Encounter forms should be audited to ensure the - ✔✔Diagnosis is in the proper ICD-
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10-CM format ||
In the insurance carrier's rate of benefits is 80%, the remaining 20% is known as -
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✔✔Coinsurance
If a provider refuses to accept assignment when must the patient pay for services -
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✔✔Time of service || ||
When speaking with an insurance company representative to follow up on a denied
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claim, an insurance and coding specialist should have which of the following
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information available? - ✔✔Date of service, physician's NPI, patient's insurance ID
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number
Which of the following fees posted to the patient's account is an example of "usual,
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customary, and reasonable?" - ✔✔Allowed amount || || || || ||
The patient opted to a have a tubal ligation performed. Which of the following is
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needed in order for the third party payer to cover the procedure? - ✔✔Pre-
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certification
When posting an insurance payment via an EOB, the amount that is considered
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contractual is the - ✔✔Insurance allowed amount || || || || || ||
Which of the following is the most likely cause of the deposits not agreeing with the
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credits in the day sheet or the patient ledgers? - ✔✔Payment is misplaced.
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