AAPC CPB - Chapter 9 Review Questions

AAPC CPB - Chapter 9 Review | Questions and Verified Solutions Latest Update

A ______ indicates the location or type of service provided for an inpatient and is reported with

_______.

• Revenue code; four-digit code
• Revenue code; three-digit code
• CPT code; five-digit code
• MSDRG code; three-digit code - Answer - a. Revenue code; four-digit code

Which of the following documentation is NOT needed for an audit?

• Encounter form
• Medical record
• Explanation of Benefits
• CMS-1500 claim form - Answer - c. Explanation of Benefits

A clearinghouse is an entity that provides which of the following services?

• Converts nonstandard data received from payers to standard transaction data to meet HIPAA

requirements.

• Pursues payments of debts owed by individuals or businesses.
• Assists providers in the collection of appropriate reimbursement for services rendered.
• Explains insurance benefits, policy requirements, and filing rules to patients. - Answer - a. Converts

nonstandard data received from payers to standard transaction data to meet HIPAA requirements.Which is a TRUE statement about daily deposits?

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• Keeping the checks and cash in the office for more than a day opens the practice up to liability for the

cash and checks.

• Daily deposits should be made for the mail receipts and personal payment receipts.
• Daily deposits of the mail receipts and personal payment receipts should be balanced each day.
• All the statements are true. - Answer - d. All the statements are true.

Mrs. Fryer takes her son to the ED for an injured arm. Her son is covered by both parents. Mr. Fryer's birthday is 10/14/1984 and Mrs. Fryer's birthday is 6/10/1986. Under the birthday rule whose insurance plan will be primary?

• Mrs. Fryer
• Mr. Fryer
• Either one can be primary
• The parent's birthday closest to the child's birthday - Answer - a. Mrs. Fryer

When a batch of claims is submitted electronically to a clearinghouse a report is sent to the provider.Which feedback does this report from the clearinghouse identify?

• Shows improper Medicare payments paid to the provider.
• Patient claims that will be sent to collections.
• All claims sent to the payer and all rejected claims.
• Patient claims that have not been paid within a certain time frame. - Answer - c. All claims sent to the

payer and all rejected claims.What is a clean claim?

• A blank claim form
• A claim that meets medical necessity
• A claim that has all of the information required to be processed
• A claim that is paid on time - Answer - c. A claim that has all of the information required to be

processed

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