Charge_Misys

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1 point

What is the place of service code for Out-patient hospital ?

1 point

CMS 1500 is used to bill Hospital Charges

True

False

1 point

Pre-existing condition means-

Disease that existed after the policy was taken.

Disease that existed at the time of taking the policy.

Disease that existed before the policy was taken.

None of the Above

1 point

Expansion for HPSA-

Health Professional Shortage Area.

None of the above

High Professional Shortage Area.

Health Provider Shortage Area.

1 point

V codes denote-

Preventive measures codes

External cause codes.

Disease codes.

PQRI codes

1 point

What do you mean by offset?

The amount to be adjusted as patient discount.

The extra payment made by the insurance will be adjusted to the next claim.

The extra payment made by the insurance will be refunded by the insurance company.

The amount to be paid by the sec/tertiary insurance.

1 point

Deductible is-

The fixed amount paid by the insurance to the provider.

The fixed amount to be paid by the patient at the time when the policy is taken

The amount paid by the patient to the provider

The amount to be paid by the provider to the insurance company

1 point

People aged 65 and above will have Medicaid Plan

True

False

1 point

Non-participating provider is-

One who has enrolled himself with the insurance co.

in-network provider.

None of the above

One who has the right to bill patient for any non-allowed amount.

10.

1 point

Allowed amount = ?

None of the above

paid amt + Coins

paid amt + Coins + Copay

paid amt + Coins+ Copay + Deductible

11.

1 point

Locum provider is-

a provider who admits the patient.

a provider who covers the main doctor in his absence.

None of the above

a provider who refers the patient to some other provider.

12.

1 point

Prior-authorization should be obtained by the-

Insurance

Patient

Provider

Billing Office

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