
|| || || || || || || || || || || || ||
an appointment
||
Which of the following must be verified to process a credit card transaction? Choose
|| || || || || || || || || || || || || ||
(3) correct answers. - ✔✔Security code, credit card number, and account number
|| || || || || || || || || || ||
The most effective method to manage statements and other financial invoices as well
|| || || || || || || || || || || || ||
as avoid payment delays is to do what? - ✔✔Collect fees at the time of service
|| || || || || || || || || || || || || || ||
, Based on the CMS 1500 manual system, when updating or maintaining the billing
|| || || || || || || || || || || || ||
code database which of the following does the R denote? - ✔✔Revised
|| || || || || || || || || || ||
An insurance and coding specialist is reviewing a patient's encounter form that is
|| || || || || || || || || || || || ||
documented in the medical record prior to completing a CMS-1500 form she notices
|| || || || || || || || || || || || ||
the physician up-coded the encounter form. The specialist has an ethical obligation to
|| || || || || || || || || || || || ||
first? - ✔✔Query the physician
|| || || ||
HIPPA allows a healthcare provider to communicate with a patient's family, friend, or
|| || || || || || || || || || || || ||
other person's who are involved in the patient's care regarding their mental health
|| || || || || || || || || || || || ||
status providing the patient does what? - ✔✔Does not object
|| || || || || || || || ||
Claims are often rejected because a provider needs to obtain what? -
|| || || || || || || || || || || ||
✔✔Preauthourizations
When using an Electronic Health Record (EHR) system to enter cpt codes on a CMS-
|| || || || || || || || || || || || || ||
1500 claim form for electronic submission which of the following should be entered on
|| || || || || || || || || || || || ||
the claim form first? - ✔✔The most resource-intensive procedure or service
|| || || || || || || || || || ||
The Fair and Debt collection Act restricts debt collectors from engaging in conduct
|| || || || || || || || || || || || ||
that includes what? - ✔✔Calling before 8:00am or after 9:00pm, unless given
|| || || || || || || || || || || ||
permission
Which of the following information is needed to determine a Medicaid sliding fee
|| || || || || || || || || || || || ||
scale? choose (3) correct answers - ✔✔Poverty, salary, and number of depedents
|| || || || || || || || || || ||
The patient presents today for upper gastroinstestinal (GI) endoscopy and a biopsy of
|| || || || || || || || || || || || ||
the stomach. Which of the cpt codes should be assigned? - ✔✔43239 Digestive
|| || || || || || || || || || || || ||
Esophagogastroduodenoscopy with biopsy || ||
