FUNDAMENTS OF MEDICAL BILLING

Fundamentals Of Medical Billing TEST

Name
1. What is DME?
2. Who will pay the DME items?
3. What is Medicare and Medicaid?
4. These are the following examples of DME.
5. Medical Billing is a process that involves health care providers submission and follow up on claims with health ins in order to get payment for services rendered.
6. Payer in Medical Billing.
7. It is a legal process where we request the insurance company to review it's adverse benefit determination with patient's claim for benefits or you are appealing a provider contract issue.
8. Difference between Rejected and Denied Claims.
9. Prior Authorization is the process of getting an agreement from the payer to cover specific services before the service is performed.
10. Which of the following is the FUNCTION OF CLEARING HOUSE?
11. What are 3P's in Medical Billing?
12. A Clean Claim is a claim that has been suspended in order to get more information from the provider.
13. Coordination Of Benefits - is a process whereby 2 or more insurance companies share the responsibility for payment of a claim for health care services provided to a client.
14. Explanation of Benefits - sent to the patient and the provider to show how the claim is processed.

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