AAPC Revenue Cycle Management

Question 1

What is the first step in the healthcare revenue cycle?

Accepted Answer

Patient registration and scheduling

Answer

The revenue cycle begins with patient registration and scheduling, where demographic and insurance information is collected.

Question 2

A 'clean claim' in revenue cycle management refers to a claim that:

Accepted Answer

Contains all required information and passes edits for processing

Answer

A clean claim contains all required data elements, passes all edits, and is ready for adjudication without additional information needed.

Question 3

What is the primary purpose of eligibility verification in the revenue cycle?

Accepted Answer

To confirm a patient's insurance coverage before services are rendered

Answer

Eligibility verification confirms the patient's insurance benefits and coverage details prior to service to prevent claim denials.

Question 4

What document does a payer send to explain how a claim was processed and paid?

Accepted Answer

Remittance advice (ERA/EOB)

Answer

A remittance advice (electronic or paper EOB) details payment decisions, adjustments, and denial reasons for submitted claims.

Question 5

What does 'days in accounts receivable (AR)' measure in revenue cycle management?

Accepted Answer

The average number of days it takes to collect payment after service

Answer

Days in AR measures the average time from service date to payment receipt, indicating the efficiency of the billing cycle.

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