Which of the following sections of the medical record is used to determine the correct evaluation and management code used for billing and coding? - ✔✔history and physical A billing and coding specialist is reviewing a CMS-1500 claim form. The "assignment of benefits" box has been checked "yes." The checked box indicates which of the following? - ✔✔The provider receives payment directly from the payer Which of the following do physicians use to electronically submit a claim? - ✔✔Clearinghouse Which of the following should the billing and coding specialist include in an authorization to release information? - ✔✔The entity to whom the information is to be released Which of the following describes the content of a medical practice aging report? - ✔✔An overview of the practice's outstanding claims HIPAA transaction standards apply to which of the following entities? - ✔✔Health care clearinghouses When a physician documents a patient's response to symptoms and various body systems, the results are documented as which of the following? - ✔✔Review of systems Which part of Medicare covers prescriptions? - ✔✔Part D Which of the following indicates a claim should be submitted on paper instead of electronically? - ✔✔The claim requires an attachment Medicare enforces mandatory submission of electronic claims for most providers. Which of the following providers is allowed to submit paper claims to Medicare? - ✔✔A provider's office with fewer than 10 full-time employees Which of the following is the correct term for an amount that has been determined to be uncollectible? - ✔✔Bad debt Which of the following statements are correct regarding a deductible? - ✔✔The deductible is the patient's responsibility Which of the following statements is true regarding the release of patient records? - ✔✔Patient access to psychotherapy notes may be restricted Why does correct claim processing rely on accurately completed encounter forms? - ✔✔They streamline patient billing by summarizing the services rendered for a given date of service When posting payment accurately. Which of the following items should the billing and coding specialist include? - ✔✔Patient's responsibility A dependent child whose parents both have insurance coverage come to the clinic. The billing and coding specialist uses the birthday rule determine which insurance policy is primary. Which of the following describes the birthday rule? - ✔✔The patient whose birthday comes first in the calendar year Which of the following actions should the billing and coding specialist take to effectively manage accounts receivable? - ✔✔Collect copayment from the patient at the time of service If a patient has osteomyelitis, he has problems with which of the following areas? - ✔✔bones, bone marrow Which of the following are used by providers to remove errors from claims before they are submitted to third-party payers? - ✔✔Clearinghouse A provider receives a reimbursement from a third-party payer accompanied by which of the following documents? - ✔✔explanation of benefits Which of the following is the appropriate diagnosis for a patient who has an abnormal accumulation of fluid in her lower leg that has resulted in swelling? - ✔✔Edema Which of the following blocks on the CMS-1500 claim form is used to bill ICD codes? - ✔✔Block 21 Patient charges that have not been paid to appear in which of the following? - ✔✔Accounts receivable A physician is contracted with an insurance company to accept the allowed amount. The insurance company allows $80 of a $120 billed amount, And $50 of the deductible has not been met. How much should the physician write off the patient's record? - ✔✔$40 This is the difference between the amount billed and allowed amount. The physician should write off $40. A provider performs an examination of a patient sore throat during an office visit. Which of the following describes the level of the examination? - ✔✔Problem-focused examination When building a secondary insurance company, which block should be billing and coding specialist fill out on the CMS-1500 claim form? - ✔✔9a Which of the following forms must be patient or representative sign to allow the release of protected health information? - ✔✔An Authorization What is the maximum number of ICD codes that can be entered on a CMS-1500 claim form as of February 2012? - ✔✔12 After a third-party payer validates a claim, which of the following takes place next? - ✔✔Claim adjudication When a patient has a condition that is both acute and chronic, how should I be reported? - ✔✔Code both acute and chronic sequencing the acute first