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Billing Assessment

Please take this billing assessment for Coding Advantage. 

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Question 1 of 14

1. The time allowed to submit a claim to Medicare is:

A

365 days

B

180 Days

C

120 Days

D

90 days

Question 2 of 14

2. A provider bills $400 for a test. The insurance pays $300 and the patient's responsibility is $23.56. What is the contractual discount and what is the patient's responsibility called?

A

$100, copay

B

$76.44, coinsurance

C

$100, coinsurance

D

$76.44, copay

Question 3 of 14

3.  _____ is a monthly payment to purchase and continue insurance coverage. A ______ is how much money you must pay before insurance begins to pay for medical services. A _____ is a flat fee you must pay every time you go see the doctor and _______ is the percentage you must pay in addition to other fees. 

A

Deductible, premium, coinsurance, copay

B

Premium, deductible, copay, coinsurance

C

Premium, copay, deductible, coinsurance

D

Copay, coinsurance, deductible, premium

Question 4 of 14

4. Which of the following is not a commercial insurance carrier:

A

Cigna

B

Aetna

C

United Healthcare

D

CMS

Question 5 of 14

5. If you are submitting a corrected claim, you must do the following:

A

Use code 7 in box 22 with original claim number and some payers require "corrected claim" in box 19

B

Write "CORRECTED CLAIM" in box 19

C

Put the original claim number in box 23 and write "Corrected claim" in box 19

D

Only use a paper claim so you can write "CORRECTED CLAIM" in big letters on the top

Question 6 of 14

6. What is a valid POS for an office?

A

Downtown

B

11

C

In a hospital

D

12

Question 7 of 14

7.  If a patient/client has both Medicare and Aetna Commercial, which insurance do you bill first?

A

Medicare first, then Aetna. Medicare will send an RA to Aetna for COB

B

Aetna first, then Medicare because private insurance should always be billed first

C

Determine which insurance is primary and bill that first

D

Check the patient's insurance card for instructions

Question 8 of 14

8. If a distinct evaluation and management service is billed with a procedure, which modifier must be attached? 

A

25 attached to the procedure

B

59 attached to the procedure

C

59 attached to the evaluation and management service

D

25 attached to the evaluation and management service

Question 9 of 14

9. The only reason you will get a prior authorization denial is if the CPT code requires it.

A

True

B

False

Question 10 of 14

10. An LPCC can bill Medicare for 2024.

A

True

B

False

Question 11 of 14

11. You can balance bill a Medicaid patient. 

A

True

B

False

Question 12 of 14

12. Which of the following correlates with deductible? 

A

PR 2

B

PR 3

C

PR 1

Question 13 of 14

13. Which of the following correlates with coinsurance?

A

PR 3

B

PR 1

C

PR 2

Question 14 of 14

14. Which of the following correlates with copay?

A

PR 2

B

PR 1

C

PR 3

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