Sim Chart 80 post case quiz

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School

UEI College, Gardena *

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Course

MEDICAL BI

Subject

Accounting

Date

Jan 9, 2024

Type

docx

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Uploaded by ConstablePigeonPerson975

In reviewing Mrs. Rainwater’s account you discover that she was charged for a service that she did not receive. This would be corrected by posting a(n): A Canceliation B. Modification C. Reversal D. Adjustment Correct: Adjustment Student: Agjustment v Rationale: An adjustment is used to correct the posting of a charge for services that were not provided. True or false? When posting charges to the ledger in SimChart there is a field for units. Correct: False Student: True ”® Rationale: There is no field for units in ledger. True or false? There a CPT codes that are used to post payments and adjustments to a patient's ledger. Correct: False Student: False v Rationale: There are no CPT codes for posting payments and adjustments to a patient’s ledger. Healthcare organizations develop service codes to be used for payments and adjustments. If Mrs. Rainwater’s insurance is through a managed care plan that Walden-Martin Family Medicine participates with the difference between the claim amount If Mrs. Rainwater’s insurance is through a managed care plan that Walden-Martin Family Medicine participates with the difference between the claim amount (§133) and the payment amount ($100) would have to written off. This is called a(n) A None of the above B. Charge C. Payment D. Adjustment Correct: Adjustment Student: Agjustment v Rationale: When the provider participates with a managed care plan they cannot balance bil for the difference between the billed amount and the ‘True or false? When filing a health insurance claim electronically the provider still needs to sign the claim. Correct: True Student: Faise ® Rationale: When filing a claim electronically the provider's signature is st required but wil be done electronically. True or false? Up to 12 diagnoses can be entered for a health insurance claim. Correct: True Student: True v Rationale: Both the CMS-1500 paper claim form and the HIPAA 5010 electronic claim allow for up o 12 diagnoses.

What billing information is used by the insurance company to identify the employer plan that the policy is through? A The ID number B. The subscriber's social security number C. The group numper D. There is no need to be able to identify the employer pian Correct: The group number Student: The group number Rationale: The group number identifies the employer group plan that the patient is covered under. The first step for filing a claim using SimChart is to A Complete the superbil B. Complete the claim form C. Review the fee schedule D. Post the charges to the ledger Correct: Complete the superbill Student: Post the charges to the ledger Rationale: The superbill needs to be completed first because the information on the superbillis auto populated in the claim. True or false? The patient's date of birth is not required to file a health insurance claim. Correct: False Student: Faise Rationale: The patient's date of birth is required to file a health insurance claim. aCPTcode? CPT codes are required information when filing a third-party claim. Which of the following A K0003 B.99213 C. None of the above are CPT codes D. S06.0x1A Correct: 99213 Student: 99213 Rationale: A CPT code is made up of 5 digits, all numeric, such as 99213.

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