Table of Contents
- 1 When entering a CPT code and block 24 identical procedures performed can be reported on the same line if which of the following circumstances apply?
- 2 Which legislation protects and compensates railroad workers?
- 3 Which is an example of a healthcare setting that would use the UB 04 claim to build institutional services?
- 4 On what type of claims are observation services reported?
- 5 Which legislation allows employees to continue health care coverage beyond the benefit termination date by paying appropriate premiums?
- 6 Which legislation allows employees to continue health care coverage?
- 7 Which of the following is the portion of the account balance the patient must pay?
- 8 What services are billed on a ub04?
- 9 Which is Act prohibits a payer from notifying the provider?
- 10 What does accept assignment mean in health insurance?
- 11 Where are the item letters in the CMS 1500 claim?
When entering a CPT code and block 24 identical procedures performed can be reported on the same line if which of the following circumstances apply?
When entering a CPT code in Block 24, identical procedures performed can be reported on the same line if which of the following circumstances apply? Block 24G (Days or Units) contains an entry.
Which legislation protects and compensates railroad workers?
The Federal Employers Liability Act, also known as FELA, is a federal law enacted in 1908, that protects and compensates railroad workers – including BMWED members – that are injured on the job. FELA is essentially the form of Workers’ Compensation in the railroad industry.
What term is used to communicate why a claim line item was denied or paid differently than it was billed?
Claim Adjustment Reason Codes (CARCs) communicate an adjustment, meaning that they must communicate why a claim or service line was paid differently than it was billed.
Which is an example of a healthcare setting that would use the UB 04 claim to build institutional services?
The UB-04 is the claim form for institutional facilities, and includes the following: Hospitals. Rehab facilities, e.g. physical therapy, occupational therapy and speech therapy. General health centers, federal health centers and rural clinics.
On what type of claims are observation services reported?
A: Observation care is reported on a single claim line using the date of service on which the patient was admitted for observation. For this example, HCPCS code G0378 would be reported on a single claim line with 18 units and the Friday date of service. No other claim would be submitted for that observation period.
What is the purpose of a new patient interview and check in procedure?
The patient interview is the primary way of obtaining comprehensive information about the patient in order to provide effective patient-centered care, and the medica- tion history component is the pharmacist’s expertise.
The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) allow employees to continue healthcare coverage beyond the benefit termination date.
Which legislation allows employees to continue health care coverage?
The Consolidated Omnibus Budget Reconciliation Act
The Consolidated Omnibus Budget Reconciliation Act, known as COBRA, is a federal law that allows employees to continue their employer-provided health insurance after they are laid off or fired, or they otherwise become ineligible for benefits (for example, because they quit or their hours are reduced below the …
Which of the following are reasons a claim may be denied?
Here are the top 5 reasons why claims are denied, and how you can avoid these situations.
- Pre-Certification or Authorization Was Required, but Not Obtained.
- Claim Form Errors: Patient Data or Diagnosis / Procedure Codes.
- Claim Was Filed After Insurer’s Deadline.
- Insufficient Medical Necessity.
- Use of Out-of-Network Provider.
Which of the following is the portion of the account balance the patient must pay?
NHA practice test 1
| Question | Answer |
|---|---|
| The portion of the account balance the patient must pay after services are rendered and the annual deductible is met | Coinsurance |
| The following claim is submitted and then optically scanned by the insurance carrier and converted to an electronic form | Paper claim |
What services are billed on a ub04?
Who Can Bill Claims Using the UB-04?
- Community mental health centers.
- Comprehensive outpatient rehabilitation facilities.
- Critical access hospitals.
- End-stage renal disease facilities.
- Federally qualified health centers.
- Histocompatibility laboratories.
- Home health agencies.
- Hospices.
What is a UB-04 and when is it used?
The UB-04 (CMS 1450) is a claim form used by hospitals, nursing facilities, in-patient, and other facility providers. A specific facility provider of service may also utilize this type of form. Both forms help to process the medical claim of a patient.
Which is Act prohibits a payer from notifying the provider?
Which act prohibits a payer from notifying the provider about payment or rejection of unassigned claims or payments sent directly to the patient? billing entity the legal business name of the provider’s practice. diagnosis pointer letters
What does accept assignment mean in health insurance?
When a patient allows the provider to bill their insurance company and collect payment from the insurer, this is known as: 1) Accept assignment 2) Assignment of benefits 3) Authorization of payment 4) Coordination of benefits
Which is entered in block on primary insurance claim?
Attestation that the services were billed properly is indicated by the provider signature in Block: 33 The name, address, and telephone number of the billing entity are entered in Block: supplemental plan Which information is entered in Blocks 9-9d on the primary insurance claim?
Where are the item letters in the CMS 1500 claim?
item letters A through L preprinted in Block 21 of the CMS-1500 claim. National Plan and Provider Enumeration System (NPPES) developed by CMS to assign unique identifiers to health care providers (NPI) and health plans (HPID). optical character reader (OCR)