NCCT Billing and Coding questions &
answers graded A+ passed
It is important to make the patient aware of the mailing address, interest rates, and length of
agreement when setting up a - correct answer ✔✔payment arrangement.
What is the correct term for a doctor who enters into an agreement with a third party payer on
charges, discounts, and services rendered to their policyholders within the network? - correct
answer ✔✔PAR (participating provider) a physician who enters into an agreement with a payer
to offer discounts on charges rendered to their policy holders.
What should a practice's financial policy always explain? - correct answer ✔✔what is required
from the patient and when payment is due
A patient had a procedure which was billed at $200.00. The allowed amount was $150.00 and
he has $50.00 left to meet of his deductible. His co-insurance is 20%. How much does the
patient owe? - correct answer ✔✔$80
The patient in this question is responsible for 20%. $150 allowed amount. 20% of $150 allowed
is $30. Patient still owes $50 deductible. Patient would owe $80 total.
The physician charges $100 for a visit. The insurer allowable amount is $80. The patient has a
$200 deductible, which has not been met. Which of the following will happen? - correct answer
✔✔The patient will be billed $80.
The allowed amount is now the cost of the service, so since the deductible is not met, the
patient will be responsible for the entire $80.
Which of the following documents from the insurance carrier should the payment poster read
and post the payments or contractual adjustments to the patient account? - correct answer
✔✔remittance advice.
,A remittance advice is used to post payments from insurance carriers.
The insurance and coding specialist received an EOB and is posting the payments to the patient
accounts. According to the following information below, how much does the patient still owe for
this service?
Non-participating provider
Copay: $20, paid at time of service
Deductible amount that patient paid: $100
Accepted fee for service: $250
Insurance payment: $75 - correct answer ✔✔$55
Total charges are $250.00 of which the patient has paid $20.00 and $100.00. This now leaves a
balance of $130.00, of which the insurance company paid $75.00. This now leaves a balance
due from the patient of $55.00.
Which of the following are the steps to posting a Medicare payment to the patient's account? -
correct answer ✔✔Review the EOB., Adjust any contractual agreements., Send the billing
statement if there is a balance.
First the EOB should be reviewed to make sure all the information is correct and the correct
patient is credited. Any payments are posted and all the adjustments are made. Once these
tasks are finished, the system will generate a statement of any balances due to send to the
patient. There is no need to check the copay since the system will automatically have this
information on the statement to the patient.
Which of the following does a thorough understanding of the Explanation of Benefits (EOB)
supplied by the payer allow the insurance and coding specialist to do? - correct answer
✔✔Apply write-offs., Bill patients correctly., Resolve payment issues.
, Which of the following information will the insurance and coding specialist need to apply the
payment correctly when in receipt of an insurance EOB and check for payment? - correct
answer ✔✔account number, date of service, patient name
The difference between the billed amount and the allowed amount for services from a
participating provider is - correct answer ✔✔adjusted by the provider.
When a patient sees a participating provider, he receives a discount. This discounted amount is
called the allowed amount. The difference between the billed amount and the allowed amount
cannot be charged to the patient when seeing a participating provider.
The patient makes a co-payment of $50. To which section of the patient's account should the
payment be applied? - correct answer ✔✔Credit
Which of the following is used to post patient payments in provider offices, electronically or
manually? - correct answer ✔✔ledgers
The ledger keeps track of all payments and outstanding balances for the patients
A third party payer sent a report to the hospital explaining the payments of multiple claims
submitted for ten patients in the month of November. Which of the following is the title of that
document? - correct answer ✔✔remittance advice
A remittance advice is used to post payments from insurance carriers. It will explain the reasons
for payments or denials, the allowable amounts, copayments, patient balances, etc. A
remittance advice is sent monthly and includes all of the patients seen by that practice, with
that insurance.
What is the correct process for posting the electronic remittance advice and Explanation of
Benefits to the patient's account? - correct answer ✔✔Upload information from the carrier file,
adjust and save
The payer provided the following information on a patient's account:
Charge - $189.00
answers graded A+ passed
It is important to make the patient aware of the mailing address, interest rates, and length of
agreement when setting up a - correct answer ✔✔payment arrangement.
What is the correct term for a doctor who enters into an agreement with a third party payer on
charges, discounts, and services rendered to their policyholders within the network? - correct
answer ✔✔PAR (participating provider) a physician who enters into an agreement with a payer
to offer discounts on charges rendered to their policy holders.
What should a practice's financial policy always explain? - correct answer ✔✔what is required
from the patient and when payment is due
A patient had a procedure which was billed at $200.00. The allowed amount was $150.00 and
he has $50.00 left to meet of his deductible. His co-insurance is 20%. How much does the
patient owe? - correct answer ✔✔$80
The patient in this question is responsible for 20%. $150 allowed amount. 20% of $150 allowed
is $30. Patient still owes $50 deductible. Patient would owe $80 total.
The physician charges $100 for a visit. The insurer allowable amount is $80. The patient has a
$200 deductible, which has not been met. Which of the following will happen? - correct answer
✔✔The patient will be billed $80.
The allowed amount is now the cost of the service, so since the deductible is not met, the
patient will be responsible for the entire $80.
Which of the following documents from the insurance carrier should the payment poster read
and post the payments or contractual adjustments to the patient account? - correct answer
✔✔remittance advice.
,A remittance advice is used to post payments from insurance carriers.
The insurance and coding specialist received an EOB and is posting the payments to the patient
accounts. According to the following information below, how much does the patient still owe for
this service?
Non-participating provider
Copay: $20, paid at time of service
Deductible amount that patient paid: $100
Accepted fee for service: $250
Insurance payment: $75 - correct answer ✔✔$55
Total charges are $250.00 of which the patient has paid $20.00 and $100.00. This now leaves a
balance of $130.00, of which the insurance company paid $75.00. This now leaves a balance
due from the patient of $55.00.
Which of the following are the steps to posting a Medicare payment to the patient's account? -
correct answer ✔✔Review the EOB., Adjust any contractual agreements., Send the billing
statement if there is a balance.
First the EOB should be reviewed to make sure all the information is correct and the correct
patient is credited. Any payments are posted and all the adjustments are made. Once these
tasks are finished, the system will generate a statement of any balances due to send to the
patient. There is no need to check the copay since the system will automatically have this
information on the statement to the patient.
Which of the following does a thorough understanding of the Explanation of Benefits (EOB)
supplied by the payer allow the insurance and coding specialist to do? - correct answer
✔✔Apply write-offs., Bill patients correctly., Resolve payment issues.
, Which of the following information will the insurance and coding specialist need to apply the
payment correctly when in receipt of an insurance EOB and check for payment? - correct
answer ✔✔account number, date of service, patient name
The difference between the billed amount and the allowed amount for services from a
participating provider is - correct answer ✔✔adjusted by the provider.
When a patient sees a participating provider, he receives a discount. This discounted amount is
called the allowed amount. The difference between the billed amount and the allowed amount
cannot be charged to the patient when seeing a participating provider.
The patient makes a co-payment of $50. To which section of the patient's account should the
payment be applied? - correct answer ✔✔Credit
Which of the following is used to post patient payments in provider offices, electronically or
manually? - correct answer ✔✔ledgers
The ledger keeps track of all payments and outstanding balances for the patients
A third party payer sent a report to the hospital explaining the payments of multiple claims
submitted for ten patients in the month of November. Which of the following is the title of that
document? - correct answer ✔✔remittance advice
A remittance advice is used to post payments from insurance carriers. It will explain the reasons
for payments or denials, the allowable amounts, copayments, patient balances, etc. A
remittance advice is sent monthly and includes all of the patients seen by that practice, with
that insurance.
What is the correct process for posting the electronic remittance advice and Explanation of
Benefits to the patient's account? - correct answer ✔✔Upload information from the carrier file,
adjust and save
The payer provided the following information on a patient's account:
Charge - $189.00
