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:
365 days
180 Days
120 Days
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?
$100, copay
$76.44, coinsurance
$100, coinsurance
$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.
Deductible, premium, coinsurance, copay
Premium, deductible, copay, coinsurance
Premium, copay, deductible, coinsurance
Copay, coinsurance, deductible, premium
Question 4 of 14
4. Which of the following is not a commercial insurance carrier:
Cigna
Aetna
United Healthcare
CMS
Question 5 of 14
5. If you are submitting a corrected claim, you must do the following:
Use code 7 in box 22 with original claim number and some payers require "corrected claim" in box 19
Write "CORRECTED CLAIM" in box 19
Put the original claim number in box 23 and write "Corrected claim" in box 19
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?
Downtown
11
In a hospital
12
Question 7 of 14
7. If a patient/client has both Medicare and Aetna Commercial, which insurance do you bill first?
Medicare first, then Aetna. Medicare will send an RA to Aetna for COB
Aetna first, then Medicare because private insurance should always be billed first
Determine which insurance is primary and bill that first
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?
25 attached to the procedure
59 attached to the procedure
59 attached to the evaluation and management service
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.
True
False
Question 10 of 14
10. An LPCC can bill Medicare for 2024.
Question 11 of 14
11. You can balance bill a Medicaid patient.
Question 12 of 14
12. Which of the following correlates with deductible?
PR 2
PR 3
PR 1
Question 13 of 14
13. Which of the following correlates with coinsurance?
Question 14 of 14
14. Which of the following correlates with copay?