AAPC Revenue Cycle Management 2

Question 1

What is 'charge capture' in the revenue cycle?

Accepted Answer

The process of recording all billable services provided to a patient

Answer

Charge capture is the process of documenting all services rendered so they can be billed accurately to the payer.

Question 2

What is the primary goal of a denial management process?

Accepted Answer

To identify, appeal, and prevent claim denials to maximize reimbursement

Answer

Denial management involves analyzing denial patterns, appealing wrongful denials, and implementing process improvements to reduce future denials.

Question 3

What is the role of a clearinghouse in medical billing?

Accepted Answer

It acts as an intermediary that scrubs and transmits claims between providers and payers

Answer

A clearinghouse receives claims from providers, checks them for errors, and routes them electronically to the appropriate payers.

Question 4

What does an 'accounts receivable aging report' track?

Accepted Answer

Outstanding balances categorized by how long they have been unpaid

Answer

AR aging reports categorize outstanding claims by time intervals (0-30, 31-60, 61-90, 90+ days) to prioritize collection efforts.

Question 5

What is the purpose of obtaining prior authorization before a medical service?

Accepted Answer

To get advance approval from the payer that the service is medically necessary and covered

Answer

Prior authorization is a payer requirement to approve certain services before they are rendered, ensuring coverage and reducing claim denials.

(AAPC) American Academy of Professional Coders Biller Certified Practice Test